Malaria In Pregnant Women Research Articles

A cross-sectional study of risk factors associated with malaria diseases in pregnant women attending a state hospital Iwo Osun State, Southwest Nigeria

BackgroundMalaria disease has been a public health issue in pregnancy, posing a risk to the mother, foetus, and newborn. Risk factors for malaria disease play a significant role in evaluating any program to prevent malaria in pregnant women. The purpose of this study was to determine the possible risk factors for malaria disease in pregnant women at the State Hospital Iwo Osun State, Southwest Nigeria. ResultsIt was a cross-sectional, facility-based study. Two hundred and eighty-four (284) pregnant women showing up at the antenatal care for the first time during their present pregnancy from April to August 2018 were enlisted in this study. Blood samples were tested for malaria parasite using microscopy. Multiple logistic regression analysis was used to compare factors associated with malaria in pregnant women. The number of malaria cases was 53 (18.7%). Those that did not sleep under insecticides-treated nets were 202 (71.4%). About, 130 (46.3%) believe that bad water transmits malaria infection. There was no correlation between insecticides treated nets (ITNs) and education level (p = 0.727), with more malaria positive results in those who did not sleep with ITNs, 40 (75.5%). No association between knowledge on the cause of malaria diseases and the education level (p = 0.450). The participants in the different levels of education reported that malaria was transmitted by mosquitoes, sun and drinking bad water. Drinking bad water was reported most by 76(58.5%) and 37(28.5%) of those in secondary and tertiary education, respectively to transmit malaria. Age <= 25 years (OR =2.054, C.I. = 1.118 - 3.772, p = 0.019) and education below tertiary level (OR =2.704, C.I. = 1.214 - 6.024, p = 0.012) were reported to be significantly associated with risk factor to malaria infection in pregnant women. ConclusionThis study revealed that malaria is still a public health issue and risk factors such as; maternal age of 25 years or less and educational class less than tertiary education may be contributing to increase in prevalence of malaria among pregnant women in this study.

Molecular Markers of Sulfadoxine-Pyrimethamine Resistance in Samples from Children with Uncomplicated Plasmodium falciparum at Three Sites in Angola in 2019.

Sulfadoxine-pyrimethamine (SP) is used for prevention of malaria in pregnant women in Angola. We sequenced the Plasmodium falciparum dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps) genes, implicated in SP resistance, in samples collected during a 2019 study of artemisinin-based combination therapy efficacy in Benguela, Lunda Sul, and Zaire provinces. A total of 90 day 0 and day of failure samples were individually sequenced, while 508 day 0 samples from participants without recurrent parasitemia were pooled after DNA extraction into 61 pools. The N51I, C59R, and S108N pfdhfr mutations and A437G pfdhps mutations were present at high proportions in all provinces (weighted allele frequencies, 62% to 100%). The K540E pfdhps mutation was present at lower proportions (10% to 14%). The A581G pfdhps mutation was only observed in Zaire, at a 4.6% estimated prevalence. The I431V and A613S mutations were also only observed in Zaire, at a prevalence of 2.8% to 2.9%. The most common (27% to 66%) reconstructed haplotype in all three provinces was the canonical quadruple pfdhfr pfdhps mutant. The canonical quintuple mutant was absent in Lunda Sul and Benguela and present in 7.9% of samples in Zaire. A single canonical sextuple (2.6%) mutant was observed in Zaire Province. Proportions of the pfdhps K540E and A581G mutations were well below the World Health Organization thresholds for meaningful SP resistance (prevalence of 95% for K540E and 10% for A581G). Samples from therapeutic efficacy studies represent a convenient source of samples for monitoring SP resistance markers.

