A Non-Inferiority, Individually Randomized Trial of Intermittent Screening and Treatment versus Intermittent Preventive Treatment in the Control of Malaria in Pregnancy
Identifieur interne : 000405 ( Main/Exploration ); précédent : 000404; suivant : 000406A Non-Inferiority, Individually Randomized Trial of Intermittent Screening and Treatment versus Intermittent Preventive Treatment in the Control of Malaria in Pregnancy
Auteurs : Harry Tagbor [Royaume-Uni, Ghana] ; Matthew Cairns [Royaume-Uni] ; Kalifa Bojang [Gambie] ; Sheick Oumar Coulibaly [Burkina Faso] ; Kassoum Kayentao [Mali] ; John Williams [Ghana] ; Ismaela Abubakar [Gambie] ; Francis Akor [Gambie] ; Khalifa Mohammed [Gambie] ; Richard Bationo [Burkina Faso] ; Edgar Dabira [Burkina Faso] ; Alamissa Soulama [Burkina Faso] ; Moussa Djimdé [Mali] ; Etienne Guirou [Mali] ; Timothy Awine [Ghana] ; Stephen Quaye [Ghana] ; Fanta Njie [Gambie] ; Jaume Ordi [Espagne] ; Ogobara Doumbo [Mali] ; Abraham Hodgson [Ghana] ; Abraham Oduro [Ghana] ; Steven Meshnick [États-Unis] ; Steve Taylor [États-Unis] ; Pascal Magnussen [Danemark] ; Feiko Ter Kuile [Royaume-Uni] ; Arouna Woukeu [Royaume-Uni] ; Paul Milligan [Royaume-Uni] ; Daniel Chandramohan [Royaume-Uni] ; Brian Greenwood [Royaume-Uni]Source :
- PLoS ONE [ 1932-6203 ] ; 2015.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Afrique, Antipaludiques (usage thérapeutique), Association médicamenteuse, Burkina, Complications parasitaires de la grossesse (diagnostic), Complications parasitaires de la grossesse (traitement médicamenteux), Dépistage systématique, Femelle, Gambie, Ghana, Grossesse, Humains, Hémoglobines (analyse), Issue de la grossesse, Jeune adulte, Mali, Paludisme (traitement médicamenteux), Placenta (parasitologie), Poids de naissance, Pyriméthamine (usage thérapeutique), Résultat thérapeutique, Sulfadoxine (usage thérapeutique).
- MESH :
- analyse : Hémoglobines.
- diagnostic : Complications parasitaires de la grossesse.
- parasitologie : Placenta.
- traitement médicamenteux : Complications parasitaires de la grossesse, Paludisme.
- usage thérapeutique : Antipaludiques, Pyriméthamine, Sulfadoxine.
- Adolescent, Adulte, Afrique, Association médicamenteuse, Burkina, Dépistage systématique, Femelle, Gambie, Ghana, Grossesse, Humains, Issue de la grossesse, Jeune adulte, Mali, Poids de naissance, Résultat thérapeutique.
- Wicri :
- geographic : Burkina Faso, Gambie, Ghana, Mali.
English descriptors
- KwdEn :
- Adolescent, Adult, Africa, Antimalarials (therapeutic use), Birth Weight, Burkina Faso, Drug Combinations, Female, Gambia, Ghana, Hemoglobins (analysis), Humans, Malaria (drug therapy), Mali, Mass Screening, Placenta (parasitology), Pregnancy, Pregnancy Complications, Parasitic (diagnosis), Pregnancy Complications, Parasitic (drug therapy), Pregnancy Outcome, Pyrimethamine (therapeutic use), Sulfadoxine (therapeutic use), Treatment Outcome, Young Adult.
- MESH :
- chemical , analysis : Hemoglobins.
- chemical , therapeutic use : Antimalarials, Pyrimethamine, Sulfadoxine.
- geographic : Africa, Burkina Faso, Drug Combinations, Gambia, Ghana, Mali.
- diagnosis : Pregnancy Complications, Parasitic.
- drug therapy : Malaria, Pregnancy Complications, Parasitic.
- parasitology : Placenta.
