Safety, efficacy and determinants of effectiveness of antimalarial drugs during pregnancy: implications for prevention programmes in Plasmodium falciparum-endemic sub-Saharan Africa.

摘要: Plasmodium falciparum malaria in pregnancy poses substantial risk to a pregnant woman and her neonate through anaemia low birth weight (LBW), respectively, is responsible for up 35% of preventable LBW malaria-endemic areas. Chemoprophylaxis or intermittent preventive treatment (IPT) with an effective antimalarial can ameliorate the adverse effects during pregnancy. Current guidelines from WHO recommend that women highly malarious areas receive IPT antimalarial. Two central considerations evaluating drugs use are safety mother foetus effectiveness, which determined by efficacy, cost, availability, deliverability acceptability drug. These factors may be scored potential drug combinations ranked order effectiveness prevention programmes. The seven most promising regimens all IPT, primarily because they more easily delivered less expensive than chemoprophylaxis. Currently, sulphadoxine-pyrimethamine (SP) likely have best overall preventing outcomes associated Its wide easy make it clear choice countries where efficacy remains good. For resistance SP rising already high, amodiaquine (alone combination artesunate) artesunate + SP, chlorproguanil-dapsone (with without artemether-lumefantrine require urgent evaluation