[Chloroquine drug prophylaxis no longer prevents Plasmodium falciparum-induced fetal hypotrophy in Kinshasa]

Abstract

Control of malaria-related antenatal morbidity and prevention of fetal hypertrophy due to Plasmodium falciparum-induced chorionitis in endemic malaria depends mainly on weekly treatment with chloroquine insofar as that drug is still effective. The purpose of this study was to evaluate the efficacy of chloroquine drug prophylaxis in preventing fetal hypotrophy in the hyper-endemic environment of Kinshasa, Democratic Republic of Congo, where emergence of chloroquine-resistant P. falciparum strains is a current threat. Data concerning the mother, fetus, and placenta were collected from 59 parturients at Saint Marc's Maternity Hospital in Kingasani, which is one of the major health institution in the Democratic Republic of Congo. The confounding effect of parity, age, and placental weight was controlled using general linear model. Our results showed that regular chloroquine treatment did not lower the risk of chorionitis (Odds ratio = 2.0; CI95% = 0.4-11.6; p = 0.226) or its impact on birth weight. Findings after correction showed that mean birth weight was significantly lower (p = 0.011) with (2.724 +/- 89 g; 24 cases) than without (2.992 +/- 80 g; 32 cases) occurrence of chorionitis.