Pregnancy and malaria: the perfect storm.
Curr Opin Infect Dis
; 35(5): 410-416, 2022 10 01.
Article
in En
| MEDLINE
| ID: mdl-35916532
PURPOSE OF REVIEW: Malaria in pregnancy continues to exert a toll on pregnant women and their offspring. RECENT FINDINGS: The burden of Plasmodium falciparum infection is especially large in Africa, and new data show lasting effects of maternal infection on the infant's neurocognitive development. Elsewhere, P. vivax infection causes relapsing infections that are challenging to prevent. Infection in first trimester of pregnancy is an area of increasing focus, and its adverse effects on pregnancy outcome are increasingly recognised. First-trimester infection is common and frequently acquired prior to conception. Although newer rapid diagnostic tests still have limited sensitivity, they may be useful in detection of early pregnancy malaria for treatment. Artemisinin-based combination therapies are efficacious in later pregnancy but have yet to be recommended in first trimester because of limited safety data. In Africa, intermittent preventive treatment in pregnancy (IPTp) with monthly sulfadoxine-pyrimethamine improves pregnancy outcomes, but sulfadoxine-pyrimethamine resistance is worsening. The alternative, IPTp with dihydroartemisinin-piperaquine, has greater antimalarial efficacy, but does not appear to improve pregnancy outcomes, because sulfadoxine-pyrimethamine has poorly understood nonmalarial benefits on birthweight. SUMMARY: Novel IPTp regimens must be combined with interventions to strengthen protection from malaria infection acquired before and in early pregnancy.
Full text:
1
Collection:
01-internacional
Health context:
1_ASSA2030
/
2_ODS3
/
3_ND
Database:
MEDLINE
Main subject:
Malaria, Vivax
/
Malaria, Falciparum
/
Pregnancy Complications, Parasitic
/
Malaria
/
Antimalarials
Limits:
Female
/
Humans
/
Pregnancy
Language:
En
Journal:
Curr Opin Infect Dis
Year:
2022
Document type:
Article