Evaluación de la eficacia y seguridad de la monoterapia con cloroquina para tratar malaria gestacional aguda no complicada debida P. vivax, Córdoba, Colombia, 2015-2017

Castro-Cavadía, Carlos; Carmona‐Fonseca, Jaime

doi:10.18597/rcog.3370

Cited by 5 publications

(2 citation statements)

References 36 publications

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“…As radical cure with primaquine cannot be given in pregnancy, the efficacy reported here is a composite of blood stage cure and relapse suppression. P. vivax recurrence was very common in this study, as in Colombia where 30% of women experienced recurrences within 120 days after chloroquine treatment [ 34 ]. Recurrent vivax malaria was by far the main complication of malaria in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial of dihydroartemisinin-piperaquine, artesunate-mefloquine and extended artemether-lumefantrine treatments for malaria in pregnancy on the Thailand-Myanmar border

Saito

Carrara

Gilder

et al. 2021

BMC Med

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Background Artemisinin and artemisinin-based combination therapy (ACT) partner drug resistance in Plasmodium falciparum have spread across the Greater Mekong Subregion compromising antimalarial treatment. The current 3-day artemether-lumefantrine regimen has been associated with high treatment failure rates in pregnant women. Although ACTs are recommended for treating Plasmodium vivax malaria, no clinical trials in pregnancy have been reported. Methods Pregnant women with uncomplicated malaria on the Thailand-Myanmar border participated in an open-label randomized controlled trial comparing dihydroartemisinin-piperaquine (DP), artesunate-mefloquine (ASMQ) and a 4-day artemether-lumefantrine regimen (AL+). The primary endpoint for P. falciparum infections was the PCR-corrected cure rate and for P. vivax infections was recurrent parasitaemia, before delivery or day 63, whichever was longer, assessed by Kaplan-Meier estimate. Results Between February 2010 and August 2016, 511 pregnant women with malaria (353 P. vivax, 142 P. falciparum, 15 co-infections, 1 Plasmodium malariae) were randomized to either DP (n=170), ASMQ (n=169) or AL+ (n=172) treatments. Successful malaria elimination efforts in the region resulted in premature termination of the trial. The majority of women had recurrent malaria (mainly P. vivax relapses, which are not prevented by these treatments). Recurrence-free proportions (95% confidence interval [95% CI]) for vivax malaria were 20.6% (5.1–43.4) for DP (n=125), 46.0% (30.9–60.0) for ASMQ (n=117) and 28.7% (10.0–50.8) for AL+ (n=126). DP and ASMQ provided longer recurrence-free intervals. PCR-corrected cure rates (95% CI) for falciparum malaria were 93.7% (81.6–97.9) for DP (n=49), 79.6% (66.1–88.1) for AMSQ (n=55) and 87.5% (74.3–94.2) for AL+ (n=50). Overall 65% (85/130) of P. falciparum infections had Pfkelch13 propeller mutations which increased over time and recrudescence occurred almost exclusively in them; risk ratio 9.42 (95% CI 1.30–68.29). Among the women with falciparum malaria, 24.0% (95% CI 16.8–33.6) had P. vivax parasitaemia within 4 months. Nausea, vomiting, dizziness and sleep disturbance were more frequent with ASMQ. Miscarriage, small-for-gestational-age and preterm birth did not differ significantly among the treatment groups, including first trimester exposures (n=46). Conclusions DP was well tolerated and safe, and was the only drug providing satisfactory efficacy for P. falciparum-infected pregnant woman in this area of widespread artemisinin resistance. Vivax malaria recurrences are very common and warrant chloroquine prophylaxis after antimalarial treatment in this area. Trial registration ClinicalTrials.gov identifier NCT01054248, registered on 22 January 2010.

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Section: Discussionmentioning

confidence: 99%

A randomized controlled trial of dihydroartemisinin-piperaquine, artesunate-mefloquine and extended artemether-lumefantrine treatments for malaria in pregnancy on the Thailand-Myanmar border

Saito

Carrara

Gilder

et al. 2021

BMC Med

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“…No obstante, sí se le puede indicar a las puérperas con dosis de 15 mg/día por 14 días, cuando la infección malárica es por P. vivax. Mientras que, en la malaria grave, el tratamiento de elección es el artesunato por vía parenteral, en dosis máxima (21,78,84,95,96).…”

Section: Prevención Y Tratamientounclassified

Malaria asociada al embarazo: revisión narrativa

Núñez-Troconis¹,

Ruiz²,

Núñez³

2023

RSOGV

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Malaria infections increase the risk of complications in the mother-fetus binomial. In Venezuela, the casuistry of this vulnerable group has not been updated in recent years. The objective of this narrative review was to comprehensively describe what pregnancy-associated malaria is and its maternal, fetal and neonatal effects; trying to answer the following research question. All forms of pregnancy-associated malaria, including gestational, placental and congenital malaria, cause maternal-fetal and neonatal alterations that, if they progress, could lead to the death of this binomial. Physiopathology and immunopathology can explain the symptoms of pregnant women and the fetus, as well as their complications; depending on the parasitic form affecting. There are new updates in the diagnosis, prevention and treatment of this entity.

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Malaria and pregnancy: a Venezuelan approach. Review article

Ruiz¹,

Núñez²,

Martín-Castelli³

et al. 2022

OGIJ

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Aim: to review and describe exhaustively the implications of malaria in pregnancy, including its maternal, fetal, and neonatal clinical manifestations and effects; immunopathology and pathophysiology; advancements in its diagnostics, histopathology, and treatment options; and epidemiology, particularly in Venezuela, a country where its data is almost non-existent. Methods: the information used to write this manuscript was obtained during a three-month period, between June and September 2022, from specialized literature, written in English and Spanish, related to malaria associated with pregnancy, mainly published during the last five years, using journals found in the most relevant medical digital archives, including PubMed, SciELO, Elsevier, Google Scholar, Latindex, and Cochrane Plus. Among the keywords used for obtaining this updated information were malaria; malaria in pregnancy; gestational malaria; placental malaria; congenital malaria. Results: all the clinical forms related to malaria in pregnancy, including gestational, placental, and congenital malaria, can cause maternal-fetal alterations, that, in case of progressing, could lead to the death of this binomial. Their pathophysiology and immunopathology can explain the gestational and fetal symptomatology, as well as their complications, depending on the parasite form that affected them. There are new updates regarding the diagnostics, prevention, and treatment of this medical entity. Conclusion: it is imperative to exalt the relevance of studying this disease in pregnant patients, especially in the Venezuelan topography, a focus of infection with a plethora of cases of said entity, whose lack of updated epidemiological data, regarding its prevalence and incidence, is profoundly preoccupying. Pregnant patients are not only one of the most vulnerable risk groups of this parasitosis, but also have the capacity of duplicating the risk of infecting the fetus.

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Evaluación de la eficacia y seguridad de la monoterapia con cloroquina para tratar malaria gestacional aguda no complicada debida P. vivax, Córdoba, Colombia, 2015-2017

Cited by 5 publications

References 36 publications

A randomized controlled trial of dihydroartemisinin-piperaquine, artesunate-mefloquine and extended artemether-lumefantrine treatments for malaria in pregnancy on the Thailand-Myanmar border

A randomized controlled trial of dihydroartemisinin-piperaquine, artesunate-mefloquine and extended artemether-lumefantrine treatments for malaria in pregnancy on the Thailand-Myanmar border

Malaria asociada al embarazo: revisión narrativa

Malaria and pregnancy: a Venezuelan approach. Review article

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