Community-based Malaria Screening and Treatment for Pregnant Women Receiving Standard Intermittent Preventive Treatment With Sulfadoxine-Pyrimethamine: A Multicenter (The Gambia, Burkina Faso, and Benin) Cluster-randomized Controlled Trial - HAL-SHS - Sciences de l'Homme et de la Société Accéder directement au contenu
Article Dans Une Revue Clinical Infectious Diseases Année : 2019

Community-based Malaria Screening and Treatment for Pregnant Women Receiving Standard Intermittent Preventive Treatment With Sulfadoxine-Pyrimethamine: A Multicenter (The Gambia, Burkina Faso, and Benin) Cluster-randomized Controlled Trial

Halidou Tinto
  • Fonction : Auteur
Maminata Traore-Coulibaly
  • Fonction : Auteur
Hamtandi Magloire Natama
  • Fonction : Auteur
Ousmane Traoré
  • Fonction : Auteur
Innocent Valea
  • Fonction : Auteur
Alain Nahum
  • Fonction : Auteur
Daniel Ahounou
  • Fonction : Auteur
Francis Bohissou
  • Fonction : Auteur
Gethaime Sondjo
  • Fonction : Auteur
Carine Agbowai
  • Fonction : Auteur
Petra Mens
  • Fonction : Auteur
Esmée Ruizendaal
  • Fonction : Auteur
Henk Schallig
  • Fonction : Auteur
Laetitia Duval
Maxime Drabo
  • Fonction : Auteur

Résumé

Background. We investigated whether adding community scheduled malaria screening and treatment (CSST) with artemether-lumefantrine by community health workers (CHWs) to standard intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) would improve maternal and infant health. Methods. In this 2-arm cluster-randomized, controlled trial, villages in Burkina Faso, The Gambia, and Benin were randomized to receive CSST plus IPTp-SP or IPTp-SP alone. CHWs in the intervention arm performed monthly CSST during pregnancy. At each contact, filter paper and blood slides were collected, and at delivery, a placental biopsy was collected. Primary and secondary endpoints were the prevalence of placental malaria, maternal anemia, maternal peripheral infection, low birth weight, antenatal clinic (ANC) attendance, and IPTp-SP coverage. Results. Malaria infection was detected at least once for 3.8% women in The Gambia, 16.9% in Benin, and 31.6% in Burkina Faso. There was no difference between study arms in terms of placenta malaria after adjusting for birth season, parity, and IPTp-SP doses (adjusted odds ratio, 1.06 [95% confidence interval, .78-1.44]; P = .72). No difference between the study arms was found for peripheral maternal infection, anemia, and adverse pregnancy outcomes. ANC attendance was significantly higher in the intervention arm in Burkina Faso but not in The Gambia and Benin. Increasing number of IPTp-SP doses was associated with a significantly lower risk of placenta malaria, anemia at delivery, and low birth weight. Conclusions. Adding CSST to existing IPTp-SP strategies did not reduce malaria in pregnancy. Increasing the number of IPTp-SP doses given during pregnancy is a priority. Clinical Trials Registration. NCT01941264; ISRCTN37259296.
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Dates et versions

hal-03184964 , version 1 (30-03-2021)

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Susana Scott, Umberto D’alessandro, Lindsay Kendall, John Bradley, Kalifa Bojang, et al.. Community-based Malaria Screening and Treatment for Pregnant Women Receiving Standard Intermittent Preventive Treatment With Sulfadoxine-Pyrimethamine: A Multicenter (The Gambia, Burkina Faso, and Benin) Cluster-randomized Controlled Trial. Clinical Infectious Diseases, 2019, 68 (4), pp.586-596. ⟨10.1093/cid/ciy522⟩. ⟨hal-03184964⟩
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