Lingkungan Rumah Berhubungan dengan Malaria pada Ibu Hamil

This study aims to determine the relationship between the home environment and malaria in pregnant women. The method used in this study is a quantitative study with a cross-sectional approach. The results showed that more pregnant women had malaria as much as 65.2%, there were standing water as much as 50.0%, there were bushes as much as 54.3%, they did not use wire netting as much as 52.2%, they did not use ceilings as much as 60.9% and not using tight walls as much as 56.5%. In conclusion, a significant relationship exists between the home environment and malaria in pregnant women.&#x0D; &#x0D; Keywords: Pregnant Women, Home Environment, Malaria

Erratum for Banda et al., "Impact of Dolutegravir-Based Antiretroviral Therapy on Piperaquine Exposure following Dihydroartemisinin-Piperaquine Intermittent Preventive Treatment of Malaria in Pregnant Women Living with HIV".

Volume 66, no. 12, e00584-22, 2022, https://doi.org/10.1128/aac.00584-22. In Fig. 2 and Fig. S1, the first value on the y axis previously read as “0” instead of “1.” The corrected Fig. 2 is shown below. Additionally, revised supplemental material is included with this Erratum. There are no changes to the text or figure legend.

Global Analysis of Plasmodium falciparum Dihydropteroate Synthase Variants Associated with Sulfadoxine Resistance Reveals Variant Distribution and Mechanisms of Resistance: A Computational-Based Study.

The continual rise in sulfadoxine (SDX) resistance affects the therapeutic efficacy of sulfadoxine-pyrimethamine; therefore, careful monitoring will help guide its prolonged usage. Mutations in Plasmodium falciparum dihydropteroate synthase (Pfdhps) are being surveilled, based on their link with SDX resistance. However, there is a lack of continuous analyses and data on the potential effect of molecular markers on the Pfdhps structure and function. This study explored single-nucleotide polymorphisms (SNPs) in Pfdhps that were isolated in Africa and other countries, highlighting the regional distribution and its link with structure. In total, 6336 genomic sequences from 13 countries were subjected to SNPs, haplotypes, and structure-based analyses. The SNP analysis revealed that the key SDX resistance marker, A437G, was nearing fixation in all countries, peaking in Malawi. The mutation A613S was rare except in isolates from the Democratic Republic of Congo and Malawi. Molecular docking revealed a general loss of interactions when comparing mutant proteins to the wild-type protein. During MD simulations, SDX was released from the active site in mutants A581G and A613S before the end of run-time, whereas an unstable binding of SDX to mutant A613S and haplotype A437A/A581G/A613S was observed. Conformational changes in mutant A581G and the haplotypes A581G/A613S, A437G/A581G, and A437G/A581G/A613S were seen. The radius of gyration revealed an unfolding behavior for the A613S, K540E/A581G, and A437G/A581G systems. Overall, tracking such mutations by the continuous analysis of Pfdhps SNPs is encouraged. SNPs on the Pfdhps structure may cause protein-drug function loss, which could affect the applicability of SDX in preventing malaria in pregnant women and children.

219. A Randomized, Double-Masked, Placebo-Controlled Phase IIB Trial of Azithromycin and Trimethoprim-Sulfamethoxazole as Bacterial STI Prophylaxis in Pregnant Women with HIV

