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Active case detection of malaria in pregnancy using loop-mediated amplification (LAMP): a pilot outcomes study in South West Ethiopia

September 1, 2020 - 09:45 -- Open Access
Guluma Tadesse, Claire Kamaliddin, Cody Doolan, Ranmalee Amarasekara, Ruth Legese, Abu Naser Mohon, James Cheaveau, Delenasaw Yewhalaw and Dylan R. Pillai
Malaria Journal 2020 19:305, 27 August 2020

125 million women are pregnant each year in malaria endemic areas and are, therefore, at risk of Malaria in Pregnancy (MiP). MiP is the direct consequence of Plasmodium infection during pregnancy. The sequestration of Plasmodium falciparum parasites in the placenta adversely affects fetal development and impacts newborn birth weight. Importantly, women presenting with MiP commonly develop anaemia. In Ethiopia, the Ministry of Health recommends screening symptomatic women only at antenatal care visits with no formal intermittent preventive therapy. Since MiP can display low-level parasitaemia, current tests which include microscopy and RDT are challenged to detect these cases. Loop mediated isothermal Amplification (LAMP) technology is a highly sensitive technique for DNA detection and is field compatible. This study aims to evaluate the impact of active malaria case detection during pregnancy using LAMP technology in terms of birth outcomes.

Impact of Health Systems on the Implementation of Intermittent Preventive Treatment for Malaria in Pregnancy in Sub-Saharan Africa: A Narrative Synthesis

August 27, 2020 - 08:07 -- Open Access
Olaleye AO, Walker O
Trop Med Infect Dis. 2020 Aug 22;5(3):E134

Malaria in pregnancy is a public health challenge with serious negative maternal and newborn consequences. Intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine is recommended for the control of malaria during pregnancy within endemic areas, but coverage for the recommended ≥3 doses IPTp regimen has remained suboptimal. We searched PubMed, Cochrane library, and HINARI database from 1 January 2010 to 23 May 2020, for studies investigating the effect of the health system on IPTp implementation.

Malaria in pregnancy regulates P-glycoprotein (P-gp/Abcb1a) and ABCA1 efflux transporters in the Mouse Visceral Yolk Sac

August 13, 2020 - 11:34 -- Open Access
Martinelli LM, Fontes KN, Reginatto MW, Andrade CBV, Monteiro VRS, Gomes HR, Silva-Filho JL, Pinheiro AAS, Vago AR, Almeida FRCL, Bloise FF, Matthews SG, Ortiga-Carvalho TM, Bloise E
J Cell Mol Med. 2020 Aug 11

Malaria in pregnancy (MiP) induces intrauterine growth restriction (IUGR) and preterm labour (PTL). However, its effects on yolk sac morphology and function are largely unexplored. We hypothesized that MiP modifies yolk sac morphology and efflux transport potential by modulating ABC efflux transporters. C57BL/6 mice injected with Plasmodium berghei ANKA (5 × 105 infected erythrocytes) at gestational day (GD) 13.5 were subjected to yolk sac membrane harvesting at GD 18.5 for histology, qPCR and immunohistochemistry.

Safety of Artemisinin Derivatives in the First Trimester of Pregnancy: A Controversial Story

August 5, 2020 - 16:21 -- Open Access
D'Alessandro S, Menegola E, Parapini S, Taramelli D, Basilico N
Molecules. 2020 Jul 31;25(15):E3505

Artemisinin combination therapy (ACT) is recommended by the World Health Organization (WHO) as first line treatment for uncomplicated malaria both in adults and children. During pregnancy, ACT is considered safe only in the second and third trimester, since animal studies have demonstrated that artemisinin derivatives can cause foetal death and congenital malformation within a narrow time window in early embryogenesis.