- Adolescent, Adult, Birth Weight, Female, Humans, Mass Screening, Pregnancy, Pregnancy Outcome, Treatment Outcome, Young Adult.
Abstract
The efficacy of intermittent preventive treatment for malaria with sulfadoxine-pyrimethamine (IPTp-SP) in pregnancy is threatened in parts of Africa by the emergence and spread of resistance to SP. Intermittent screening with a rapid diagnostic test (RDT) and treatment of positive women (ISTp) is an alternative approach.
An open, individually randomized, non-inferiority trial of IPTp-SP versus ISTp was conducted in 5,354 primi- or secundigravidae in four West African countries with a low prevalence of resistance to SP (The Gambia, Mali, Burkina Faso and Ghana). Women in the IPTp-SP group received SP on two or three occasions whilst women in the ISTp group were screened two or three times with a RDT and treated if positive for malaria with artemether-lumefantrine (AL). ISTp-AL was non-inferior to IPTp-SP in preventing low birth weight (LBW), anemia and placental malaria, the primary trial endpoints. The prevalence of LBW was 15.1% and 15.6% in the IPTp-SP and ISTp-AL groups respectively (OR = 1.03 [95% CI: 0.88, 1.22]). The mean hemoglobin concentration at the last clinic attendance before delivery was 10.97g/dL and 10.94g/dL in the IPTp-SP and ISTp-AL groups respectively (mean difference: -0.03 g/dL [95% CI: -0.13, +0.06]). Active malaria infection of the placenta was found in 24.5% and in 24.2% of women in the IPTp-SP and ISTp-AL groups respectively (OR = 0.95 [95% CI 0.81, 1.12]). More women in the ISTp-AL than in the IPTp-SP group presented with malaria parasitemia between routine antenatal clinics (310 vs 182 episodes, rate difference: 49.4 per 1,000 pregnancies [95% CI 30.5, 68.3], but the number of hospital admissions for malaria was similar in the two groups.
Despite low levels of resistance to SP in the study areas, ISTp-AL performed as well as IPTp-SP. In the absence of an effective alternative medication to SP for IPTp, ISTp-AL is a potential alternative to IPTp in areas where SP resistance is high. It may also have a role in areas where malaria transmission is low and for the prevention of malaria in HIV positive women receiving cotrimoxazole prophylaxis in whom SP is contraindicated.
ClinicalTrials.gov
Pan African Clinical trials Registry
Url:
DOI: 10.1371/journal.pone.0132247
PubMed: 26258474
PubMed Central: 4530893
Affiliations:
- Burkina Faso, Danemark, Espagne, Gambie, Ghana, Mali, Royaume-Uni, États-Unis
- Angleterre, Caroline du Nord, Catalogne, Grand Londres, Hovedstaden
- Barcelone, Copenhague, Londres
- Université de Barcelone
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Le document en format XML
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type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName><orgName type="university">Université de Barcelone</orgName></affiliation></author><author><name sortKey="Doumbo, Ogobara" sort="Doumbo, Ogobara" uniqKey="Doumbo O" first="Ogobara" last="Doumbo">Ogobara Doumbo</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Malaria Research and Training Centre, Faculty of Medicine and Odonto-stomatology, University of Sciences, Technics and Technologies, Bamako, Mali</addr-line></nlm:aff><country xml:lang="fr">Mali</country><wicri:regionArea>Malaria Research and Training Centre, Faculty of Medicine and Odonto-stomatology, University of Sciences, Technics and Technologies, Bamako</wicri:regionArea><wicri:noRegion>Bamako</wicri:noRegion></affiliation></author><author><name sortKey="Hodgson, Abraham" sort="Hodgson, Abraham" uniqKey="Hodgson A" first="Abraham" last="Hodgson">Abraham Hodgson</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Navrongo Health Research Centre, Navrongo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Navrongo Health Research Centre, Navrongo</wicri:regionArea><wicri:noRegion>Navrongo</wicri:noRegion></affiliation></author><author><name sortKey="Oduro, Abraham" sort="Oduro, Abraham" uniqKey="Oduro A" first="Abraham" last="Oduro">Abraham Oduro</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Navrongo Health Research Centre, Navrongo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Navrongo Health Research