Cot M, Le Hesran J Y, Miailhes P, Esveld M, Etya'ale D, Breart G
Institut Francais de Recherche Scientifique pour le Developpement en Cooperation, Organisation de Coordination pour la Lutte Contre les Endemies en Afrique Centrale, Yaounde, Cameroon.
Am J Trop Med Hyg. 1995 Dec;53(6):581-5. doi: 10.4269/ajtmh.1995.53.581.
A randomized trial was carried out from 1991 to 1993 among women attending an antenatal clinic in Ebolowa, Cameroon where malaria is hyperendemic and transmission occurs at a high level all year round. All pregnant women attending the clinic for their first prenatal visit between October 1991 and November 1992 were alternately assigned to chloroquine (CQ) or control (CT) groups. Chloroquine was given under observation at a weekly oral dose of 300 mg. At delivery, smears from maternal, cord, and placental blood were made and stained with Giemsa for parasites. An in vivo chloroquine sensitivity investigation was carried out on women attending the postnatal consultation to evaluate the level of chloroquine resistance in the target population. The efficacy of chloroquine was moderate in placental infection (39.2% infected in the CQ group versus 57.8% in the CT group: P = 0.05), probably because of a resistance to chloroquine estimated to be 10.9%. In the CQ group, the mean birth weight was significantly higher (P = 0.02) and the proportion of low birth weight newborns was lower (10.5% versus 27.7%; P = 0.02). A strong correlation between placental infection and birth weight was observed: the mean birth weight difference between infected and noninfected placentae was 359 g (P < 0.0001) and the proportion of low birth weight new born babies was 35.6% versus 5.9% (P = 0.0001). In Cameroon, in spite of a moderate resistance to chloroquine, this drug proved to be highly effective in increasing birth weight when administered to primigravidae. We therefore think such a prophylaxis should be recommended only to primigravidae in high transmission areas.
1991年至1993年期间，在喀麦隆埃博洛瓦的一家产前诊所对孕妇进行了一项随机试验，该地疟疾高度流行，全年传播水平都很高。1991年10月至1992年11月期间首次到该诊所进行产前检查的所有孕妇被交替分配到氯喹（CQ）组或对照组（CT）。氯喹在观察下每周口服剂量为300毫克。分娩时，采集母体、脐带和胎盘血涂片，用吉姆萨染色检测寄生虫。对产后咨询的妇女进行了氯喹体内敏感性调查，以评估目标人群中氯喹耐药水平。氯喹对胎盘感染的疗效中等（CQ组感染率为39.2%，CT组为57.8%：P = 0.05），这可能是因为估计氯喹耐药率为10.9%。在CQ组，平均出生体重显著更高（P = 0.02），低出生体重新生儿的比例更低（10.5%对27.7%；P = 0.02）。观察到胎盘感染与出生体重之间有很强的相关性：感染胎盘和未感染胎盘的平均出生体重差异为359克（P < 0.0001），低出生体重新生儿的比例分别为35.6%和5.9%（P = 0.0001）。在喀麦隆，尽管对氯喹有中等耐药性，但该药物在给予初产妇时被证明对增加出生体重非常有效。因此，我们认为仅应向高传播地区的初产妇推荐这种预防措施。