Abstract Background This phase IIB randomized clinical trial was designed to test the efficacy of a novel regimen to prevent bacterial sexually transmitted infections and malaria in pregnant women with HIV in Cameroon, where HIV prevalence in pregnancy is 5.7%. Here we present the analysis of STI rates. Methods Pregnant women in prenatal care with confirmed HIV, gestational age &amp;lt; 28 weeks and singleton pregnancies were randomized to monthly azithromycin (AZ) 1 gram daily for 3 days and daily trimethoprim-sulfamethoxazole (TMPS) or the standard regimen of daily TMPS with monthly placebo AZ. The main outcome of interest was the proportion of women with a composite STI measure: chlamydia, gonorrhea and/or incident syphilis at delivery. Nucleic acid amplification testing (NAAT) for CT/NG was performed on provider-collected vaginal swabs. Incident syphilis was defined serologically as a newly positive treponemal test or 4 fold increase in RPR/VDRL titer since baseline. The proportion was compared by relative risk with 95% confidence intervals and a significant p value set at &amp;lt; 0.05. Results A total of 308 women were enrolled at three hospital facilities between March 2018 and August 2020. In all, 155 women were randomized to the AZ/TMPS arm and 153 women to the TMPS arm. A total of 260 women (84%) had delivery samples collected. Both groups were similar with median age 32 years, maternal education (71% secondary school or university), HIV diagnosis 3 years prior, and 94% reported excellent adherence to antiretroviral therapy (ART). Median CD4 count was 473 cells/mm3 (IQR 326-663). At baseline, prevalence of chlamydia was 1.4%, gonorrhea 1.0% and syphilis 1.9%. There was no difference in the proportion of women with the composite STI measure (3.2% in the AZ/TMPS arm and 3.3% in the TMPS arm; RR 0.78 (95% CI 0.21 – 2.84); p=0.70). Adverse birth outcomes were lower in the AZ/TMPS arm, but not significantly (preterm delivery 5% vs 10.3% [p=0.1], low birthweight 2.8% vs 5.1% [p=0.34], composite adverse birth outcome 8.4% vs 13.1% [p=0.19]. Table 1:Baseline Characteristics of Study Participants (n=308)Table 2:Efficacy Outcomes at Delivery by Arm - Intention to Treat Analysis (n= 278) Conclusion The addition of monthly azithromycin to standard daily TMPS prophylaxis in pregnant women living with HIV in Cameroon did not reduce the rate of bacterial STI at delivery. Women reported excellent ART adherence and rates of STI, malaria, and adverse birth outcome were low. Disclosures Katia J. Bruxvoort, PhD, MPH, Dynavax: Grant/Research Support|Gilead: Grant/Research Support|Glaxosmithkline: Grant/Research Support|Moderna: Grant/Research Support|Pfizer: Grant/Research Support|Seqirus: Grant/Research Support.

Comparison of intermittent screening (using ultra-sensitive malaria rapid diagnostic test) and treatment (using a newly registered antimalarial pyronaridine-artesunate—PYRAMAX®) to standard intermittent preventive treatment with sulfadoxine-pyrimethamine for the prevention of malaria in pregnant women living in endemic areas: ULTRAPYRAPREG

BackgroundIntermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is an important malaria control strategy in sub-Saharan Africa. Indeed, it overcomes the risk of misdiagnosis due to low peripheral parasitemia during pregnancy by treating women with SP on predetermined schedules. However, over time, the spread of Plasmodium-resistant strains has threatened this strategy in many countries. As an alternative, the intermittent screening and treatment for pregnancy (ISTp) aims at a monthly screening of pregnant women, preferably by using very sensitive tests such as ultrasensitive rapid diagnostic tests (us-RDTs) and the treatment of positive cases with artemisinin-based combination therapy (ACT) regardless of the presence of symptoms. Unlike IPTp-SP, ISTp prevents overuse of antimalarials limiting the drug pressure on parasites, an advantage which can be potentiated by using an ACT like pyronaridine-artesunate (Pyramax®) that is not yet used in pregnant women in the field.MethodsThis study aims to compare the non-inferiority of ISTp using us-RDTs and Pyramax® versus IPTp-SP on malaria in pregnancy through a randomized clinical trial performed in Kisenso, Kinshasa, the Democratic Republic of the Congo, a malaria perennial transmission area.DiscussionThe results will be essential for the National Malaria Control Program to update the malaria prevention policy in pregnant women in the Democratic Republic of the Congo.Trial registrationClinicalTrials.gov NCT04783051

Prevalence and Risk Factors of Malaria among Pregnant Women receiving Antenatal Care in a Health Facility in Delta State, Southern Nigeria

