Journal Article

Failure of a Chloroquine Chemoprophylaxis Program to Adequately Prevent Malaria during Pregnancy in Koupéla District, Burkina Faso

Sodiomon B. Sirima, Romial Sawadogo, Allisyn C. Moran, Amadou Konate, Amidou Diarra, Mathias Yameogo, Monica E. Parise and Robert D. Newman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 36, issue 11, pages 1374-1382
Published in print June 2003 | ISSN: 1058-4838
Published online June 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/375077
Failure of a Chloroquine Chemoprophylaxis Program to Adequately Prevent Malaria during Pregnancy in Koupéla District, Burkina Faso

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In West Africa, administration of chloroquine chemoprophylaxis during pregnancy is common, but little is known about its impact on Plasmodium falciparum infection during pregnancy. Therefore, cross-sectional studies in antenatal care clinics (ANCs) and delivery units (DUs) were conducted in Koupéla District, Burkina Faso. Chloroquine chemoprophylaxis was reported by 69% of 597 pregnant women at ANCs and by 93% of 853 women in DUs. P. falciparum peripheral parasitemia was identified in 29% of women at both ANCs and DUs. Placental parasitemia was identified in 22% of delivering women and was strongly associated with low birth weight (LBW) (risk ratio [RR], 1.7; 95% confidence interval [CI], 1.2–2.4) and prematurity (RR, 2.9; 95% CI, 1.6–5.4). In multivariate analysis, use of chemoprophylaxis was not associated with a reduction in the prevalence of placental parasitemia, LBW, or prematurity. Despite the high reported chloroquine chemoprophylaxis coverage, peripheral and placental malaria rates remain high and are associated with known adverse outcomes during pregnancy, including maternal anemia, prematurity, and LBW. Alternative prevention strategies, such as use of insecticide-treated mosquito nets and intermittent preventive treatment with more-effective antimalarials, are needed.

Journal Article.  4651 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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