| Parasitological efficacy of antimalarials in the treatment and prevention of falciparum malaria in pregnancy 1998 to 2009: a systematic review. | |
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MedLine Citation:
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PMID: 21159117 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Pregnant women are at increased risk from malaria. Resistance to all classes of antimalarials has affected the treatment and prevention of malaria in pregnancy. OBJECTIVES: To review the therapeutic efficacy of antimalarials used for treatment and intermittent preventive treatment (IPT) in pregnancy. SEARCH STRATEGY: We searched MEDLINE and the Cochrane Library between January 1998 and December 2009 for publications using the medical subject headings: efficacy, antimalarials, malaria, pregnancy, pharmacokinetics, treatment, IPT and placenta positive. In May 2010 we searched the register of clinical trials (http://clinicaltrials.gov/) and of WHO (http://apps.who.int/trialsearch/) using 'malaria', and 'pregnancy' and 'treatment'. SELECTION CRITERIA: We identified 233 abstracts, reviewed 83 full text articles and included 60 studies. DATA COLLECTION AND ANALYSIS: Two authors entered extracted data to an excel spreadsheet. MAIN RESULTS: Parasitological failure rates, placenta positivity rates (assessed by microscopy) or both were reported in 44% (21/48), 46% (22/48) and 10% (5/48) of articles, respectively. Most pharmacokinetic studies (9/12) suggested dose optimisation. In 23 treatment studies 17 different antimalarial drugs were delivered in 53 study arms; 43.4% (23/53) reported a failure rate of < 5%; 83.3% of sulphadoxine-pyrimethamine (SP) arms and 9% of artemisinin combination therapy (ACT) arms had failure rates ≥ 10%. Placenta-positive rates (mostly reported in the context of IPT in pregnancy) were > 10% in 68% (23/34) of SP trial arms and > 15% in all seven chloroquine arms. The ACT provided lower parasitological failure and gametocyte carriage rates. AUTHOR'S CONCLUSIONS: Drugs used in pregnancy should aim for 95% efficacy but many currently deployed regimens are associated with much lower cure rates. |
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Authors:
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R McGready; N J White; F Nosten |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 118 ISSN: 1471-0528 ISO Abbreviation: BJOG Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 123-35 Citation Subset: AIM; IM |
Copyright Information:
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© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology. |
Affiliation:
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Shoklo Malaria Research Unit, Tak, Thailand. rose@shoklo-unit.com |
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Descriptor/Qualifier:
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| Grant Support | |
ID/Acronym/Agency:
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//Wellcome Trust |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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