| Malaria in pregnancy |
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The increasing malaria caseload, largely fuelled by the spread of multi-drug resistant strains of P. falciparum, translates into a disproportionately high burden in pregnant women in terms of mortality and morbidity. Malaria is detrimental to the pregnant woman and her unborn child and creates a major burden of disease. The lack of information to decide on safe and effective antimalarial dosing puts the lives of many hundreds of thousands of mothers and babies at risk each year. Optimal dosing regimens need to be identified, in order to reduce malaria-related mother and child mortality and morbidity and to circumvent parasite resistance. At present pregnant women are given the same doses of antimalarial treatment as non-pregnant women, despite their being substantial physiological changes occurring in pregnancy that often result in far lower drug concentrations being achieved, and thus increasing the risk of the failure of malaria treatment in pregnant women. Currently, there is essentially no data on the pharmacokinetics of the anti-malarials most widely used in pregnancy. Artemisinin-based combination therapies (ACTs), now at the forefront of malaria treatment in non-pregnant patients, must be assessed during pregnancy, especially where no other suitable alternative exists. MORU’s Shoklo Malaria research Unit has undertaken the majority of the world’s published studies on malaria in pregnancy, and is a founding partner of the Maternal Malaria Operational Research Group, which brings together researchers conducting pivotal studies on anti-malarial pharmacokinetics, who have a common interest in maternal malaria. By including teams working in regions with different genetic composition epidemiology and patterns of drug resistance, the results of these studies will be of global relevance. Our primary objective is to quickly provide essential data on the disposition of the anti-malarials used to treat and/or prevent malaria in pregnant women. |
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