Table 1 |
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Description of the studies included in the review on the use of artemisinin in pregnancy. |
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| Study site, year Reference |
Study Population |
Antimalarial treatment |
Primary Outcomes |
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| Randomized trials* |
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| Nigeria, 1994–1997 [14] |
Pregnant women infected with P. falciparum malaria after treatment failure§ |
1) Artemether IM + mefloquine n = 22 2) Artemether IM n = 23 Artemether overall dosage: 3.2–9.6 mg/kg |
Parasitaemia at day 28; AEs Foetal outcomes; infant neurodevelopment |
| