Malaria in pregnancy: a call for a safe, efficient, and patient-centred approach to first-trimester treatment

Abstract

using ACTs in all trimesters may also have secondary safety implications if a simpler guideline means that women with severe malaria are not treated with inferior regimens of intravenous quinine. WHO's Malaria Policy Advisory Committee has recommended that guidelines for treatment of malaria in the first trimester of pregnancy be revised. 10 We strongly support this recommendation, and urge WHO to follow our position and thus reduce barriers to access to the best quality care for pregnant women.

Development of New Strategies for Malaria Chemoprophylaxis: From Monoclonal Antibodies to Long-Acting Injectable Drugs

“…As a result, the safety of almost all antimalarials in first-trimester pregnancy is simply unknown and typically the oldest drugs, quinine or mefloquine, are used in this category of patients which, as monotherapies, are not universally effective. In summary, there is an urgent need for safe and efficacious antimalarials for this early phase of pregnancy [38]., where the fetus is also most vulnerable to xenobiotics.…”

Pregnancy outcomes after first-trimester treatment with artemisinin derivatives versus non-artemisinin antimalarials: a systematic review and individual patient data meta-analysis

“…However, it did not change WHO treatment guidelines, which still recommend quinine-based regimens. 25 , 26 In 2021, WHO commissioned an update to the previous meta-analysis to assess whether ACTs should be reconsidered for the treatment of uncomplicated P falciparum malaria in the first trimester of pregnancy. This Article expands on the previous meta-analysis 23 by including all studies published or completed since 2015 and by doing an individual patient data (IPD) meta-analysis.…”