Centre, Navrongo</wicri:regionArea><wicri:noRegion>Navrongo</wicri:noRegion></affiliation></author><author><name sortKey="Meshnick, Steven" sort="Meshnick, Steven" uniqKey="Meshnick S" first="Steven" last="Meshnick">Steven Meshnick</name><affiliation wicri:level="2"><nlm:aff id="aff008"><addr-line>Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Taylor, Steve" sort="Taylor, Steve" uniqKey="Taylor S" first="Steve" last="Taylor">Steve Taylor</name><affiliation wicri:level="2"><nlm:aff id="aff009"><addr-line>Duke University Medical Center, Durham, NC, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke University Medical Center, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Magnussen, Pascal" sort="Magnussen, Pascal" uniqKey="Magnussen P" first="Pascal" last="Magnussen">Pascal Magnussen</name><affiliation wicri:level="3"><nlm:aff id="aff010"><addr-line>(Institute of International Health, Immunology and Microbiology and Institute of Veterinary Disease Biology, University of Copenhagen, Copenhagen, Denmark</addr-line></nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>(Institute of International Health, Immunology and Microbiology and Institute of Veterinary Disease Biology, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Ter Kuile, Feiko" sort="Ter Kuile, Feiko" uniqKey="Ter Kuile F" first="Feiko" last="Ter Kuile">Feiko Ter Kuile</name><affiliation wicri:level="1"><nlm:aff id="aff011"><addr-line>Liverpool School of Tropical Medicine, Liverpool, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Liverpool School of Tropical Medicine, Liverpool</wicri:regionArea><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Woukeu, Arouna" sort="Woukeu, Arouna" uniqKey="Woukeu A" first="Arouna" last="Woukeu">Arouna Woukeu</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>London School of Hygiene & Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Milligan, Paul" sort="Milligan, Paul" uniqKey="Milligan P" first="Paul" last="Milligan">Paul Milligan</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>London School of Hygiene & Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Chandramohan, Daniel" sort="Chandramohan, Daniel" uniqKey="Chandramohan D" first="Daniel" last="Chandramohan">Daniel Chandramohan</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>London School of Hygiene & Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Greenwood, Brian" sort="Greenwood, 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type="wicri:Area/Main/Curation">000405</idno><idno type="wicri:Area/Main/Exploration">000405</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A Non-Inferiority, Individually Randomized Trial of Intermittent Screening and Treatment versus Intermittent Preventive Treatment in the Control of Malaria in Pregnancy</title><author><name sortKey="Tagbor, Harry" sort="Tagbor, Harry" uniqKey="Tagbor H" first="Harry" last="Tagbor">Harry Tagbor</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>London School of Hygiene & Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Cairns, Matthew" sort="Cairns, Matthew" uniqKey="Cairns M" first="Matthew" last="Cairns">Matthew Cairns</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>London School of Hygiene & Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Bojang, Kalifa" sort="Bojang, Kalifa" uniqKey="Bojang K" first="Kalifa" last="Bojang">Kalifa Bojang</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Medical Research Council Unit, Fajara, The Gambia</addr-line></nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Medical Research Council Unit, Fajara</wicri:regionArea><wicri:noRegion>Fajara</wicri:noRegion></affiliation></author><author><name sortKey="Coulibaly, Sheick Oumar" sort="Coulibaly, Sheick Oumar" uniqKey="Coulibaly S" first="Sheick Oumar" last="Coulibaly">Sheick Oumar Coulibaly</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso</addr-line></nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Faculty of Health Sciences, University of Ouagadougou, Ouagadougou</wicri:regionArea><wicri:noRegion>Ouagadougou</wicri:noRegion></affiliation></author><author><name sortKey="Kayentao, Kassoum" sort="Kayentao, Kassoum" uniqKey="Kayentao K" first="Kassoum" last="Kayentao">Kassoum