Background: Malaria is one of the major causes of morbidity and mortality in developing countries including Nigeria. Malaria in pregnancy is estimated to cause about 15% of maternal deaths globally, accounting for over 10,000 maternal and 200,000 neonatal deaths annually. This study determined the prevalence and risk factors of malaria infection among pregnant women receiving antenatal care in a health facility in Delta State. Methods: This was a facility-based cross-sectional study carried out among 418 pregnant women who were selected by systematic sampling technique. Clinical malaria was confirmed using microscopy method (Giemsa staining technique) while a pre-tested, structured, interviewer administered questionnaire was used to collect information on soscio-demographic characteristics and obstetrics history of the respondents. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0 and the level of statistical significance was set at p&lt; 0.05. Results: The mean age of the participants was 29.9 ± 5.7 years. Two hundred and sixty three (62.9%) pregnant women tested positive for malaria. Respondents who were pregnant for the second time (AOR = 0.521, 95% CI: 0.28 – 0.99, p = 0.045) and those from a family size of 1-6 (AOR = 2.123, 95% CI: 1.12 – 4.04, p = 0.022) were more likely to test positive to malaria parasite. Conclusion: In this study, the prevalence of malaria in pregnant women was high and the significant predictors were; family size of 1–6, skill level 1, first trimester and multigravidae. The Delta State Ministry of Health should ensure increasing access to IPT, ITNs/LLIN and health education on malaria in all hospitals rendering ANC services.

Prevalence of Malaria and Associated Factors among Pregnant Women Attending Uniosun Teaching Hospital Osogbo Osun State, Nigeria

Pregnancy-related malaria is still a public health issue, as it contributes to a high infant mortality rate, low birth weight, and maternal mortality. Over 80% of the world's malaria cases were found in sub-Saharan Africa and India. More than 500,000 cases were reported in Nigeria, Madagascar, and the Democratic Republic of Congo. Pregnant women in sub-Saharan Africa, particularly in Nigeria, are most at risk of malaria infection each year, with about 50 million pregnancies at risk. Therefore, the objective of this study was to determine malaria prevalence and associated risk factors among pregnant women in Osun State, Nigeria.&#x0D; The study was retrospective of five years between January 2017- December 2021. The medical records of 277 pregnant women who tested positive for malaria were retrieved to examine the contributing factors and malaria-related complications. Data were analyzed using the SPSS statistical software package, version 23. The Chi-square test was used to determine statistical significance. Data were presented in their simplest form and P - value &lt; 0.05 was statistical significance.&#x0D; The prevalence of malaria reported among pregnant women was found to be 98.9% caused by Plasmodium falciparum. While most pregnant women who tested positive for malaria parasite had no complications, low birth weight was the most common complication among pregnant women who were infected with malaria, Proportion of malaria in pregnant women during the gestational period was found, according to the findings - 1st Trimester 33.2%, 2nd Trimester 47.3%, and 3rd Trimester 19.5%. There was no significant association between the prevalence of malaria and Genotypes (P=0.498).&#x0D; It was discovered that the prevalence of malaria among pregnant women was high with P. falciparum being the most common malaria parasite found in the stud. Prenatal care was found to be a major factor in the early detection of signs and symptoms associated with pregnancy.

Phase 3 Evaluation of an Innovative Simple Molecular Test for the Diagnosis of Malaria and Follow-Up of Treatment Efficacy in Pregnant Women in Sub-Saharan Africa (Preg-Diagmal).

The malaria parasite Plasmodium falciparum (Pf) can sequester in the placenta resulting in low density of peripheral parasitemia and consequently in false negative malaria diagnosis (by microscopy) in pregnant women. Moreover, the use of rapid diagnostic tests (RDTs) in diagnostic strategies, including those for the detection of a malaria infection during pregnancy, is constrained by either persistent malaria antigen (histidine-rich protein 2; HRP2) after successful treatment, leading to false positive test results, or by false negative results as previously mentioned due to parasite sequestration (which is further exacerbated due to the low limited of detection [LoD] of conventional RDTs) or to HRP2 deletion. Recently, a direct blood polymerase chain reaction combined with a nucleic acid lateral flow immunoassay (dbPCR-NALFIA) has been developed, which circumvents these challenges and has demonstrated its diagnostic potential in phase 1 and 2 studies. The PREG-DIAGMAL trial presented in this manuscript will assess the diagnostic performance of dbPCR-NALFIA for the diagnostic of malaria in pregnant women and its potential to monitor treatment efficacy in these subjects. The work is ancillary embedded in an ongoing EDCTP funded trial, the PyraPreg project (PACTR202011812241529) in which the safety and efficacy of a newly registered Artemisinin-Based Combination (Pyronaridine-Artesunate) is being evaluated in pregnant women. This is a Phase 3 diagnostic evaluation conducted in 2 African countries: Democratic Republic of the Congo (DRC) and Burkina Faso. Pregnant women fulfilling the inclusion criteria of the PyraPreg study will be also invited to participate in the PREG-DIAGMAL study. Diagnostic accuracy will be assessed following the WHO/TDR guidelines for the evaluation of diagnostics and reported according to STARD principles. Due to the lack of a 100% specific and sensitive standard diagnostic test for malaria, the sensitivity and specificity of the new test will be compared to the available diagnostic practice in place at the selected settings (microscopy and/or RDT) and to quantitative PCR as the reference test. This phase 3 diagnostic study is designed towards the evaluation of the performance of a new diagnostic tool for the screening of malaria and the monitoring of treatment in pregnant women under real conditions life. If successful, the dbPCR-NALFIA could be a valuable tool to add to the diagnostic arsenal for malaria, in particular during pregnancy. Trial registration: Pan African Clinical Trial Registry database (PACTR202203780981413). Registered on 17 March 2022.

