Adverse effects of falciparum and vivax malaria and the safety of antimalarial treatment in early pregnancy: a population-based study

McGready, Rose; Sj, Lee; Wiladphaingern, Jacher; Ashley, Elizabeth A.; Rijken, Marcus J.; Boel, Machteld E.; Simpson, Julie A; Paw, Moo Kho; Pimanpanarak, Mupawjay; Mu, Oh; Singhasivanon, Pratap; White, Nicholas J.; Nosten, François

doi:10.1016/s1473-3099(11)70339-5

Cited by 200 publications

(229 citation statements)

References 32 publications

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“…Additional sensitivity analyses were performed regarding stillbirths and miscarriages, which are likely to be associated with LBW but may also be related to malaria. 18 Concordant findings were found whether the birth weights The upper left entry in the table gives the P value of the main analysis. *Multiple outcome global comparison of mefloquine (MQ) with sulfadoxine-pyrimethamine (SP): 1) superiority of MQ to SP on at least low birth weight (LBW), placental malaria, and maternal anemia at delivery, 2) non-inferiority of MQ to SP on LBW, placental malaria, maternal anemia, and tolerability.…”

Section: Discussionmentioning

confidence: 88%

Mefloquine Versus Sulfadoxine–Pyrimethamine for Intermittent Preventive Treatment in Pregnancy: A Joint Analysis on Efficacy and Tolerability

Briand¹,

Escolano²,

Journot³

et al. 2015

The American Journal of Tropical Medicine and Hygiene

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Abstract. Since there is no ideal candidate to replace sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment (IPTp), alternatives need to be evaluated on basis of their benefit-risk ratio. We reanalyzed the first Beninese trial on mefloquine (MQ) versus SP for IPTp using a multiple outcome approach, which allowed the joint assessment of efficacy and tolerability. Overall superiority of MQ to SP was defined as superiority on at least one efficacy outcome (low birth weight [LBW], placental malaria, or maternal anemia), non-inferiority on all of them as well as on tolerability defined as cutaneous or neuropsychiatric adverse events (AEs) or low compliance with the treatment. The analysis included 1,601 women. MQ was found to be overall superior to SP (P = 0.004). Performing several sensitivity analyses to handle both missing data and stillbirths provided similar results. Using MQ for IPTp as an example, we show that a multiple outcome analysis is a pragmatic way to assess the benefits/disadvantages of one drug compared with another. In the current context of a lack of antimalarials that could be used for IPTp, such a statistical approach could be widely used by institutional policy makers for future recommendations regarding the prevention of malaria in pregnancy (MiP).

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Section: Discussionmentioning

confidence: 88%

Mefloquine Versus Sulfadoxine–Pyrimethamine for Intermittent Preventive Treatment in Pregnancy: A Joint Analysis on Efficacy and Tolerability

Briand¹,

Escolano²,

Journot³

et al. 2015

The American Journal of Tropical Medicine and Hygiene

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“…As for the dynamics of infection throughout pregnancy, no studies have addressed the issue. Recent reports supported the concept that detection and treatment of pregnant malaria during early gestation prevents miscarriage both in P. vivax and P. falciparum infections [31,43]. At delivery, placental infection by P. vivax has been confirmed both in cases from America and Asia [35,[45][46][47].…”

Section: Dynamics Of Gestational and Placental Malariamentioning

confidence: 85%

“…Regarding P. vivax infections during pregnancy, mortality is rarely seen, but there is association with multiple relapses, anemia, abortion, and a reduction in birth weight in pregnant women with malaria [11,[43][44][45]. Pregnant women are also more likely to experience relapses than non-pregnant ones [44].…”

Section: Dynamics Of Gestational and Placental Malariamentioning

confidence: 99%

Immune responses during gestational malaria: a review of the current knowledge and future trend of research

Maestre

Carmona‐Fonseca

2014

J Infect Dev Ctries

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Women pregnant with their first child are susceptible to severe P. falciparum disease from placental malaria because they lack immunity to placenta-specific cytoadherence proteins. In subsequent pregnancies, as immunity against placental parasites is acquired, there is a reduced risk of adverse effects of malaria on the mother and fetus and asymptomatic parasitaemia is common. In the case of vivax malaria, with increasing reports of severe cases in Asia and South America, the effects of infection by this species during pregnancy remain to be elucidated. This review summarized the main aspects involved in the acquisition of specific antimalarial immune responses during pregnancy with emphasis in research carried out in America and Asia, in order to offer a framework of interpretation for studies on pregnant women with malaria which are recently being produced in these regions. The authors conclude that (1) Effective humoral responses during gestational malaria are mainly directed against variant surface antigens codified by genes of the var2Csa family of P. falciparum; (2) Acquisition of immunity against these variant antigens depends on the degree and intensity of transmission, and the chance increases with age and successive pregnancies; (3) Antibody development is guided by specific cellular immune responses in cases of placental and maternal infection, and (4) The study of the significance of acquisition of specific immunity against both P. falciparum and P. vivax in America, should be performed.

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“…In endemic regions, this relapsing disease is responsible for substantial morbidity, mostly associated with recurrent bouts of fever, anaemia [3] and adverse pregnancy outcomes [4,5]. Plasmodium vivax is not generally regarded as sufficiently virulent to cause death.…”

Section: Introductionmentioning

confidence: 99%

Mortality attributable to Plasmodium vivax malaria: a clinical audit from Papua, Indonesia

Douglas

Pontororing²,

Lampah³

et al. 2014

BMC Medicine

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Background: Plasmodium vivax causes almost half of all malaria cases in Asia and is recognised as a significant cause of morbidity. In recent years it has been associated with severe and fatal disease. The extent to which P. vivax contributes to death is not known. Methods: To define the epidemiology of mortality attributable to vivax malaria in southern Papua, Indonesia, a retrospective clinical records-based audit was conducted of all deaths in patients with vivax malaria at a tertiary referral hospital. Results: Between January 2004 and September 2009, hospital surveillance identified 3,495 inpatients with P. vivax monoinfection and 65 (1.9%) patients who subsequently died. Charts for 54 of these 65 patients could be reviewed, 40 (74%) of whom had pure P. vivax infections on cross-checking. Using pre-defined conservative criteria, vivax malaria was the primary cause of death in 6 cases, a major contributor in 17 cases and a minor contributor in a further 13 cases. Extreme anaemia was the most common primary cause of death. Malnutrition, sepsis with respiratory and gastrointestinal manifestations, and chronic diseases were the commonest attributed causes of death for patients in the latter two categories. There were an estimated 293,763 cases of pure P. vivax infection in the community during the study period giving an overall minimum case fatality of 0.12 per 1,000 infections. The corresponding case fatality in hospitalised patients was 10.3 per 1,000 infections. Conclusions: Although uncommonly directly fatal, vivax malaria is an important indirect cause of death in southern Papua in patients with malnutrition, sepsis syndrome and chronic diseases, including HIV infection.

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Adverse effects of falciparum and vivax malaria and the safety of antimalarial treatment in early pregnancy: a population-based study

Cited by 200 publications

References 32 publications

Mefloquine Versus Sulfadoxine–Pyrimethamine for Intermittent Preventive Treatment in Pregnancy: A Joint Analysis on Efficacy and Tolerability

Mefloquine Versus Sulfadoxine–Pyrimethamine for Intermittent Preventive Treatment in Pregnancy: A Joint Analysis on Efficacy and Tolerability

Immune responses during gestational malaria: a review of the current knowledge and future trend of research

Mortality attributable to Plasmodium vivax malaria: a clinical audit from Papua, Indonesia

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