@article{fdi:010072647,
  title = {{A}ntimalarial drug use in general populations of tropical {A}frica},
  author = {{G}ardella, {F}. and {A}ssi, {S}. and {S}imon, {F}. and {B}ogreau, {H}. and {E}ggelte, {T}. and {B}a, {F}. and {F}oumane, {V}. and {H}enry, {M}.{C}. and {K}ientega {T}raore, {P}. and {B}asco, {L}eonardo and {T}rape, {J}ean-{F}rancois and {L}alou, {R}ichard and {M}artelloni, {M}. and {D}esbordes, {M}. and {B}aragatti, {M}. and {B}riolant, {S}. and {A}lmeras, {L}. and {P}radines, {B}. and {F}usai, {T}. and {R}ogier, {C}hristophe},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground : {T}he burden of {P}lasmodium falciparum malaria has worsened because of the emergence of chloroquine resistance. {A}ntimalarial drug use and drug pressure are critical factors contributing to the selection and spread of resistance. {T}he present study explores the geographical, socio-economic and behavioural factors associated with the use of antimalarial drugs in {A}frica. {M}ethods : {T}he 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 {S}enegal (10), {B}urkina-{F}aso (10) and {C}ameroon (10). {Q}uestionnaires have been administered to the parents of sampled children and to a random sample of households in each site. {T}he 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. {R}esults : {A}ccording to the sites, the prevalence rates of {CQ} and {PYR} ranged from 9% to 91% and from 0% to 21%, respectively. {I}n 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). {C}onclusion : {A}ntimalarial drug pressure varied considerably from one site to another. {I}t was significantly higher in areas with intermediate malaria transmission level and in the most accessible sites. {T}hus, {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.},
  keywords = {{AFRIQUE} ; {ZONE} {TROPICALE} ; {BURKINA} {FASO} ; {SENEGAL} ; {CAMEROUN}},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {7},
  numero = {},
  pages = {124 [12 ]},
  ISSN = {1475-2875},
  year = {2008},
  DOI = {10.1186/1475-2875-7-124},
  URL = {https://www.documentation.ird.fr/hor/fdi:010072647},
}