Systematic scoping review of innovation on malaria prevention programs in pregnancy during pandemic

The World Health Organization (WHO) has warned that the prevalence of malaria among pregnant women in Indonesia could rise as a result of the COVID-19 pandemic. Malaria during pregnancy has a severe effect on both the mother and the fetus, and is particularly dangerous for those who are infected while pregnant. The study is intended to summarize the literature on strategies for preventing and treating malaria in pregnancy in Indonesia during the COVID-19 pandemic. The literature search strategy was systematically applied using keywords in the Springerlink database, Scopus, Google scholar, Garuda Portal. The inclusion criteria applied include Languages (English and Indonesian), which are the results of public health research, published since 2018. There are a total of 11 articles that match the inclusion criteria for further qualitative descriptive analysis. it was discovered that several strategies and innovations, including the evaluation of pregnancy-specific malaria prevention programs, health promotion strategies, wire netting home modifications, and sustainable midwifery care, were implemented in Indonesia to prevent and treat malaria in pregnant women.

The Demographical Prevalence of Malaria in Pregnant Women in Oshimili South Local Government Area of Delta State, Nigeria

This study evaluated the prevalence of malaria in pregnant women attending antenatal clinics in Delta state. Thick-film microscopy was used to detect parasitaemia while polymerase chain reaction (PCR) was employed to confirm positivity. Statistical method used were Chi square, Paired Sample T test and Pearson Correlation test at 5% level using SPSS version 23.0. Out of three hundred and fifty (350) HIV-negative and asymptomatic pregnant women examined at first antenatal registration, one hundred and twenty-two (122) were found positive for malaria parasite. The percentage prevalence of malaria positive cases recorded using microscopy was 34.86% (122/350) while PCR confirmed the positivity of 84% (21/25) for both positive and negative samples derived from microscopy. Prevalence of malaria in relation to age, gravidity, and educational qualification were statistically significant while prevalence in relation to occupation, the hospital they attended were not statistically significant. Participants within the age group of 15-19(66.6%), primigravidae (42.6%), primary education (100%) and traders/businessmen had the highest prevalence of malaria. It is therefore recommended that malaria test should be one of the routine tests compulsorily done on pregnant women to avoid complications and public awareness campaign programs on preventive measures against malaria should be regularly conducted to make the journey to eradication of malaria from Nigeria an easier one.

