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Artemisinin-Based Combination Therapy Versus Quinine or Other Combinations for Treatment of Uncomplicated Plasmodium falciparum Malaria in the Second and Third Trimester of Pregnancy: A Systematic Review and Meta-Analysis

Burger, Renee J., vanEijk, Anna ORCID: https://orcid.org/0000-0003-1635-1289, Bussink, Milena, Hill, Jenny ORCID: https://orcid.org/0000-0003-1588-485X and terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617 (2016) 'Artemisinin-Based Combination Therapy Versus Quinine or Other Combinations for Treatment of Uncomplicated Plasmodium falciparum Malaria in the Second and Third Trimester of Pregnancy: A Systematic Review and Meta-Analysis'. Open Forum Infectious Diseases, Vol 3, Issue 1.

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Abstract

The World Health Organization recommends artemisinin-based combination therapies (ACTs) for the treatment of uncomplicated falciparum malaria in the second and third trimesters of pregnancy. We conducted a meta-analysis to compare efficacy, safety and tolerability of ACTs versus quinine and other non-ACT antimalarials. The median PCR-adjusted failure rate by days 28 to 63 in the non-ACT group was 6 (range 0–37) per 100 women, lower in the ACT group overall (pooled risk ratio [PRR] random effects, 0.41; 95% confidence interval [CI], 0.16–1.05; 6 trials), and significantly lower compared with oral quinine (PRR, 0.20; 95% CI, 0.08–0.49; 4 trials). There were no differences in fetal deaths and congenital abnormalities. Compared with quinine, artemisinin-based combinations therapies were associated with less tinnitus (PRR, 0.19; 95% CI, 0.03–1.11; 4 studies), dizziness (PRR, 0.64; 95% CI, 0.44–0.93; 3 trials), and vomiting (PRR, 0.33; 95% CI, 0.15–0.73; 3 trials). Artemisinin-based combination therapies are better than quinine in the second and third trimesters; their use should be encouraged among health workers.

Item Type: Article
Uncontrolled Keywords: Treatment; Artemisinins; Malaria; Pregnancy; Quinine
Subjects: WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 770 Therapy
WQ Obstetrics > Pregnancy Complications > WQ 256 Infectious diseases
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1093/ofid/ofv170
Depositing User: Jacqueline Pearce
Date Deposited: 22 Jan 2016 12:15
Last Modified: 16 Aug 2019 13:40
URI: https://archive.lstmed.ac.uk/id/eprint/5528

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