Gardella F., Assi S., Simon F., Bogreau H., Eggelte T., Ba F., Foumane V., Henry M.C., Kientega Traore P., Basco Leonardo, Trape Jean-Francois, Lalou Richard, Martelloni M., Desbordes M., Baragatti M., Briolant S., Almeras L., Pradines B., Fusai T., Rogier Christophe. (2008). Antimalarial drug use in general populations of tropical Africa. Malaria Journal, 7, 124 [12 p.]. ISSN 1475-2875.
Titre du document
Antimalarial drug use in general populations of tropical Africa
Année de publication
2008
Auteurs
Gardella F., Assi S., Simon F., Bogreau H., Eggelte T., Ba F., Foumane V., Henry M.C., Kientega Traore P., Basco Leonardo, Trape Jean-Francois, Lalou Richard, Martelloni M., Desbordes M., Baragatti M., Briolant S., Almeras L., Pradines B., Fusai T., Rogier Christophe
Source
Malaria Journal, 2008,
7, 124 [12 p.] ISSN 1475-2875
Background : The burden of Plasmodium falciparum malaria has worsened because of the emergence of chloroquine resistance. Antimalarial drug use and drug pressure are critical factors contributing to the selection and spread of resistance. The present study explores the geographical, socio-economic and behavioural factors associated with the use of antimalarial drugs in Africa. Methods : The presence of chloroquine (CQ), pyrimethamine (PYR) and other antimalarial drugs has been evaluated by immuno-capture and high-performance liquid chromatography in the urine samples of 3,052 children (2-9 y), randomly drawn in 2003 from the general populations at 30 sites in Senegal (10), Burkina-Faso (10) and Cameroon (10). Questionnaires have been administered to the parents of sampled children and to a random sample of households in each site. The presence of CQ in urine was analysed as dependent variable according to individual and site characteristics using a random - effect logistic regression model to take into account the interdependency of observations made within the same site. Results : According to the sites, the prevalence rates of CQ and PYR ranged from 9% to 91% and from 0% to 21%, respectively. In multivariate analysis, the presence of CQ in urine was significantly associated with a history of fever during the three days preceding urine sampling (OR = 1.22, p = 0.043), socio-economic level of the population of the sites (OR = 2.74, p = 0.029), age (2-5 y = reference level; 6-9 y OR = 0.76, p = 0.002), prevalence of anti-circumsporozoite protein (CSP) antibodies (low prevalence: reference level; intermediate level OR = 2.47, p = 0.023), proportion of inhabitants who lived in another site one year before (OR = 2.53, p = 0.003), and duration to reach the nearest tarmacked road (duration less than one hour = reference level, duration equal to or more than one hour OR = 0.49, p = 0.019). Conclusion : Antimalarial drug pressure varied considerably from one site to another. It was significantly higher in areas with intermediate malaria transmission level and in the most accessible sites. Thus, P. falciparum strains arriving in cross-road sites or in areas with intermediate malaria transmission are exposed to higher drug pressure, which could favour the selection and the spread of drug resistance.
Plan de classement
Entomologie médicale / Parasitologie / Virologie [052]
Description Géographique
AFRIQUE ; ZONE TROPICALE ; BURKINA FASO ; SENEGAL ; CAMEROUN
Localisation
Fonds IRD [F B010072647]
Identifiant IRD
fdi:010072647
