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pregnancy

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
Author(s): 
Olaleye AO, Walker O
Reference: 
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
Author(s): 
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
Reference: 
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
Author(s): 
D'Alessandro S, Menegola E, Parapini S, Taramelli D, Basilico N
Reference: 
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
Author(s): 
Salman S, Davis TME, Moore B
Reference: 
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
Author(s): 
González R, Pons-Duran C, Bardají A, Leke RGF, Clark R, Menendez C
Reference: 
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
Author(s): 
Saito M, Mansoor R, Guérin PJ, et al.
Reference: 
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
Author(s): 
Park S, Nixon CE, Miller O, Choi NK, Kurtis JD, Friedman JF, Michelow IC
Reference: 
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
Author(s): 
Balami AD, Said SM, Zulkefli NM, Bachok N, Audu BM
Reference: 
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
Author(s): 
Noel Patson, Mavuto Mukaka, Tobias Chirwa, et al.
Reference: 
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.

Why is WHO failing women with falciparum malaria in the first trimester of pregnancy?

March 17, 2020 - 12:53 -- Open Access
Author(s): 
McGready R, Nosten F, Barnes KI, Mokuolu O, White NJ
Reference: 
Lancet. 2020 Mar 7;395(10226):779

In the opening to WHO's World Malaria Report 2019, subtitled Leaving no one behind in the march to a malaria-free world, WHO's Director-General Tedros Adhanom Ghebreyesus noted that the scourge of malaria continues to strike hardest against pregnant women and children in Africa. The Director-General reported that “some 11 million pregnant women in sub-Saharan Africa were infected with malaria and, consequently, nearly 900 000 children were born with a low birthweight”. Furthermore, he noted that “Malaria in pregnancy compromises the mother's health and puts her at greater risk of death. It impacts the health of the fetus, leading to prematurity and low birthweight, major contributors to neonatal and infant mortality.”

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