Kayentao</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Malaria Research and Training Centre, Faculty of Medicine and Odonto-stomatology, University of Sciences, Technics and Technologies, Bamako, Mali</addr-line></nlm:aff><country xml:lang="fr">Mali</country><wicri:regionArea>Malaria Research and Training Centre, Faculty of Medicine and Odonto-stomatology, University of Sciences, Technics and Technologies, Bamako</wicri:regionArea><wicri:noRegion>Bamako</wicri:noRegion></affiliation></author><author><name sortKey="Williams, John" sort="Williams, John" uniqKey="Williams J" first="John" last="Williams">John Williams</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Navrongo Health Research Centre, Navrongo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Navrongo Health Research Centre, Navrongo</wicri:regionArea><wicri:noRegion>Navrongo</wicri:noRegion></affiliation></author><author><name sortKey="Abubakar, Ismaela" sort="Abubakar, Ismaela" uniqKey="Abubakar I" first="Ismaela" last="Abubakar">Ismaela Abubakar</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Medical Research Council Unit, Fajara, The Gambia</addr-line></nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Medical Research Council Unit, Fajara</wicri:regionArea><wicri:noRegion>Fajara</wicri:noRegion></affiliation></author><author><name sortKey="Akor, Francis" sort="Akor, Francis" uniqKey="Akor F" first="Francis" last="Akor">Francis Akor</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Medical Research Council Unit, Fajara, The Gambia</addr-line></nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Medical Research Council Unit, Fajara</wicri:regionArea><wicri:noRegion>Fajara</wicri:noRegion></affiliation></author><author><name sortKey="Mohammed, Khalifa" sort="Mohammed, Khalifa" uniqKey="Mohammed K" first="Khalifa" last="Mohammed">Khalifa Mohammed</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Medical Research Council Unit, Fajara, The Gambia</addr-line></nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Medical Research Council Unit, Fajara</wicri:regionArea><wicri:noRegion>Fajara</wicri:noRegion></affiliation></author><author><name sortKey="Bationo, Richard" sort="Bationo, Richard" uniqKey="Bationo R" first="Richard" last="Bationo">Richard Bationo</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso</addr-line></nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Faculty of Health Sciences, University of Ouagadougou, Ouagadougou</wicri:regionArea><wicri:noRegion>Ouagadougou</wicri:noRegion></affiliation></author><author><name sortKey="Dabira, Edgar" sort="Dabira, Edgar" uniqKey="Dabira E" first="Edgar" last="Dabira">Edgar Dabira</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso</addr-line></nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Faculty of Health Sciences, University of Ouagadougou, Ouagadougou</wicri:regionArea><wicri:noRegion>Ouagadougou</wicri:noRegion></affiliation></author><author><name sortKey="Soulama, Alamissa" sort="Soulama, Alamissa" uniqKey="Soulama A" first="Alamissa" last="Soulama">Alamissa Soulama</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso</addr-line></nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Faculty of Health Sciences, University of Ouagadougou, Ouagadougou</wicri:regionArea><wicri:noRegion>Ouagadougou</wicri:noRegion></affiliation></author><author><name sortKey="Djimde, Moussa" sort="Djimde, Moussa" uniqKey="Djimde M" first="Moussa" last="Djimdé">Moussa Djimdé</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Malaria Research and Training Centre, Faculty of Medicine and Odonto-stomatology, University of Sciences, Technics and Technologies, Bamako, Mali</addr-line></nlm:aff><country xml:lang="fr">Mali</country><wicri:regionArea>Malaria Research and Training Centre, Faculty of Medicine and Odonto-stomatology, University of Sciences, Technics and Technologies, Bamako</wicri:regionArea><wicri:noRegion>Bamako</wicri:noRegion></affiliation></author><author><name sortKey="Guirou, Etienne" sort="Guirou, Etienne" uniqKey="Guirou E" first="Etienne" last="Guirou">Etienne Guirou</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Malaria Research and Training Centre, Faculty