Risk Factors For Malaria Incidence In Pregnant Women In Puskemas Bosnik And Marau Regency Biak Numfor

Malaria infection in pregnancy is very detrimental to both the mother and the fetus it contains, because it can increase the morbidity and mortality of the mother and fetus. The prevalence of malaria in Papua Province with Annual Parasite Incendence in 2016 amounted to 208.95 per thousand population, the prevalence of malaria in pregnant women in Papua Province as much as (3.09%). The prevalence of malaria in pregnant women in Biak Numfor Regency in 2017 was 4.11%. The purpose of this study was to determine the risk factors for the incidence of malaria in pregnant women at the Bosnik and Marau Health Centers, Biak Numfor Regency in 2018.This study is an observational study with case control design in pregnant women in the Bosnik Health Center and Marauw Health Center area of Biak Numfor Regency. The study sample with simple random sampling was 27 pregnant women as cases and 27 pregnant women as control.data analised with chi square test. From the results of a multivariate analysis found 2 (two) variables associated with malaria incidence in pregnant women, namely sleeping not using mosquito nets (OR = 3,768 p = 0.024 95% CI 1,158-12,270) and Hb anemia &lt; 9 gr% (OR = 5,500 p = 0.013 95% CI 1,323-22,862) while 3 (three) variables namely low economic status, first parity and ≥ 4 and nutritional status is not associated with malaria incidence. Risk factors for malaria incidence in pregnant women are related to sleep habits not using mosquito nets and anemia Hb &lt; 9gr%.

Age-modified factors associated with placental malaria in rural Burkina Faso

BackgroundMalaria in pregnancy can result in placental infection with fetal implications. This study aimed at assessing placental malaria (PM) prevalence and its associated factors in a cohort of pregnant women with peripheral malaria and their offspring.MethodThe data were collected in the framework of a clinical trial on treatments for malaria in pregnant women . Placental malaria (PM) was diagnosed by histopathological detection of parasites and/or malaria pigment on placenta biopsies taken at delivery. Factors associated with PM were assessed using logistic regression.ResultsOut of 745 biopsies examined, PM was diagnosed in 86.8 % of women. Acute, chronic and past PM were retrieved in 11 (1.5 %), 170 (22.8 %), and 466 (62.6 %) women, respectively. A modifying effect was observed in the association of gravidity or anemia at the study start with pooled PM (presence of parasites and/or malaria pigment). In women under 30, gravidity ≤ 2 was associated with an increased prevalence of pooled PM but in women aged 30 years or more, gravidity was no more associated with pooled PM (OR 6.81, 95 % CI 3.18 – 14.60; and OR 0.52, 95 % CI 0.10 – 2.76, respectively). Anemia was associated with pooled PM in women under 30 (OR 1.96, 95 % CI 1.03 – 3.72) but not in women aged 30 years or more (OR 0.68, 95 % CI 0.31 – 1.49). Similarly, the association of gravidity with past-chronic PM depended also on age. A higher prevalence of active PM was observed in women under 30 presenting with symptomatic malaria (OR 3.79, 95 % CI 1.55 – 9.27), while there was no significant increase in the prevalence of active PM (presence of parasites only) in women with symptomatic malaria when aged 30 years or more (OR 0.42, 95 % CI 0.10 – 1.75). In women with chronic PM, the prevalence of low birth weight or prematurity was the highest (31.2 %) as compared with past PM or no PM.ConclusionDespite the rapid diagnosis and efficacious treatment of peripheral infection, the prevalence of placental malaria remained high in women with P. falciparum peripheral infection in Nanoro, especially in younger women This underlines the importance of preventive measures in this specific group.

Assessment of the Teratogenic Effect of Sulfadoxine-Pyrimethamine on the Chicken Embryo.

Background The sulfadoxine-pyrimethamine combination is a product used in the intermittent preventive treatment (IPT) of malaria in pregnant women in our country. To date, there is very little data on the teratogenic effect of this product. This study proposed to evaluate the teratogenic effect of sulfadoxine-pyrimethamine on chicken embryos. Methods The teratogenic effect of the product was evaluated on chicken embryos at a dose of 1.3 mg/g sulfadoxine and 0.06 mg/g pyrimethamine. The product was injected before the start of incubation and on days 12, 14, 16, and 18 of incubation. One batch received a double injection of the product on days 16 and 18 of incubation. The quality of the hatched chicks was evaluated by the Tona Score followed by the determination of hematological and biochemical parameters. Results From the aforementioned, it appears that the eggs treated with sulfadoxine-pyrimethamine significantly decreased the hatchability rate of the eggs. The chicks obtained were all of very good quality. Apart from a significant decrease in the weight of the chicks of the batch that received the injection twice and a significant increase in the weight of the yolk sac of the chicks of the batch that received the injection on day 16 compared to the control, no variation was obtained. A significant increase in the white blood cell count of the chicks compared to the control was reported in the chicks of the batch injected before incubation and on day 12, as well as a significant increase in the platelet count of the chicks of the batch injected twice. For biochemical parameters, no significant difference was reported in ALT and AST. Conclusion Sulfadoxine-pyrimethamine decreased egg hatch and caused an increase in embryo and chick mortality as well as a loss in relative chick weight and an increase in relative yolk sac weight. More in-depth studies would be needed on sulfadoxine-pyrimethamine teratogenicity and the benefit/risk ratio of this drug during pregnancy.

