The effect and control of malaria in pregnancy and lactating women in the Asia-Pacific region

Holger W. Unger; Sanjaya Acharya; Lachlan Arnold; Connie Wu; Anna Maria van Eijk; Georgia R. Gore-Langton; Feiko O. ter Kuile; Elvin Lufele; R. Matthew Chico; Ric N. Price; Brioni R. Moore; Kamala Thriemer; Stephen J. Rogerson

doi:10.1016/S2214-109X(23)00415-1

The effect and control of malaria in pregnancy and lactating women in the Asia-Pacific region

Holger W. Unger, Sanjaya Acharya, Lachlan Arnold, Connie Wu, Anna Maria van Eijk, Georgia R. Gore-Langton, Feiko O. ter Kuile, Elvin Lufele, R. Matthew Chico, Ric N. Price, Brioni R. Moore, Kamala Thriemer, Stephen J. Rogerson

Research output: Contribution to journal › Review article › peer-review

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Abstract

Half of all pregnancies at risk of malaria worldwide occur in the Asia–Pacific region, where Plasmodium falciparum and Plasmodium vivax co-exist. Despite substantial reductions in transmission, malaria remains an important cause of adverse health outcomes for mothers and offspring, including pre-eclampsia. Malaria transmission is heterogeneous, and infections are commonly subpatent and asymptomatic. High-grade antimalarial resistance poses a formidable challenge to malaria control in pregnancy in the region. Intermittent preventive treatment in pregnancy reduces infection risk in meso-endemic New Guinea, whereas screen-and-treat strategies will require more sensitive point-of-care tests to control malaria in pregnancy. In the first trimester, artemether–lumefantrine is approved, and safety data are accumulating for other artemisinin-based combinations. Safety of novel antimalarials to treat artemisinin-resistant P falciparum during pregnancy, and of 8-aminoquinolines during lactation, needs to be established. A more systematic approach to the prevention of malaria in pregnancy in the Asia–Pacific is required.

Original language	English
Pages (from-to)	e1805-e1818
Number of pages	14
Journal	The Lancet Global Health
Volume	11
Issue number	11
DOIs	https://doi.org/10.1016/S2214-109X(23)00415-1
Publication status	Published - Nov 2023

Bibliographical note

Funding Information:
We thank Jaehun Jung (Korea Disease Control Agency, Republic of Korea) for assistance with sourcing and translating country guidelines. HWU is supported by a Menzies School of Health Research (Darwin) Future Researcher Fellowship. KT is a CSL Centenary Fellow. Funding sources were not involved in the collection, analysis, and interpretation of the data, the writing of the article, or in submission of the Review for publication. The views expressed in the Review are those of the authors and do not represent the funding agencies.

Funding Information:
We thank Jaehun Jung (Korea Disease Control Agency, Republic of Korea) for assistance with sourcing and translating country guidelines. HWU is supported by a Menzies School of Health Research (Darwin) Future Researcher Fellowship. KT is a CSL Centenary Fellow. Funding sources were not involved in the collection, analysis, and interpretation of the data, the writing of the article, or in submission of the Review for publication. The views expressed in the Review are those of the authors and do not represent the funding agencies.

Publisher Copyright:
© 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license

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10.1016/S2214-109X(23)00415-1

88382178-oaFinal published version, 629 KBLicence: CC BY-NC-ND

Cite this

Unger, H. W., Acharya, S., Arnold, L., Wu, C., van Eijk, A. M., Gore-Langton, G. R., ter Kuile, F. O., Lufele, E., Chico, R. M., Price, R. N., Moore, B. R., Thriemer, K., & Rogerson, S. J. (2023). The effect and control of malaria in pregnancy and lactating women in the Asia-Pacific region. The Lancet Global Health, 11(11), e1805-e1818. https://doi.org/10.1016/S2214-109X(23)00415-1

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title = "The effect and control of malaria in pregnancy and lactating women in the Asia-Pacific region",

abstract = "Half of all pregnancies at risk of malaria worldwide occur in the Asia–Pacific region, where Plasmodium falciparum and Plasmodium vivax co-exist. Despite substantial reductions in transmission, malaria remains an important cause of adverse health outcomes for mothers and offspring, including pre-eclampsia. Malaria transmission is heterogeneous, and infections are commonly subpatent and asymptomatic. High-grade antimalarial resistance poses a formidable challenge to malaria control in pregnancy in the region. Intermittent preventive treatment in pregnancy reduces infection risk in meso-endemic New Guinea, whereas screen-and-treat strategies will require more sensitive point-of-care tests to control malaria in pregnancy. In the first trimester, artemether–lumefantrine is approved, and safety data are accumulating for other artemisinin-based combinations. Safety of novel antimalarials to treat artemisinin-resistant P falciparum during pregnancy, and of 8-aminoquinolines during lactation, needs to be established. A more systematic approach to the prevention of malaria in pregnancy in the Asia–Pacific is required.",

