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Title: Treatment of uncomplicated and severe malaria during pregnancy
Authors: Umberto D'Alessandro
Jenny Hill
Joel Tarning
Christopher Pell
Jayne Webster
Julie Gutman
Esperanca Sevene
Universidade Eduardo Mondlane
Medical Research Council Laboratories Gambia
London School of Hygiene & Tropical Medicine
Centers for Disease Control and Prevention
Liverpool School of Tropical Medicine
Mahidol University
Nuffield Department of Clinical Medicine
University of Amsterdam
Amsterdam Institute for Global Health and Development
Manhiça Health Research Center (CISM)
Keywords: Medicine
Issue Date: 1-Apr-2018
Citation: The Lancet Infectious Diseases. Vol.18, No.4 (2018), e133-e146
Abstract: © 2018 Elsevier Ltd 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.
ISSN: 14744457
Appears in Collections:Scopus 2018

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