of Medicine and Odonto-stomatology, University of Sciences, Technics and Technologies, Bamako, Mali</addr-line></nlm:aff><country xml:lang="fr">Mali</country><wicri:regionArea>Malaria Research and Training Centre, Faculty of Medicine and Odonto-stomatology, University of Sciences, Technics and Technologies, Bamako</wicri:regionArea><wicri:noRegion>Bamako</wicri:noRegion></affiliation></author><author><name sortKey="Awine, Timothy" sort="Awine, Timothy" uniqKey="Awine T" first="Timothy" last="Awine">Timothy Awine</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Navrongo Health Research Centre, Navrongo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Navrongo Health Research Centre, Navrongo</wicri:regionArea><wicri:noRegion>Navrongo</wicri:noRegion></affiliation></author><author><name sortKey="Quaye, Stephen" sort="Quaye, Stephen" uniqKey="Quaye S" first="Stephen" last="Quaye">Stephen Quaye</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Navrongo Health Research Centre, Navrongo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Navrongo Health Research Centre, Navrongo</wicri:regionArea><wicri:noRegion>Navrongo</wicri:noRegion></affiliation></author><author><name sortKey="Njie, Fanta" sort="Njie, Fanta" uniqKey="Njie F" first="Fanta" last="Njie">Fanta Njie</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Medical Research Council Unit, Fajara, The Gambia</addr-line></nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Medical Research Council Unit, Fajara</wicri:regionArea><wicri:noRegion>Fajara</wicri:noRegion></affiliation></author><author><name sortKey="Ordi, Jaume" sort="Ordi, Jaume" uniqKey="Ordi J" first="Jaume" last="Ordi">Jaume Ordi</name><affiliation wicri:level="4"><nlm:aff id="aff007"><addr-line>Barcelona Centre for International Health Research (CRESIB), Department of Pathology, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain</addr-line></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Barcelona Centre for International Health Research (CRESIB), Department of Pathology, Hospital Clinic-Universitat de Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName><orgName type="university">Université de Barcelone</orgName></affiliation></author><author><name sortKey="Doumbo, Ogobara" sort="Doumbo, Ogobara" uniqKey="Doumbo O" first="Ogobara" last="Doumbo">Ogobara Doumbo</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Malaria Research and Training Centre, Faculty of Medicine and Odonto-stomatology, University of Sciences, Technics and Technologies, Bamako, Mali</addr-line></nlm:aff><country xml:lang="fr">Mali</country><wicri:regionArea>Malaria Research and Training Centre, Faculty of Medicine and Odonto-stomatology, University of Sciences, Technics and Technologies, Bamako</wicri:regionArea><wicri:noRegion>Bamako</wicri:noRegion></affiliation></author><author><name sortKey="Hodgson, Abraham" sort="Hodgson, Abraham" uniqKey="Hodgson A" first="Abraham" last="Hodgson">Abraham Hodgson</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Navrongo Health Research Centre, Navrongo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Navrongo Health Research Centre, Navrongo</wicri:regionArea><wicri:noRegion>Navrongo</wicri:noRegion></affiliation></author><author><name sortKey="Oduro, Abraham" sort="Oduro, Abraham" uniqKey="Oduro A" first="Abraham" last="Oduro">Abraham Oduro</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Navrongo Health Research Centre, Navrongo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Navrongo Health Research Centre, Navrongo</wicri:regionArea><wicri:noRegion>Navrongo</wicri:noRegion></affiliation></author><author><name sortKey="Meshnick, Steven" sort="Meshnick, Steven" uniqKey="Meshnick S" first="Steven" last="Meshnick">Steven Meshnick</name><affiliation wicri:level="2"><nlm:aff id="aff008"><addr-line>Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Taylor, Steve" sort="Taylor, Steve" uniqKey="Taylor S" first="Steve" last="Taylor">Steve Taylor</name><affiliation wicri:level="2"><nlm:aff id="aff009"><addr-line>Duke University Medical Center, Durham, NC, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke University Medical