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