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Treatment of uncomplicated and severe malaria during pregnancy.

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D'Alessandro, Umberto, Hill, Jenny ORCID: https://orcid.org/0000-0003-1588-485X, Tarning, Joel, Pell, Christopher, Webster, Jayne, Gutman, Julie and Sevene, Esperanca (2018) 'Treatment of uncomplicated and severe malaria during pregnancy.'. Lancet Infectious Diseases, Vol 18, Issue 4, e133-e146.

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Abstract

Over the past 10 years, the available evidence on the treatment of malaria during pregnancy has increased substantially. Owing to their relative ease of use, good sensitivity and specificity, histidine rich protein 2 based rapid diagnostic tests are appropriate for symptomatic pregnant women; however, such tests are less appropriate for systematic screening because they will not detect an important proportion of infections among asymptomatic women. The effect of pregnancy on the pharmacokinetics of antimalarial drugs varies greatly between studies and class of antimalarial drugs, emphasising the need for prospective studies in pregnant and non-pregnant women. For the treatment of malaria during the first trimester, international guidelines are being reviewed by WHO. For the second and third trimester of pregnancy, results from several trials have confirmed that artemisinin-based combination treatments are safe and efficacious, although tolerability and efficacy might vary by treatment. It is now essential to translate such evidence into policies and clinical practice that benefit pregnant women in countries where malaria is endemic. Access to parasitological diagnosis or appropriate antimalarial treatment remains low in many countries and regions. Therefore, there is a pressing need for research to identify quality improvement interventions targeting pregnant women and health providers. In addition, efficient and practical systems for pharmacovigilance are needed to further expand knowledge on the safety of antimalarial drugs, particularly in the first trimester of pregnancy. [Abstract copyright: Copyright © 2018 Elsevier Ltd. All rights reserved.]

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 770 Therapy
WQ Obstetrics > Pregnancy > WQ 200 General works
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1016/S1473-3099(18)30065-3
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 16 Feb 2018 16:57
Last Modified: 13 Apr 2018 13:54
URI: https://archive.lstmed.ac.uk/id/eprint/8242

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