Center, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Magnussen, Pascal" sort="Magnussen, Pascal" uniqKey="Magnussen P" first="Pascal" last="Magnussen">Pascal Magnussen</name><affiliation wicri:level="3"><nlm:aff id="aff010"><addr-line>(Institute of International Health, Immunology and Microbiology and Institute of Veterinary Disease Biology, University of Copenhagen, Copenhagen, Denmark</addr-line></nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>(Institute of International Health, Immunology and Microbiology and Institute of Veterinary Disease Biology, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Ter Kuile, Feiko" sort="Ter Kuile, Feiko" uniqKey="Ter Kuile F" first="Feiko" last="Ter Kuile">Feiko Ter Kuile</name><affiliation wicri:level="1"><nlm:aff id="aff011"><addr-line>Liverpool School of Tropical Medicine, Liverpool, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Liverpool School of Tropical Medicine, Liverpool</wicri:regionArea><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Woukeu, Arouna" sort="Woukeu, Arouna" uniqKey="Woukeu A" first="Arouna" last="Woukeu">Arouna Woukeu</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>London School of Hygiene & Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Milligan, Paul" sort="Milligan, Paul" uniqKey="Milligan P" first="Paul" last="Milligan">Paul Milligan</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>London School of Hygiene & Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Chandramohan, Daniel" sort="Chandramohan, Daniel" uniqKey="Chandramohan D" first="Daniel" last="Chandramohan">Daniel Chandramohan</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>London School of Hygiene & Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Greenwood, Brian" sort="Greenwood, Brian" uniqKey="Greenwood B" first="Brian" last="Greenwood">Brian Greenwood</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>London School of Hygiene & Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene & Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Africa</term><term>Antimalarials (therapeutic use)</term><term>Birth Weight</term><term>Burkina Faso</term><term>Drug Combinations</term><term>Female</term><term>Gambia</term><term>Ghana</term><term>Hemoglobins (analysis)</term><term>Humans</term><term>Malaria (drug therapy)</term><term>Mali</term><term>Mass Screening</term><term>Placenta (parasitology)</term><term>Pregnancy</term><term>Pregnancy Complications, Parasitic (diagnosis)</term><term>Pregnancy Complications, Parasitic (drug therapy)</term><term>Pregnancy Outcome</term><term>Pyrimethamine (therapeutic use)</term><term>Sulfadoxine (therapeutic use)</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Afrique</term><term>Antipaludiques (usage thérapeutique)</term><term>Association médicamenteuse</term><term>Burkina</term><term>Complications parasitaires de la grossesse (diagnostic)</term><term>Complications parasitaires de la grossesse (traitement médicamenteux)</term><term>Dépistage systématique</term><term>Femelle</term><term>Gambie</term><term>Ghana</term><term>Grossesse</term><term>Humains</term><term>Hémoglobines (analyse)</term><term>Issue de la grossesse</term><term>Jeune adulte</term><term>Mali</term><term>Paludisme (traitement médicamenteux)</term><term>Placenta (parasitologie)</term><term>Poids de naissance</term><term>Pyriméthamine (usage thérapeutique)</term><term>Résultat thérapeutique</term><term>Sulfadoxine (usage thérapeutique)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analysis" xml:lang="en"><term>Hemoglobins</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antimalarials</term><term>Pyrimethamine</term><term>Sulfadoxine</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Africa</term><term>Burkina Faso</term><term>Drug Combinations</term><term>Gambia</term><term>Ghana</term><term>Mali</term></keywords><keywords scheme="MESH" qualifier="analyse" xml:lang="fr"><term>Hémoglobines</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Pregnancy Complications, Parasitic</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Complications parasitaires de la grossesse</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Malaria</term><term>Pregnancy Complications, Parasitic</term></keywords><keywords