Table 3.
Risk factors for PCR-corrected treatment failure in pregnant women infected with falciparum malaria
| Number assessed (failure) |
Univariable analysis |
Multivariable analysis* |
||||
|---|---|---|---|---|---|---|
| HR (95% CI) | p-value | HR (95% CI) | p-value | |||
| Treatment | ||||||
| AL | 1278 (68) | .. | .. | .. | .. | |
| AAP | 91 (2) | 0·39 (0·07–2·11) | 0·27 | 0·31 (0·06–1·61) | 0·17 | |
| AC | 142 (6) | 0·46 (0·19–1·15) | 0·10 | 0·37 (0·15–0·91) | 0·03 | |
| AS | 230 (15) | 0·72 (0·37–1·42) | 0·35 | 0·64 (0·34–1·23) | 0·18 | |
| ASAQ | 841 (12) | 0·27 (0·14–0·52) | <0·0001 | 0·27 (0·14–0·52) | <0·0001 | |
| ASMQ | 1028 (25) | 0·56 (0·33–0·94) | 0·03 | 0·56 (0·34–0·94) | 0·03 | |
| ASSP | 173 (4) | 1·68 (0·30–9·31) | 0·55 | 2·05 (0·38–11·03) | 0·40 | |
| DP | 874 (14) | 0·38 (0·20–0·74) | 0·004 | 0·35 (0·18–0·68) | 0·002 | |
| Q | 244 (31) | 5·70 (2·09–15·55) | <0·0001 | 6·11 (2·57–14·54) | <0·0001 | |
| QC | 67 (1) | 0·63 (0·05–7·22) | 0·71 | 0·48 (0·04–5·24) | 0·55 | |
| Age (years) | 4968 (178) | 0·96 (0·93–0·98) | 0·002 | .. | .. | |
| Parity | ||||||
| 0 | 2130 (89) | .. | .. | .. | .. | |
| 1 | 1040 (31) | 0·60 (0·40–0·90) | 0·01 | 0·59 (0·39–0·89) | 0·01 | |
| ≥2 | 1733 (56) | 0·51 (0·36–0·72) | 0·0002 | 0·62 (0·44–0·89) | 0·009 | |
| Trimester | ||||||
| 1 | 27 (1) | 0·45 (0·06–3·31) | 0·44 | .. | .. | |
| 2 | 3325 (131) | .. | .. | .. | .. | |
| 3 | 1610 (46) | 0·81 (0·58–1·15) | 0·24 | .. | .. | |
| Weight (kg) | 4943 (177) | 1·00 (0·98–1·03) | 0·78 | .. | .. | |
| Parasitaemia (log10/μL) | 4968 (178) | 1·97 (1·65–2·35) | 0·0001 | 1·93 (1·61–2·32) | <0·0001 | |
| Hyperparasitaemia | ||||||
| Yes | 79 (6) | 1·74 (0·76–4·00) | 0·19 | .. | .. | |
| No | 4889 (172) | .. | .. | .. | .. | |
| Fever >37·5°C | ||||||
| Yes | 504 (32) | 1·46 (0·98–2·18) | 0·07 | .. | .. | |
| No | 4350 (142) | .. | .. | .. | .. | |
| Haemoglobin (g/dL) | 4917 (175) | 0·97 (0·88–1·08) | 0·60 | .. | .. | |
| Presence of gametocytes | ||||||
| Yes | 197 (12) | 1·28 (0·70–2·33) | 0·42 | .. | .. | |
| No | 4629 (157) | .. | .. | .. | .. | |
| Mixed infection | ||||||
| Yes | 54 (5) | 1·76 (0·70–4·43) | 0·23 | .. | .. | |
| No | 4914 (173) | .. | .. | .. | .. | |
| Intercalated vivax infection | ||||||
| Yes | 233 (10) | 0·59 (0·30–1·18) | 0·14 | .. | .. | |
| No | 4735 (168) | .. | .. | .. | .. | |
| Transmission intensity | ||||||
| Low | 1319 (81) | 1·75 (0·46–6·73) | 0·41 | .. | .. | |
| Moderate | 2594 (49) | 1·26 (0·30–5·26) | 0·75 | .. | .. | |
| High | 1055 (48) | .. | .. | .. | .. | |
p value for shared frailty <0·001. AAP=artesunate with atovaquone-proguanil. AC=artesunate with clindamycin. AL=artemether-lumefantrine. AS=artesunate monotherapy. ASAQ=artesunate-amodiaquine. ASMQ=artesunate-mefloquine. ASSP=artesunate-sulfadoxine-pyrimethamine. DP=dihydroartemisinin-piperaquine. HR=hazard ratio. Q=quinine monotherapy. QC=quinine with clindamycin.
*
Adjusted by treatment, parity, parasitaemia, and previous antimalarial treatment.