Efficacy and Safety of Artemisinin-Based Combination Therapy for the Treatment of Uncomplicated Malaria in Pregnant Women: A Systematic Review and Meta-Analysis.

IntroductionMalaria is one of the infectious diseases with substantial risks for pregnant women, the fetus and the newborn child. Thus, prevention and treatment of malaria with safe and effective drugs is of paramount importance. Pregnant women are mostly excluded from clinical trials, and systematic approaches of pharmacovigilance in pregnancy are limited. This means the safety and efficacy of antimalarial agents during pregnancy are unclear.PurposeThis study was designed to carry out a systematic review and aggregate data meta-analysis of literature published on efficacy and safety of artemisinin-based combination therapy (ACT) for uncomplicated malaria in pregnant women.MethodsA search of literature published between 1998 to 2020 on efficacy and safety of artemisinin-based combination therapy (ACT) in pregnant women was made using Cochrane Library, Medline and the Malaria in Pregnancy Consortium Library. Data were extracted independently by two reviewers, and any discrepancies were resolved by consensus. Meta-analysis was carried out using Open Meta-Analyst software. Random effects model was applied, and the heterogeneity of studies was evaluated using Higgins I2.ResultsTwenty-four studies that fulfilled the inclusion criteria were included in the final assessment. Overall, days 28 to 63 malaria treatment success rate was 96.1%. Overall days 28 to 63 cure rates for AL, AS+AQ, AS+MQ, DHA+PQ, AS+ATQ+PG and AS+SP were 95.1%, 92.2%, 97.0%,94.3%, 96.5% and 97.4%, respectively. Comparison of ACTs with non-ACTs revealed that the risk of treatment failure was substantially lower in patients treated with ACTs than with non-ACTs (risk ratio 0.20, 95% C.I. 0.09–0.43). The overall prevalences of miscarriage, stillbirth and congenital anomalies were 0.3%, 2.1% and 1.0%, respectively, and found to be comparable among various ACTs. There was comparable tolerability across ACTs during pregnancy.ConclusionACTs demonstrated a high cure rate, safety and tolerability against Plasmodium falciparum infection in pregnant women. The higher treatment success and comparable tolerability could be used as an input for decision makers to support the continued usage of ACTs for treatment of uncomplicated falciparum malaria in pregnant women.

Malaria Infection Effect to Haemoglobin and Haematocrit in Pregnant Mus Musculus

Malaria is a disease that is caused by Plasmodium Sp. And infected by Anopheles mosquitos. Kalimantanis one of endemic places for malaria. Prevalence of malaria is 2-76% depent to the places.Effect ofmalaria to pregnant women can be anemia, renal failure, cerebral oedema and death. Prevamence ofanemia because of malaria in pregnant women is about 3-15%. This research was done by using animalmodel to show malaria in pregnant. Goal of this research was to analyze malaria infection effect tohaemoglobin and haematocrit in pregnant Mus musculus. Research design was experimental usingposttest only with control group design. It consisted of K0 for control (20 samples) and K1 for infectedgroup (19 samples).Pregnant Mus musculus was injected P. berghei to infect plasmodium using 0,2 mlinfected serum intraperioteal in the first day of pregnant. Mus musculus was terminated in 19th day ofpregnant and took cardial blood to examine Hb and Ht of pregnant Mus musculus.The result was Hblevel mean for K0= 12,69 gr/dl and K1=12,832 dr/dl. Mean of Ht for K0=38,070% and K1=38,495%.Statistical anayzes used U-Mann Whitney test, with p value for Hb level was 0,574 and Ht was 0,574.The conclusion was malaria infection could not effect yet to Hb dan Ht level in pregnant Mus musculus.

