[In vivo sensitivity of Plasmodium falciparum to chloroquine and sulfadoxine pyrimethamine in the Bobo Dioulasso region (1998 -- 2001): risk factors associated with treatments failures to the two drugs]

The therapeutic efficacy of chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) was determined over a 4 year period (1998-2001) in Bobo Dioulasso Burkina Faso with an analysis of the risk factors associated to treatment failures to the 2 drugs. In total 2008 children (6 months-15 years old) attending in 4 health centres (1 urban and 3 rural) were included in the study. Children were alternatively allocated to either CQ or SP. The WHO 14-days in vivo field test was carried out. PCV was measured at day 0 and 14. CQ treatment failure was 24.4% (229/940) most of them being late failures. Between 1998 and 2001 a significant increase in CQ treatment failure (p 0.1). Univariate analysis showed that the site the age of children the time of recruitment and the parasitaemia were significantly associated with CQ treatment failure. In the multivariate analysis these 4 variables remain significantly and independently associated with the risk of CQ treatment failure. After adjusting for the effect of the 3 other factors the risk of treatment failure was reduced by half in rural area compared to urban area as well as in children of 5 -15 years of age compared to those under 5. The risk of treatment failure was significantly increased in 2000-2001 (OR = 1.66 p or= 16 000/µl than in those having a lower parasitaemia. For SP we have not observed such connexions with the univariate and multivariate analysis.