Safety of artemether-lumefantrine exposure in first trimester of pregnancy: an observational cohort

Mosha, Dominic; Mazuguni, Festo; Mrema, Sigilbert; Sevene, Esperança; Abdulla, Salim; Genton, Blaise

doi:10.1186/1475-2875-13-197

Cited by 33 publications

(50 citation statements)

References 19 publications

(25 reference statements)

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“…Although preclinical safety signals were seen in many experimental species, no overt increase in birth defects or early abortions have been seen with artemisinin use in humans. To establish that there was not a twofold increase in the risk of such an event, an analysis of some 800 reported inadvertent ACT exposures in first-trimester pregnancy was needed [39, 94, 95]. For any new medicine, it would usually be at least a decade after launch before such data were available, underlying the need for more investment in the post-registration safety monitoring in disease-endemic countries.…”

Section: Selecting Medicines For Use In Pregnancy and Small Childrenmentioning

confidence: 99%

New developments in anti-malarial target candidate and product profiles

Burrows

Duparc

Gutteridge

et al. 2017

Malar J

410

480

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A decade of discovery and development of new anti-malarial medicines has led to a renewed focus on malaria elimination and eradication. Changes in the way new anti-malarial drugs are discovered and developed have led to a dramatic increase in the number and diversity of new molecules presently in pre-clinical and early clinical development. The twin challenges faced can be summarized by multi-drug resistant malaria from the Greater Mekong Sub-region, and the need to provide simplified medicines. This review lists changes in anti-malarial target candidate and target product profiles over the last 4 years. As well as new medicines to treat disease and prevent transmission, there has been increased focus on the longer term goal of finding new medicines for chemoprotection, potentially with long-acting molecules, or parenteral formulations. Other gaps in the malaria armamentarium, such as drugs to treat severe malaria and endectocides (that kill mosquitoes which feed on people who have taken the drug), are defined here. Ultimately the elimination of malaria requires medicines that are safe and well-tolerated to be used in vulnerable populations: in pregnancy, especially the first trimester, and in those suffering from malnutrition or co-infection with other pathogens. These updates reflect the maturing of an understanding of the key challenges in producing the next generation of medicines to control, eliminate and ultimately eradicate malaria.

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Section: Selecting Medicines For Use In Pregnancy and Small Childrenmentioning

confidence: 99%

New developments in anti-malarial target candidate and product profiles

Burrows

Duparc

Gutteridge

et al. 2017

Malar J

410

480

View full text Add to dashboard Cite

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“…The studies were included from 11 East African countries. Nineteen studies were from Tanzania [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]…”

Section: Study Characteristicsmentioning

confidence: 99%

Determinants of preterm birth among mothers who gave birth in East Africa: systematic review and meta-analysis

Laelago¹,

Yohannes

Tsige

2020

Ital J Pediatr

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Background: Preterm birth (PTB) can be caused by different factors. The factors can be classified into different categories: socio demographic, obstetric, reproductive health, medical, behavioral and nutritional related. The objective of this review was identifying determinants of PTB among mothers who gave birth in East African countries. Methods: We have searched the following electronic bibliographic databases: PubMed, Google scholar, Cochrane library, AJOL (African journal online). Cross sectional, case control and cohort study published in English were included. There was no restriction on publication period. Studies with no abstracts and or full texts, editorials, and qualitative in design were excluded. Funnel plot was used to check publication bias. I-squared statistic was used to check heterogeneity. Pooled analysis was done by using fixed and random effect model. The Joanna Briggs Critical Appraisal Tools for review and meta-analysis was used to check the study quality. Results: A total of 58 studies with 134,801 participants were used to identify determinants of PTB. On pooled analysis, PTB was associated with age < 20 years (AOR 1.76, 95% CI: 1.33-2.32), birth interval less than 24 months (AOR 2.03, 95% CI 1.57-2.62), multiple pregnancy (AOR 3.44,95% CI: 3.02-3.91), < 4 antenatal care (ANC) visits (AOR 5.52, 95%

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“…These include extreme maternal age (<20 and >35 years), obesity, parity, history of miscarriage, history of preterm delivery, period on titis history of abortion, low social economic status and alcohol use, living in rural areas, use of herbal medicine, maternal anaemia, diabetes mellitus, shoulder dystocia, hypertension, premature rupture of membrane (PROM), untreated bacterial vaginosis, human immune deficiency virus infection (HIV) and Escherichia coli infection [3,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Preterm Birth among Women Who Delivered Preterm Babies at Bugando Medical Centre, Tanzania

Rugaimukam¹,

Mahande²,

Msuya³

et al. 2017

SOJGOW

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BackgroundPreterm birth is the leading cause of infant morbidity and mortality globally. Infants who are born preterm suffer long term health consequences. There only few studies done on risk factors for prematurity in Tanzania. This study aimed to determine the risk factors for preterm birth among women who delivered preterm babies at Bugando Medical Centre in Mwanza, Tanzania. MethodsA matched case-control study was conducted at the Bugando Medical Centre from May to June 2015. A total of 50 women with preterm birth (cases) were matched with 50 women who had term births (controls). Cases were matched with controls by date of delivery. We excluded mothers with multiple gestations and those who were sick and unsuitable for the interview. A structured questionnaire was used to collected relevant information from all participants. Data analysis was performed using SPSS version 20.0. Odds ratios with 95% confidence interval were estimated in a multivariate regression model to determine factors associated with preterm delivery. ResultsThe preterm birth rate was 13%. Numerous factors were associated with increased odds of preterm birth. These include regular menstrual cycle (OR 5.8; 95% CI: 2.3-14.9); planned abortion (OR 3.8; 95% CI: 1.1-13.1); use of fertility treatment during the index pregnancy (OR 7.0; 95% CI: 1.9-27.3); inadequate ANC visits (OR 9.0; 95% CI: 3.2-28.3); antepartum haemorrhage (OR 3.1 95% CI: 1.1-8.8); uterine pain during the index pregnancy (OR 5.0 95% CI: 1.7-14.4); urinary tract infections during the current pregnancy (OR 5.7 95% CI: 2.1-14.9); abnormal vaginal discharge in the current pregnancy (OR 7.4; 95% CI:2.6-20.7) and use of traditional medicine (OR 5.6; 95% CI: 2.1-14.9). The association between preterm birth and previous miscarriage, chronic hypertension, physical abuse during pregnancy and previous preterm birth disappeared after controlling for other covariates. ConclusionsThe rate of preterm birth in our study corresponds with the national prevalence. A number of maternal factors increase women likelihood of having preterm delivery. Early identification of these factors during prenatal care and provide with appropriate care may reduce the risk of preterm birth.

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Safety of artemether-lumefantrine exposure in first trimester of pregnancy: an observational cohort

Cited by 33 publications

References 19 publications

New developments in anti-malarial target candidate and product profiles

New developments in anti-malarial target candidate and product profiles

Determinants of preterm birth among mothers who gave birth in East Africa: systematic review and meta-analysis

Risk Factors for Preterm Birth among Women Who Delivered Preterm Babies at Bugando Medical Centre, Tanzania

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