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Abstract Background Both treatment and prevention strategies are recommended by the World Health Organization for the control of malaria during pregnancy in tropical areas. The aim of this study was to assess use of a rapid diagnostic test for prompt management of malaria in pregnancy in Bangui, Central African Republic. Methods A cohort of 76 pregnant women was screened systematically for malaria with ParacheckPf® at each antenatal visit. The usefulness of the method was analysed by comparing the number of malaria episodes requiring treatment in the cohort with the number of prescriptions received by another group of pregnant women followed-up in routine antenatal care. Results In the cohort group, the proportion of positive ParacheckPf® episodes during antenatal clinics visits was 13.8%, while episodes of antimalarial prescriptions in the group which was followed-up routinely by antenatal personnel was estimated at 26.3%. Hence, the relative risk of the cohort for being prescribed an antimalarial drug was 0.53. Therefore, the attributable fraction of presumptive treatment avoided by systematic screening with ParacheckPf® was 47%. Conclusions Use of a rapid diagnostic test is useful, affordable and easy for adequate treatment of malaria in pregnant women. More powerful studies of the usefulness of introducing the test into antenatal care are needed in all heath centres in the country and in other tropical areas.

Introduction. The aim of this study was to estimate the prevalence of malaria among women giving birth in Bangui. Association between sociodemographic characteristics of those women and malaria, as well as prevention compliance (use of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTsp) and insecticide-treated bed nets (ITNs)), was analyzed. Methods. During September 2009, a survey was conducted on 328 women who gave birth at two main maternities of Bangui. Information was obtained by standardized questionnaire about sociodemographic criteria, IPTsp, other antimalarial treatment, and use of bet nets. Smears prepared from peripheral and placental blood were analysed for malaria parasites. Findings and Discussion. Positive results were found in 2.8% of thick peripheral blood smears and in 4.0% of placental slides. A proportion of 30.5% of the women had received at least two doses of IPTsp during the current pregnancy. Only a proportion of 42.4% of this study population had ITNs. Multigravid women were less likely to use IPTsp and ITNs. However, use of IPTsp was associated with personal income and secondary or university educational status. Hence, although this relatively prevalence was observed, more efforts are needed to implement IPTsp and ITNs, taking into account sociodemographic criteria. [ABSTRACT FROM AUTHOR]

Objective: Transmission of malaria in the Central African Republic is holoendemic. The disease accounts for 40% of medical consultations and is the leading cause of morbidity and mortality. Central African Republic is classified by WHO in zone C for resistance to traditional anti-malaria drugs such as chloroquine, sulfadoxine-pyrimethamine, and amodiaquine. In this setting, our study sought to evaluate the therapeutic effectiveness and the feasibility (acceptability) of artemether in the treatment of uncomplicated malaria in young children in Bangui., Methods: This non-comparative, cross-sectional, open study included children aged from 6 months to 5 years of age treated for uncomplicated malaria at the Urban Health Center (CSU) of Bédé-Combatant from May through November 2005. All children had a specific Plasmodium falciparum infection and both parasitemia ranging from 2,000 to 100,000 parasites/microL in uncomplicated malaria and an axillary temperature of 37.5 degrees C or higher but lower than 39.5 degrees C. Epi info software, version 6.03, was used for the data analysis., Results: The study included 53 children, only 49 of whom could be analysed. An adequate clinical and parasitological response (ACPR) was obtained for 47 (96%), early therapeutic failure was detected for 1 patient (on D2), and late parasitological failure on D14 for another. On the whole, only 4% could be qualified as early or late treatment failure. Tolerance was excellent., Conclusion: Artemether was well tolerated. This agent is an effective and safe alternative for the treatment of uncomplicated P. falciparum malaria in children in the Central African Republic.