scheme="MESH" qualifier="parasitologie" xml:lang="fr"><term>Placenta</term></keywords><keywords scheme="MESH" qualifier="parasitology" xml:lang="en"><term>Placenta</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Complications parasitaires de la grossesse</term><term>Paludisme</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antipaludiques</term><term>Pyriméthamine</term><term>Sulfadoxine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Birth Weight</term><term>Female</term><term>Humans</term><term>Mass Screening</term><term>Pregnancy</term><term>Pregnancy Outcome</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Afrique</term><term>Association médicamenteuse</term><term>Burkina</term><term>Dépistage systématique</term><term>Femelle</term><term>Gambie</term><term>Ghana</term><term>Grossesse</term><term>Humains</term><term>Issue de la grossesse</term><term>Jeune adulte</term><term>Mali</term><term>Poids de naissance</term><term>Résultat thérapeutique</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Burkina Faso</term><term>Gambie</term><term>Ghana</term><term>Mali</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>The efficacy of intermittent preventive treatment for malaria with sulfadoxine-pyrimethamine (IPTp-SP) in pregnancy is threatened in parts of Africa by the emergence and spread of resistance to SP. Intermittent screening with a rapid diagnostic test (RDT) and treatment of positive women (ISTp) is an alternative approach.</p></sec><sec id="sec002"><title>Methods and Findings</title><p>An open, individually randomized, non-inferiority trial of IPTp-SP versus ISTp was conducted in 5,354 primi- or secundigravidae in four West African countries with a low prevalence of resistance to SP (The Gambia, Mali, Burkina Faso and Ghana). Women in the IPTp-SP group received SP on two or three occasions whilst women in the ISTp group were screened two or three times with a RDT and treated if positive for malaria with artemether-lumefantrine (AL). ISTp-AL was non-inferior to IPTp-SP in preventing low birth weight (LBW), anemia and placental malaria, the primary trial endpoints. The prevalence of LBW was 15.1% and 15.6% in the IPTp-SP and ISTp-AL groups respectively (OR = 1.03 [95% CI: 0.88, 1.22]). The mean hemoglobin concentration at the last clinic attendance before delivery was 10.97g/dL and 10.94g/dL in the IPTp-SP and ISTp-AL groups respectively (mean difference: -0.03 g/dL [95% CI: -0.13, +0.06]). Active malaria infection of the placenta was found in 24.5% and in 24.2% of women in the IPTp-SP and ISTp-AL groups respectively (OR = 0.95 [95% CI 0.81, 1.12]). More women in the ISTp-AL than in the IPTp-SP group presented with malaria parasitemia between routine antenatal clinics (310 vs 182 episodes, rate difference: 49.4 per 1,000 pregnancies [95% CI 30.5, 68.3], but the number of hospital admissions for malaria was similar in the two groups.</p></sec><sec id="sec003"><title>Conclusions</title><p>Despite low levels of resistance to SP in the study areas, ISTp-AL performed as well as IPTp-SP. In the absence of an effective alternative medication to SP for IPTp, ISTp-AL is a potential alternative to IPTp in areas where SP resistance is high. It may also have a role in areas where malaria transmission is low and for the prevention of malaria in HIV positive women receiving cotrimoxazole prophylaxis in whom SP is contraindicated.</p></sec><sec id="sec004"><title>Trial Registration</title><p>ClinicalTrials.gov <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT01084213">NCT01084213</ext-link></p><p>Pan African Clinical trials Registry <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/PACT201202000272122">PACT201202000272122</ext-link></p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Eisele, Tp" uniqKey="Eisele T">TP Eisele</name></author><author><name sortKey="Larsen, Da" uniqKey="Larsen D">DA Larsen</name></author><author><name sortKey="Anglewicz, Pa" uniqKey="Anglewicz P">PA Anglewicz</name></author><author><name sortKey="Keating, J" uniqKey="Keating J">J 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name="Angleterre"><name sortKey="Tagbor, Harry" sort="Tagbor, Harry" uniqKey="Tagbor H" first="Harry" last="Tagbor">Harry