Management of Malaria in Pregnancy

Overview

Journal Indian J Med Res

Specialty General Medicine

Date 2018 Jan 23

PMID 29355138

Citations 20

Authors

Stephen J Rogerson

Affiliations

Soon will be listed here.

Abstract

Pregnant women are especially susceptible to malaria infection. Without existing immunity, severe malaria can develop requiring emergency treatment, and pregnancy loss is common. In semi-immune women, consequences of malaria for the mother include anaemia while stillbirth, premature delivery and foetal growth restriction affect the developing foetus. Preventive measures include insecticide-treated nets and (in some African settings) intermittent preventive treatment. Prompt management of maternal infection is key, using parenteral artemisinins for severe malaria, and artemisinin combination treatments (ACTs) in the second and third trimesters of pregnancy. ACTs may soon also be recommended as an alternative to quinine as a treatment in the first trimester of pregnancy. Monitoring the safety of antimalarials and understanding their pharmacokinetics is particularly important in pregnancy with the altered maternal physiology and the risks to the developing foetus. As increasing numbers of countries embrace malaria elimination as a goal, the special needs of the vulnerable group of pregnant women and their infants should not be overlooked.

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References

Pekyi D, Ampromfi A, Tinto H, Traore-Coulibaly M, Tahita M, Valea I . Four Artemisinin-Based Treatments in African Pregnant Women with Malaria. N Engl J Med. 2016; 374(10):913-27. DOI: 10.1056/NEJMoa1508606. View

Tegegne B, Getie S, Lemma W, Mohon A, Pillai D . Performance of loop-mediated isothermal amplification (LAMP) for the diagnosis of malaria among malaria suspected pregnant women in Northwest Ethiopia. Malar J. 2017; 16(1):34. PMC: 5244525. DOI: 10.1186/s12936-017-1692-4. View

Goncalves B, Walker P, Cairns M, Tiono A, Bousema T, Drakeley C . Pregnant Women: An Overlooked Asset to Plasmodium falciparum Malaria Elimination Campaigns?. Trends Parasitol. 2017; 33(7):510-518. DOI: 10.1016/j.pt.2017.03.001. View

. Malaria Policy Advisory Committee to the WHO: conclusions and recommendations of eighth biannual meeting (September 2015). Malar J. 2016; 15:117. PMC: 4766637. DOI: 10.1186/s12936-016-1169-x. View

Clark R . Animal Embryotoxicity Studies of Key Non-Artemisinin Antimalarials and Use in Women in the First Trimester. Birth Defects Res. 2017; 109(14):1075-1126. DOI: 10.1002/bdr2.1035. View

Russo G, Paganotti G, Soeria-Atmadja S, Haverkamp M, Ramogola-Masire D, Vullo V . Pharmacogenetics of non-nucleoside reverse transcriptase inhibitors (NNRTIs) in resource-limited settings: Influence on antiretroviral therapy response and concomitant anti-tubercular, antimalarial and contraceptive treatments. Infect Genet Evol. 2015; 37:192-207. DOI: 10.1016/j.meegid.2015.11.014. View

Desai M, Gutman J, Taylor S, Wiegand R, Khairallah C, Kayentao K . Impact of Sulfadoxine-Pyrimethamine Resistance on Effectiveness of Intermittent Preventive Therapy for Malaria in Pregnancy at Clearing Infections and Preventing Low Birth Weight. Clin Infect Dis. 2015; 62(3):323-333. PMC: 4762476. DOI: 10.1093/cid/civ881. View

Bardaji A, Martinez-Espinosa F, Arevalo-Herrera M, Padilla N, Kochar S, Ome-Kaius M . Burden and impact of Plasmodium vivax in pregnancy: A multi-centre prospective observational study. PLoS Negl Trop Dis. 2017; 11(6):e0005606. PMC: 5481034. DOI: 10.1371/journal.pntd.0005606. View

Taylor S, Madanitsa M, Thwai K, Khairallah C, Kalilani-Phiri L, van Eijk A . Minimal Impact by Antenatal Subpatent Plasmodium falciparum Infections on Delivery Outcomes in Malawian Women: A Cohort Study. J Infect Dis. 2017; 216(3):296-304. PMC: 5853861. DOI: 10.1093/infdis/jix304. View

10.

