Comparative efficacy of chloroquine and sulphadoxine - pyrimethamine in pregnant women and children: a meta-analysis

Kalanda, Gertrude, Hill, Jenny ORCID: https://orcid.org/0000-0003-1588-485X, Verhoeff, Francine H. and Brabin, Bernard (2006) 'Comparative efficacy of chloroquine and sulphadoxine - pyrimethamine in pregnant women and children: a meta-analysis'. Tropical Medicine & International Health, Vol 11, Issue 5, pp. 569-577.

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Abstract

Objective: To compare the efficacy of chloroquine and sulphadoxine-pyremethamine against Plasmodium falciparum infection in pregnant women and in children from the same endemic areas of Africa, with the aim of determining the level of correspondence in efficacy determinations in these two risk groups.
Methods: Meta-analysis of nine published and unpublished in vivo antimalarial efficacy studies in pregnant women and in children across five African countries.
Results: Pregnant women (all gravidae) were more likely to be sensitive than children to both chloroquine (odds ratio: 2.07; 95% confidence interval: 1.5, 2.9) and sulphadoxine-pyrimethamine (odds ratio: 2.66; 95% confidence interval: 11.1, 6.7). Pregnant women demonstrated an almost uniform increased sensitivity for peripheral parasite clearance at day 14 compared with children. This finding was consistent across a wide range of drug sensitivities. Primigravidae at day 14 showed lower clearance to antimalarial drugs than multigravidae (P < 0.05). There was no significant difference between parasite clearance in primigravidae and in children.
Conclusion: The greater drug sensitivity in pregnant women probably indicates differences in host susceptibility rather than parasite resistance. Parasite sensitivity patterns in children may be a suitable guide to antimalarial policy in pregnant women.

Item Type:	Article
Uncontrolled Keywords:	malaria pregnancy child chloroquine sulphadoxine-pyrimethamine immunodeficiency-virus-infection plasmodium-falciparum malaria birth-weight northern nigeria treatment policy kenya resistance africa parasitemia district
Subjects:	QV Pharmacology > Anti-Inflammatory Agents. Anti-Infective Agents. Antineoplastic Agents > QV 256 Antimalarials QX Parasitology > Protozoa > QX 135 Plasmodia WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WQ Obstetrics > Pregnancy Complications > WQ 256 Infectious diseases WS Pediatrics > Diseases of Children and Adolescents > General Diseases > WS 200 General works
Faculty: Department:	Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI):	https://doi.org/10.1111/j.1365-3156.2006.01608.x
Depositing User:	Ms Julia Martin
Date Deposited:	24 Sep 2010 14:31
Last Modified:	06 Feb 2018 13:02
URI:	https://archive.lstmed.ac.uk/id/eprint/1527

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