author = "Unger, {Holger W.} and Sanjaya Acharya and Lachlan Arnold and Connie Wu and {van Eijk}, {Anna Maria} and Gore-Langton, {Georgia R.} and {ter Kuile}, {Feiko O.} and Elvin Lufele and Chico, {R. Matthew} and Price, {Ric N.} and Moore, {Brioni R.} and Kamala Thriemer and Rogerson, {Stephen J.}",

note = "Funding Information: We thank Jaehun Jung (Korea Disease Control Agency, Republic of Korea) for assistance with sourcing and translating country guidelines. HWU is supported by a Menzies School of Health Research (Darwin) Future Researcher Fellowship. KT is a CSL Centenary Fellow. Funding sources were not involved in the collection, analysis, and interpretation of the data, the writing of the article, or in submission of the Review for publication. The views expressed in the Review are those of the authors and do not represent the funding agencies. Funding Information: We thank Jaehun Jung (Korea Disease Control Agency, Republic of Korea) for assistance with sourcing and translating country guidelines. HWU is supported by a Menzies School of Health Research (Darwin) Future Researcher Fellowship. KT is a CSL Centenary Fellow. Funding sources were not involved in the collection, analysis, and interpretation of the data, the writing of the article, or in submission of the Review for publication. The views expressed in the Review are those of the authors and do not represent the funding agencies. Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license",

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doi = "10.1016/S2214-109X(23)00415-1",

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AU - Unger, Holger W.

AU - Acharya, Sanjaya

AU - Arnold, Lachlan

AU - Wu, Connie

AU - van Eijk, Anna Maria

AU - Gore-Langton, Georgia R.

AU - ter Kuile, Feiko O.

AU - Lufele, Elvin

AU - Chico, R. Matthew

AU - Price, Ric N.

AU - Moore, Brioni R.

AU - Thriemer, Kamala

AU - Rogerson, Stephen J.

N1 - Funding Information: We thank Jaehun Jung (Korea Disease Control Agency, Republic of Korea) for assistance with sourcing and translating country guidelines. HWU is supported by a Menzies School of Health Research (Darwin) Future Researcher Fellowship. KT is a CSL Centenary Fellow. Funding sources were not involved in the collection, analysis, and interpretation of the data, the writing of the article, or in submission of the Review for publication. The views expressed in the Review are those of the authors and do not represent the funding agencies. Funding Information: We thank Jaehun Jung (Korea Disease Control Agency, Republic of Korea) for assistance with sourcing and translating country guidelines. HWU is supported by a Menzies School of Health Research (Darwin) Future Researcher Fellowship. KT is a CSL Centenary Fellow. Funding sources were not involved in the collection, analysis, and interpretation of the data, the writing of the article, or in submission of the Review for publication. The views expressed in the Review are those of the authors and do not represent the funding agencies. Publisher Copyright: © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license

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N2 - Half of all pregnancies at risk of malaria worldwide occur in the Asia–Pacific region, where Plasmodium falciparum and Plasmodium vivax co-exist. Despite substantial reductions in transmission, malaria remains an important cause of adverse health outcomes for mothers and offspring, including pre-eclampsia. Malaria transmission is heterogeneous, and infections are commonly subpatent and asymptomatic. High-grade antimalarial resistance poses a formidable challenge to malaria control in pregnancy in the region. Intermittent preventive treatment in pregnancy reduces infection risk in meso-endemic New Guinea, whereas screen-and-treat strategies will require more sensitive point-of-care tests to control malaria in pregnancy. In the first trimester, artemether–lumefantrine is approved, and safety data are accumulating for other artemisinin-based combinations. Safety of novel antimalarials to treat artemisinin-resistant P falciparum during pregnancy, and of 8-aminoquinolines during lactation, needs to be established. A more systematic approach to the prevention of malaria in pregnancy in the Asia–Pacific is required.

AB - Half of all pregnancies at risk of malaria worldwide occur in the Asia–Pacific region, where Plasmodium falciparum and Plasmodium vivax co-exist. Despite substantial reductions in transmission, malaria remains an important cause of adverse health outcomes for mothers and offspring, including pre-eclampsia. Malaria transmission is heterogeneous, and infections are commonly subpatent and asymptomatic. High-grade antimalarial resistance poses a formidable challenge to malaria control in pregnancy in the region. Intermittent preventive treatment in pregnancy reduces infection risk in meso-endemic New Guinea, whereas screen-and-treat strategies will require more sensitive point-of-care tests to control malaria in pregnancy. In the first trimester, artemether–lumefantrine is approved, and safety data are accumulating for other artemisinin-based combinations. Safety of novel antimalarials to treat artemisinin-resistant P falciparum during pregnancy, and of 8-aminoquinolines during lactation, needs to be established. A more systematic approach to the prevention of malaria in pregnancy in the Asia–Pacific is required.

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U2 - 10.1016/S2214-109X(23)00415-1

DO - 10.1016/S2214-109X(23)00415-1

M3 - Review article

AN - SCOPUS:85174161478

SN - 2214-109X

VL - 11

SP - e1805-e1818

JO - The Lancet Global Health

JF - The Lancet Global Health

IS - 11

ER -

The effect and control of malaria in pregnancy and lactating women in the Asia-Pacific region

Abstract

Bibliographical note

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