Tagbor</name></region><name sortKey="Cairns, Matthew" sort="Cairns, Matthew" uniqKey="Cairns M" first="Matthew" last="Cairns">Matthew Cairns</name><name sortKey="Chandramohan, Daniel" sort="Chandramohan, Daniel" uniqKey="Chandramohan D" first="Daniel" last="Chandramohan">Daniel Chandramohan</name><name sortKey="Greenwood, Brian" sort="Greenwood, Brian" uniqKey="Greenwood B" first="Brian" last="Greenwood">Brian Greenwood</name><name sortKey="Milligan, Paul" sort="Milligan, Paul" uniqKey="Milligan P" first="Paul" last="Milligan">Paul Milligan</name><name sortKey="Ter Kuile, Feiko" sort="Ter Kuile, Feiko" uniqKey="Ter Kuile F" first="Feiko" last="Ter Kuile">Feiko Ter Kuile</name><name sortKey="Woukeu, Arouna" sort="Woukeu, Arouna" uniqKey="Woukeu A" first="Arouna" last="Woukeu">Arouna Woukeu</name></country><country name="Ghana"><noRegion><name sortKey="Tagbor, Harry" sort="Tagbor, Harry" uniqKey="Tagbor H" first="Harry" last="Tagbor">Harry Tagbor</name></noRegion><name sortKey="Awine, Timothy" sort="Awine, Timothy" uniqKey="Awine T" first="Timothy" last="Awine">Timothy Awine</name><name sortKey="Hodgson, Abraham" sort="Hodgson, Abraham" uniqKey="Hodgson A" first="Abraham" last="Hodgson">Abraham Hodgson</name><name sortKey="Oduro, Abraham" sort="Oduro, Abraham" uniqKey="Oduro A" first="Abraham" last="Oduro">Abraham Oduro</name><name sortKey="Quaye, Stephen" sort="Quaye, Stephen" uniqKey="Quaye S" first="Stephen" last="Quaye">Stephen Quaye</name><name sortKey="Williams, John" sort="Williams, John" uniqKey="Williams J" first="John" last="Williams">John Williams</name></country><country name="Gambie"><noRegion><name sortKey="Bojang, Kalifa" sort="Bojang, Kalifa" uniqKey="Bojang K" first="Kalifa" last="Bojang">Kalifa Bojang</name></noRegion><name sortKey="Abubakar, Ismaela" sort="Abubakar, Ismaela" uniqKey="Abubakar I" first="Ismaela" last="Abubakar">Ismaela Abubakar</name><name sortKey="Akor, Francis" sort="Akor, Francis" uniqKey="Akor F" first="Francis" last="Akor">Francis Akor</name><name sortKey="Mohammed, Khalifa" sort="Mohammed, Khalifa" uniqKey="Mohammed K" first="Khalifa" last="Mohammed">Khalifa Mohammed</name><name sortKey="Njie, Fanta" sort="Njie, Fanta" uniqKey="Njie F" first="Fanta" last="Njie">Fanta Njie</name></country><country name="Burkina Faso"><noRegion><name sortKey="Coulibaly, Sheick Oumar" sort="Coulibaly, Sheick Oumar" uniqKey="Coulibaly S" first="Sheick Oumar" last="Coulibaly">Sheick Oumar Coulibaly</name></noRegion><name sortKey="Bationo, Richard" sort="Bationo, Richard" uniqKey="Bationo R" first="Richard" last="Bationo">Richard Bationo</name><name sortKey="Dabira, Edgar" sort="Dabira, Edgar" uniqKey="Dabira E" first="Edgar" last="Dabira">Edgar Dabira</name><name sortKey="Soulama, Alamissa" sort="Soulama, Alamissa" uniqKey="Soulama A" first="Alamissa" last="Soulama">Alamissa Soulama</name></country><country name="Mali"><noRegion><name sortKey="Kayentao, Kassoum" sort="Kayentao, Kassoum" uniqKey="Kayentao K" first="Kassoum" last="Kayentao">Kassoum Kayentao</name></noRegion><name sortKey="Djimde, Moussa" sort="Djimde, Moussa" uniqKey="Djimde M" first="Moussa" last="Djimdé">Moussa Djimdé</name><name sortKey="Doumbo, Ogobara" sort="Doumbo, Ogobara" uniqKey="Doumbo O" first="Ogobara" last="Doumbo">Ogobara Doumbo</name><name sortKey="Guirou, Etienne" sort="Guirou, Etienne" uniqKey="Guirou E" first="Etienne" last="Guirou">Etienne Guirou</name></country><country name="Espagne"><region name="Catalogne"><name sortKey="Ordi, Jaume" sort="Ordi, Jaume" uniqKey="Ordi J" first="Jaume" last="Ordi">Jaume Ordi</name></region></country><country name="États-Unis"><region name="Caroline du Nord"><name sortKey="Meshnick, Steven" sort="Meshnick, Steven" uniqKey="Meshnick S" first="Steven" last="Meshnick">Steven Meshnick</name></region><name sortKey="Taylor, Steve" sort="Taylor, Steve" uniqKey="Taylor S" first="Steve" last="Taylor">Steve Taylor</name></country><country name="Danemark"><region name="Hovedstaden"><name sortKey="Magnussen, Pascal" sort="Magnussen, Pascal" uniqKey="Magnussen P" first="Pascal" last="Magnussen">Pascal Magnussen</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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