{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:09:35Z","timestamp":1790467775907,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004431","name":"Fondation de France","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004431","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The main objective of the MACOMBA (Maternity and Control of Malaria\u2010HIV co\u2010infection in Bangui) trial was to show that cotrimoxazole (CTX) is more effective than sulphadoxine\u2013pyremethamine\u2013IPTp (IPTp\u2010SP) to prevent placental malaria infection (primary end point) among HIV\u2010positive pregnant women with a CD4+ count \u2265350\u00a0cells\/mm<jats:sup>3<\/jats:sup> in Bangui, CAR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MACOMBA is a multicentre, open\u2010label randomised trial conducted in four maternity hospitals in Bangui. Between 2013 and 2017, 193 women were randomised and 112 (59 and 53 in CTX and IPTp\u2010SP arms, respectively) were assessed for placental infection defined by microscopic parasitaemia or PCR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirteen women had a placental infection: five in the CTX arm (one by microscopic placental parasitaemia and four by PCR) and eight by PCR in the SP\u2010IPTp (8.5% vs. 15.1%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.28). The percentage of newborns with low birthweight (&lt;2500\u00a0g) did not differ statistically between the two arms. Self\u2010reported compliance to CTX prophylaxis was good. There was a low overall rate of adverse events in both arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although our results do not allow us to conclude that CTX is more effective, drug safety and good compliance among women with this treatment favour its widespread use among HIV\u2010infected pregnant women, as currently recommended by WHO.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13668","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T17:41:07Z","timestamp":1629308467000},"page":"1314-1323","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cotrimoxazole versus sulfadoxine\u2013pyrimethamine for intermittent preventive treatment of malaria in HIV\u2010infected pregnant women in Bangui, Central African Republic: A pragmatic randomised controlled 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