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© Research
Publication : Tropical medicine & international health : TM & IH

Cotrimoxazole versus sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria in HIV-infected pregnant women in Bangui, Central African Republic: a Pragmatic Randomized Controlled Trial.

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Tropical medicine & international health : TM & IH - 18 Aug 2021

Manirakiza A, Tondeur L, Yvette Batoumbou Ketta M, Sepou A, Serdouma E, Gondje S, Géraud Banthas Bata G, Boulay A, Methode Moyen J, Sakanga O, Le-Fouler L, Kazanji M, Briand V, Pierre Lombart J, Vray M,

Link to Pubmed [PMID] – 34407273

Link to DOI – 10.1111/tmi.13668

Trop Med Int Health 2021 Aug; ():

The main objective of the MACOMBA (Maternity and Control of Malaria-HIV co-infection in Bangui) trial was to show that cotrimoxazole (CTX) is more effective than Sulphadoxine-Pyremethamine-IPTp (IPTp-SP) to prevent placental malaria infection (primary endpoint) among HIV-positive pregnant women with a CD4+ count ≥350 cells/mm3 in Bangui, CAR.MACOMBA is a multicenter, open-label randomized trial conducted in four maternity hospitals in Bangui. Between 2013 and 2017, 193 women were randomized and 112 (59 and 53 in CTX and IPTp-SP arms, respectively) were assessed for placental infection defined by microscopic parasitemia or PCR.Thirteen women had a placental infection: 5 in the CTX arm (1 by microscopic placental parasitemia and 4 by PCR) and 8 by PCR in the SP-IPTp (8.5% vs 15.1%, p = 0.28). The percentage of newborns with low birthweight (< 2500 g) did not differ statistically between the two arms. Self-reported compliance to CTX prophylaxis was good. There was a low overall rate of adverse events in both arms.Although our results do not allow us to conclude that CTX is more effective, drug safety and good compliance among women with this treatment favour its widespread use among HIV-infected pregnant women, as currently recommended by WHO.

https://pubmed.ncbi.nlm.nih.gov/34407273