Publication: Artemisinin antimalarials in pregnancy: A prospective treatment study of 539 episodes of multidrug-resistant Plasmodium falciparum
Issued Date
2001-12-15
Resource Type
ISSN
10584838
DOI
Other identifier(s)
2-s2.0-0035893146
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinical Infectious Diseases. Vol.33, No.12 (2001), 2009-2016
Suggested Citation
Rose McGready, Thein Cho, Napaporn Khan Keo, Kyaw Lay Kyaw Lay Thwai, Leopoldo Villegas, Sornchai Looareesuwan, Nicholas J. White, François Nosten Artemisinin antimalarials in pregnancy: A prospective treatment study of 539 episodes of multidrug-resistant Plasmodium falciparum. Clinical Infectious Diseases. Vol.33, No.12 (2001), 2009-2016. doi:10.1086/324349 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/26608
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Title
Artemisinin antimalarials in pregnancy: A prospective treatment study of 539 episodes of multidrug-resistant Plasmodium falciparum
Abstract
The emergence and spread of multidrug-resistant Plasmodium falciparum compromises the treatment of malaria, especially during pregnancy, where the choice of antimalarials is already limited. Artesunate (n = 528) or artemether (n = 11) was used to treat 539 episodes of acute P. falciparum malaria in 461 pregnant women, including 44 first-trimester episodes. Most patients (310 [57.5%]) received re-treatments after earlier treatment with quinine or mefloquine. By use of survival analysis, the cumulative artemisinin failure rate for primary infections was 6.6% (95% confidence interval, 1.0-12.3), compared with the re-treatment failure rate of 21.7% (95% confidence interval, 15.4-28.0; P = .004). The artemisinins were well tolerated with no evidence of adverse effects. Birth outcomes did not differ significantly to community rates for abortion, stillbirth, congenital abnormality, and mean gestation at delivery. These results are reassuring, but further information about the safety of these valuable antimalarials in pregnancy is needed.