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Eficacia comparativa de la cloroquina y la sulfadoxina‐pirimetamina en mujeres embarazadas y niños: meta‐análisis
Author(s) -
Kalanda Gertrude C.,
Hill Jenny,
Verhoeff Francine H.,
Brabin Bernard J.
Publication year - 2006
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2006.01608.x
Subject(s) - chloroquine , sulfadoxine , odds ratio , medicine , malaria , pyrimethamine , confidence interval , sulfadoxine/pyrimethamine , plasmodium falciparum , pregnancy , obstetrics , immunology , biology , genetics
Summary 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 Methods Meta‐analysis of nine published and unpublished in vivo antimalarial efficacy studies in pregnant women and in children across five African countries.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.