Efficacité et innocuité de la prophylaxie palustique par méfloquine pendant la grossesse à Kisangani, République démocratique du Congo : un essai clinique randomisé
drug safety; clinical pharmacology, parasitology; infectious diseases, pregnancy; gynaecology/obstetrics
Abstract :
[en] Aims: Kisangani is an area with intense malaria transmission and sulfadoxine–
pyrimethamine resistance. Alternative antimalaria prophylaxis medication and protocols
are needed, particularly with pregnant individuals. In this study, we compare the
tolerance and effectiveness of mefloquine regimen as a split dose with a meal vs.
sulfadoxine–pyrimethamine for the intermittent preventive treatment in pregnant
individuals in Kisangani.
Methods: This study was conducted from 15 May to 30 November 2019 as a singleblind,
randomized clinical trial comparing 2 regimens of intermittent preventive
treatment during pregnancy. The first regimen consisted of 4 doses of sulfadoxine–
pyrimethamine, and the second of 2 doses of mefloquine taken as a split dose
with meal.
Results: The occurrence of major or minor side-effects among patients treated
with mefloquine and those treated with sulfadoxine–pyrimethamine were not
statistically significant (major side effects: Fisher exact = 0.5014; minor side effects:
P = 0.0961). Intermittent preventive treatment using mefloquine significantly
reduced the risk of placental malaria (risk ratio [RR]: 0.4315, 95% confidence interval
[CI]: 0.2201–0.8460), maternal peripheral parasitaemia (RR: 0.4397, 95% CI:
0.2377–0.8132) and low birth weight (RR: 0.4708, 95% CI: 0.2455–0.9029).
Conclusion: Splitting dose and intake with a meal increased mefloquine tolerability
while keeping its efficacy higher compared to sulfadoxine–pyrimethamine. Intermittent
preventive treatment during pregnancy using mefloquine reduces the risk of placental
malaria, maternal peripheral parasitaemia and low birth weight, compared to
sulfadoxine–pyrimethamine. Thus, mefloquine is a good alternative to intermittent
preventive treatment in pregnancy.
Research Center/Unit :
CIRM - Centre Interdisciplinaire de Recherche sur le Médicament - ULiège
Disciplines :
Pharmacy, pharmacology & toxicology
Author, co-author :
Labama Otuli, Noël; Université de Kisangani > Gynécologie Obstétrique
Losimba Likwela, Joris; Université de Kisangani > Santé Publique
Bosenge Nguma, Jean-Didier; Université de Kisangani > Gynécologie Obstétrique
Maido Alongo, Mike-Antoine; Université de Kisangani > Gynécologie Obsétrique
Ahuka Ona Longombe, Albert; Université de Kisangani > Chirurgie
Mbutu Mango, Bernard; Université de Kisangani > Chirurgie
Bono M.N., Diane
Mokili L., John
Manga Okenge, Pascal; Université de Kisangani > Gynécologie Obstétrique
Language :
English
Title :
Efficacité et innocuité de la prophylaxie palustique par méfloquine pendant la grossesse à Kisangani, République démocratique du Congo : un essai clinique randomisé
Alternative titles :
[en] Efficacy and safety of malarial prophylaxis with mefloquine during pregnancy in Kisangani, Democratic Republic of Congo: A randomized clinical trial
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