Passive Surveillance of Malaria in Pregnant Women, Non-pregnant Women and Children Under 5 Years of Age in Bannu District, Khyber Pakhtunkhwa Pakistan.

Background: Malaria among pregnant women is one of the major causes of maternal and infant mortality and morbidity, especially in high-risk areas. Therefore, our study identified the burden of malaria for pregnant women, non-pregnant women, and children under 5 years of age, and malaria service health facilities in Bannu district, Khyber Pakhtunkhwa, Pakistan.Methods: A cross-sectional study was conducted. In this survey, 15,650 individuals were surveyed, and 1,283 were malaria-positive detected. The data were collected from 80 different healthcare centers. SPSS version 23 was used for data analysis. ArcGIS version 10.8 was used for study area mapping.Results: Malaria was detected in 23.3% of children under five, 4.4% of pregnant women, and 72.3% of non-pregnant women, respectively. Moreover, P. falciparum, P. vivax, and mixed infection had a prevalence of 2.1, 96.8, and 1.1%. The most often used and effective medications to treat malaria were chloroquine (29.7%) and primaquine (69.4%).Conclusion: This study's findings depict that malaria's prevalence in the non-pregnant women's group was high. Additionally, P. vivax infection was found to be more prevalent than other types of malaria infection. Due to the scarcity of healthcare facilities in this endemic region, special attention should be directed to strengthening the malaria surveillance and eradication programs.

Status of Biochemical and Hematological Changes in Pregnant Malaria Patients and Pregnant Nonmalaria Women

Background: Malaria, a condition that affects immunological responsiveness, appears to interfere with immune processes during pregnancy. During pregnancy, females are especially vulnerable to illnesses, which can have catastrophic repercussions for both the mother and the fetus. Materials and Methods: A total of 64 participants out of which 32 pregnant nonmalaria participants in Group A and 32 pregnant malaria participants in Group B. The study included participants between 20 and 42 years of age. Participants presenting with the symptoms of malaria such as headache, fever, weakness, and nausea were included. Results: The hematological parameters among the study participants. The mean transferrin level in Group A and Group B was 3.42 ± 1.26 and 4.86 ± 2.37 [Figure 1]. There was a significant difference between the two groups. The total iron-binding capacity and serum iron also showed a significant difference between the two groups. The transferrin saturation in Group A was 25.6 ± 8.51 and in Group B was 26.24 ± 5.61. There was no significant difference in the transferrin saturation and hemoglobin levels between the groups. Conclusion: Hematological and biochemical indicators may be effective in detecting malaria in pregnant women with parasites deep in tissues that are difficult to identify using a microscope.

Factors Related to the Event of Malaria in Pregnant Women in Harapan Health Center

Malaria prevalence based on blood history in Indonesia in 2018 is 0.4% (Riskesdas, 2018). Data on pregnant women in Jayapura Regency in 2018 are 4,120 people. Of these, 132 were positively infected by malaria pregnant women (Dinkes District of Jayapura, 2018 - 2019). The purpose of the study was to determine the relationship batween knowledge, ANC compliance and parity with incidence of malaria in pregnant women at the Puskesmas Harapan. The study design was quantitative analytic with croos sectional approach with a total sample of 37 trimester II dan II pregnant women, with sampling techniques exachautive sampling and data analysis with chi-square test. The results showed that the knowledge variables (p = 0.140), ANC compliance (p = 0.873) and parity (p = 0.140). It can be concluded that there is no relationship between knowledge, ANC compliance and parity with the incidence of malaria in pregnant women at the Puskesma Harapan Key word: Malaria, Pregnant Women, Knowledge, ANC, Parity