Options for Treatment and Control of Malaria in Pregnancy in Zambia

Datum: 4 april 2014

Locatie: University of Antwerp - Promotiezaal - Universiteitsplein 1 - 2610 Wilrijk

Tijdstip: 17.30 - 20.30 uur

Organisatie / co-organisatie: International Health Unit

Promovendus: Christine Manyando

Promotor: Prof J.-P. Van geertruyden

Co-promotor: Prof B. Colebunders, Dr M. Mulenga

Korte beschrijving: PhD defense Christine Manyando - Faculty of Medicine and Health Sciences





Abstract

The use of AL for the treatment of malaria in pregnancy (including the first trimester)
Exposure to AL in pregnancy, including first trimester, is probably not associated with particular safety risks in terms of perinatal mortality (stillbirths and neonatal deaths), preterm deliveries, and low birth weights. Infant neurodevelopmental assessments up to 12 months were also similar. The adverse effects of P. falciparum malaria in the first trimester substantially outweigh any adverse effects of its treatment.

Use of CTX for malaria treatment and prophylaxis
CTX has been extensively used worldwide for half a century as an antimicrobial agent, including in malaria endemic countries. Despite its known antimalarial properties, it has been ignored for this purpose. Its long term use for prophylaxis of opportunistic infections in HIV infected children and adults indicated that CTX can prevent and treat malaria. However, from the global review, there was no information on its use in pregnancy, irrespective of HIV status. The information gathered from a randomized clinical trial revealed that exposure to CTX during the latter part of pregnancy may not be associated with increased safety risks. However, in light of increasing parasite resistance to SP, the only available drug for IPTp, there is the need of exploring further the safety, efficacy and effectiveness of daily CTX and the role it may have in preventing malaria during pregnancy in both HIV infected and uninfected women. 



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