TY - JOUR
T1 - The effect and control of malaria in pregnancy and lactating women in the Asia-Pacific region
AU - Unger, Holger W.
AU - Acharya, Sanjaya
AU - Arnold, Lachlan
AU - Wu, Connie
AU - Van Eijk, Anna
AU - Gore-Langton, Georgia R.
AU - ter Kuile, Feiko O.
AU - Lufele, Elvin
AU - Chico, R. Matthew
AU - Price, Ric N.
AU - Moore, Brioni R.
AU - Thriemer, Kamala
AU - Rogerson, Stephen J.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - Half of all pregnancies at risk of malaria worldwide occur in the Asia-Pacific region, where Plasmodium falciparum and Plasmodium vivax co-exist. Despite substantial reductions in transmission, malaria remains an important cause of adverse health outcomes for mothers and offspring, including pre-eclampsia. Malaria transmission is heterogeneous, and infections are commonly subpatent and asymptomatic. High-grade antimalarial resistance poses a formidable challenge to malaria control in pregnancy in the region. Intermittent preventive treatment in pregnancy reduces infection risk in meso-endemic New Guinea, whereas screen-and-treat strategies will require more sensitive point-of-care tests to control malaria in pregnancy. In the first trimester, artemether-lumefantrine is approved, and safety data are accumulating for other artemisinin-based combinations. Safety of novel antimalarials to treat artemisinin-resistant P falciparum during pregnancy, and of 8-aminoquinolines during lactation, needs to be established. A more systematic approach to the prevention of malaria in pregnancy in the Asia-Pacific is required.
AB - Half of all pregnancies at risk of malaria worldwide occur in the Asia-Pacific region, where Plasmodium falciparum and Plasmodium vivax co-exist. Despite substantial reductions in transmission, malaria remains an important cause of adverse health outcomes for mothers and offspring, including pre-eclampsia. Malaria transmission is heterogeneous, and infections are commonly subpatent and asymptomatic. High-grade antimalarial resistance poses a formidable challenge to malaria control in pregnancy in the region. Intermittent preventive treatment in pregnancy reduces infection risk in meso-endemic New Guinea, whereas screen-and-treat strategies will require more sensitive point-of-care tests to control malaria in pregnancy. In the first trimester, artemether-lumefantrine is approved, and safety data are accumulating for other artemisinin-based combinations. Safety of novel antimalarials to treat artemisinin-resistant P falciparum during pregnancy, and of 8-aminoquinolines during lactation, needs to be established. A more systematic approach to the prevention of malaria in pregnancy in the Asia-Pacific is required.
U2 - 10.1016/s2214-109x(23)00415-1
DO - 10.1016/s2214-109x(23)00415-1
M3 - Review article
SN - 2572-116X
VL - 11
SP - e1805-e1818
JO - The Lancet Global Health
JF - The Lancet Global Health
IS - 11
ER -
