Cotrimoxazole versus sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria in HIV-infected pregnant women in Bangui, Central African Republic: A pragmatic randomised controlled trial.
Trop Med Int Health
; 26(10): 1314-1323, 2021 10.
Article
em En
| MEDLINE
| ID: mdl-34407273
ABSTRACT
OBJECTIVE:
The main objective of the MACOMBA (Maternity and Control of Malaria-HIV co-infection in Bangui) trial was to show that cotrimoxazole (CTX) is more effective than sulphadoxine-pyremethamine-IPTp (IPTp-SP) to prevent placental malaria infection (primary end point) among HIV-positive pregnant women with a CD4+ count ≥350 cells/mm3 in Bangui, CAR.METHODS:
MACOMBA is a multicentre, open-label randomised trial conducted in four maternity hospitals in Bangui. Between 2013 and 2017, 193 women were randomised and 112 (59 and 53 in CTX and IPTp-SP arms, respectively) were assessed for placental infection defined by microscopic parasitaemia or PCR.RESULTS:
Thirteen women had a placental infection five in the CTX arm (one by microscopic placental parasitaemia and four by PCR) and eight by PCR in the SP-IPTp (8.5% vs. 15.1%, p = 0.28). The percentage of newborns with low birthweight (<2500 g) did not differ statistically between the two arms. Self-reported compliance to CTX prophylaxis was good. There was a low overall rate of adverse events in both arms.CONCLUSION:
Although our results do not allow us to conclude that CTX is more effective, drug safety and good compliance among women with this treatment favour its widespread use among HIV-infected pregnant women, as currently recommended by WHO.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
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2_ODS3
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3_ND
Base de dados:
MEDLINE
Assunto principal:
Pirimetamina
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Sulfadoxina
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Infecções por HIV
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Combinação Trimetoprima e Sulfametoxazol
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Complicações Parasitárias na Gravidez
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Malária
Tipo de estudo:
Clinical_trials
Limite:
Adult
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Female
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Humans
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Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Revista:
Trop Med Int Health
Ano de publicação:
2021
Tipo de documento:
Article