Kayentao K, Garner P, van Eijk A, Naidoo I, Roper C, Mulokozi A . Intermittent preventive therapy for malaria during pregnancy using 2 vs 3 or more doses of sulfadoxine-pyrimethamine and risk of low birth weight in Africa: systematic review and meta-analysis. JAMA. 2013; 309(6):594-604. PMC: 4669677. DOI: 10.1001/jama.2012.216231. View

11.

Umbers A, Unger H, Rosanas-Urgell A, Wangnapi R, Kattenberg J, Jally S . Accuracy of an HRP-2/panLDH rapid diagnostic test to detect peripheral and placental Plasmodium falciparum infection in Papua New Guinean women with anaemia or suspected malaria. Malar J. 2015; 14:412. PMC: 4617889. DOI: 10.1186/s12936-015-0927-5. View

12.

Williams J, Cairns M, Njie F, Quaye S, Awine T, Oduro A . The Performance of a Rapid Diagnostic Test in Detecting Malaria Infection in Pregnant Women and the Impact of Missed Infections. Clin Infect Dis. 2016; 62(7):837-844. PMC: 4787605. DOI: 10.1093/cid/civ1198. View

13.

Gonzalez R, Mombo-Ngoma G, Ouedraogo S, Kakolwa M, Abdulla S, Accrombessi M . Intermittent preventive treatment of malaria in pregnancy with mefloquine in HIV-negative women: a multicentre randomized controlled trial. PLoS Med. 2014; 11(9):e1001733. PMC: 4172436. DOI: 10.1371/journal.pmed.1001733. View

14.

Dellicour S, Sevene E, McGready R, Tinto H, Mosha D, Manyando C . First-trimester artemisinin derivatives and quinine treatments and the risk of adverse pregnancy outcomes in Africa and Asia: A meta-analysis of observational studies. PLoS Med. 2017; 14(5):e1002290. PMC: 5412992. DOI: 10.1371/journal.pmed.1002290. View

15.

Rijken M, McGready R, Boel M, Poespoprodjo R, Singh N, Syafruddin D . Malaria in pregnancy in the Asia-Pacific region. Lancet Infect Dis. 2011; 12(1):75-88. DOI: 10.1016/S1473-3099(11)70315-2. View

16.

Gonzalez R, Desai M, Macete E, Ouma P, Kakolwa M, Abdulla S . Intermittent preventive treatment of malaria in pregnancy with mefloquine in HIV-infected women receiving cotrimoxazole prophylaxis: a multicenter randomized placebo-controlled trial. PLoS Med. 2014; 11(9):e1001735. PMC: 4172537. DOI: 10.1371/journal.pmed.1001735. View

17.

Rogerson S, Unger H . Prevention and control of malaria in pregnancy - new threats, new opportunities?. Expert Rev Anti Infect Ther. 2016; 15(4):361-375. DOI: 10.1080/14787210.2017.1272411. View

18.

Britton S, Cheng Q, McCarthy J . Novel molecular diagnostic tools for malaria elimination: a review of options from the point of view of high-throughput and applicability in resource limited settings. Malar J. 2016; 15:88. PMC: 4754967. DOI: 10.1186/s12936-016-1158-0. View

19.

Grigg M, William T, Menon J, Dhanaraj P, Barber B, Wilkes C . Artesunate-mefloquine versus chloroquine for treatment of uncomplicated Plasmodium knowlesi malaria in Malaysia (ACT KNOW): an open-label, randomised controlled trial. Lancet Infect Dis. 2015; 16(2):180-188. PMC: 4753673. DOI: 10.1016/S1473-3099(15)00415-6. View

20.

Ndam N, Denoeud-Ndam L, Doritchamou J, Viwami F, Salanti A, Nielsen M . Protective Antibodies against Placental Malaria and Poor Outcomes during Pregnancy, Benin. Emerg Infect Dis. 2015; 21(5):813-23. PMC: 4412227. DOI: 10.3201/eid2105.141626. View