• Michael Nambozi
  • Halidou Tinto
  • Victor Mwapasa
  • Harry Tagbor
  • Jean-Bertin Bukasa Kabuya
  • Sebastian Hachizovu
  • Maminata Traoré
  • Innocent Valea
  • Marc Christian Tahita
  • Gifty Ampofo
  • Jozefien Buyze
  • Raffaella Ravinetto
  • Diana Arango
  • Kamala Thriemer
  • Modest Mulenga
  • Jean-Pierre van Geertruyden
  • Umberto D'Alessandro

BACKGROUND: The World Health Organization (WHO) recommendation of treating uncomplicated malaria during the second and third trimester of pregnancy with an artemisinin-based combination therapy (ACT) has already been implemented by all sub-Saharan African countries. However, there is limited knowledge on the effect of ACT on pregnancy outcomes, and on newborn and infant's health.

METHODS: Pregnant women with malaria in four countries (Burkina Faso, Ghana, Malawi and Zambia) were treated with either artemether-lumefantrine (AL), amodiaquine-artesunate (ASAQ), mefloquine-artesunate (MQAS), or dihydroartemisinin-piperaquine (DHA-PQ); 3127 live new-borns (822 in the AL, 775 in the ASAQ, 765 in the MQAS and 765 in the DHAPQ arms) were followed-up until their first birthday.

RESULTS: Prevalence of placental malaria and low birth weight were 28.0% (738/2646) and 16.0% (480/2999), respectively, with no significant differences between treatment arms. No differences in congenital malformations (p = 0.35), perinatal mortality (p = 0.77), neonatal mortality (p = 0.21), and infant mortality (p = 0.96) were found.

CONCLUSIONS: Outcome of pregnancy and infant survival were similar between treatment arms indicating that any of the four artemisinin-based combinations could be safely used during the second and third trimester of pregnancy without any adverse effect on the baby. Nevertheless, smaller safety differences between artemisinin-based combinations cannot be excluded; country-wide post-marketing surveillance would be very helpful to confirm such findings. Trial registration ClinicalTrials.gov, NCT00852423, Registered on 27 February 2009, https://clinicaltrials.gov/ct2/show/NCT00852423.

Original languageEnglish
Article number105
JournalMalaria Journal
Volume18
Issue number1
Number of pages8
ISSN1475-2875
DOIs
Publication statusPublished - 2019

Bibliographical note

CPDF; CINTEXT

    Research areas

  • ARTESUNATE, BURDEN, DIHYDROARTEMISININ-PIPERAQUINE, FALCIPARUM-MALARIA, INTERMITTENT PREVENTIVE TREATMENT, MEFLOQUINE, OPEN-LABEL, QUININE, SULFADOXINE-PYRIMETHAMINE, WOMEN

ID: 2894312