Defining the combined benefit of intermittent preventive malaria treatment in pregnancy

July 8, 2020 - 15:27 -- Open Access
Salman S, Davis TME, Moore B
Lancet Glob Health. 2020 Jul;8(7):e871-e872

WHO  has  included  intermittent  preventive  treatment  in  pregnancy  (IPTp)  with  sulfadoxine-pyrimethamine  as  an  important  malaria  intervention  since  2012.1  Although  other candidate therapies remain under investigation and despite  waning  sulfadoxine-pyrimethamine  antimalarial  efficacy  due  to  increasing  parasite  resistance,  IPTp  with  sulfadoxine-pyrimethamine  remains  a  key  component  of   the   management   of   pregnant   women   in   malaria-endemic areas. In areas of high-grade parasite resistance, the   use   of   IPTp   with   sulfadoxine-pyrimethamine   is   associated with improved birth weight, suggesting that there are benefits of beyond antimalarial efficacy.

NOT Open Access | Systematic review of artemisinin embryotoxicity in animals: Implications for malaria control in human pregnancy

July 7, 2020 - 13:15 -- NOT Open Access
González R, Pons-Duran C, Bardají A, Leke RGF, Clark R, Menendez C
Toxicol Appl Pharmacol. 2020 Jul 2:115127

Pregnant women are one of the most susceptible and vulnerable groups to malaria, the most important parasitic disease worldwide. Artemisinin-based combination therapies (ACTs) are recommended for the treatment of uncomplicated malaria in all population groups including pregnant women. However, due to the embryotoxicity observed in animal studies, ACTs have long been contraindicated during the first trimester in pregnant women.

Pregnancy outcomes and risk of placental malaria after artemisinin-based and quinine-based treatment for uncomplicated falciparum malaria in pregnancy: a WorldWide Antimalarial Resistance Network systematic review and individual patient data meta-analysis

June 2, 2020 - 13:57 -- Open Access
Saito M, Mansoor R, Guérin PJ, et al.
BMC Med. 2020 Jun 2; 18(1):138

Malaria in pregnancy, including asymptomatic infection, has a detrimental impact on foetal development. Individual patient data (IPD) meta-analysis was conducted to compare the association between antimalarial treatments and adverse pregnancy outcomes, including placental malaria, accompanied with the gestational age at diagnosis of uncomplicated falciparum malaria infection.

NOT Open Access | Impact of malaria in pregnancy on risk of malaria in young children: systematic review and meta-analyses

March 30, 2020 - 10:19 -- NOT Open Access
Park S, Nixon CE, Miller O, Choi NK, Kurtis JD, Friedman JF, Michelow IC
J Infect Dis. 2020 Mar 27. pii: jiaa139

Our objective was to quantify the risk of acquiring malaria among progeny of women with malaria during pregnancy.

Validity and reliability of a Hausa language questionnaire assessing information, motivation and Behavioural skills for malaria prevention during pregnancy

March 25, 2020 - 14:51 -- Open Access
Balami AD, Said SM, Zulkefli NM, Bachok N, Audu BM
BMC Public Health. 2020 Mar 24;20(1):384

Many studies on malaria knowledge, attitude and practice among pregnant women have been conducted in Hausa speaking communities in Nigeria. Despite this, no standard and uniform instrument for assessing this important public health problem has been developed in the Hausa language, even though it is widely spoken. The aim of this study was to develop and validate a questionnaire in Hausa language assessing information, motivation, and behavioural skills for malaria prevention during pregnancy.

Systematic review of statistical methods for safety data in malaria chemoprevention in pregnancy trials

March 24, 2020 - 11:42 -- Open Access
Noel Patson, Mavuto Mukaka, Tobias Chirwa, et al.
Malaria Journal 2020 19:119, 20 March 2020

Drug safety assessments in clinical trials present unique analytical challenges. Some of these include adjusting for individual follow-up time, repeated measurements of multiple outcomes and missing data among others. Furthermore, pre-specifying appropriate analysis becomes difficult as some safety endpoints are unexpected. Although existing guidelines such as CONSORT encourage thorough reporting of adverse events (AEs) in clinical trials, they provide limited details for safety data analysis. The limited guidelines may influence suboptimal analysis by failing to account for some analysis challenges above. A typical example where such challenges exist are trials of anti-malarial drugs for malaria prevention during pregnancy. Lack of proper standardized evaluation of the safety of antimalarial drugs has limited the ability to draw conclusions about safety. Therefore, a systematic review was conducted to establish the current practice in statistical analysis for preventive antimalarial drug safety in pregnancy.


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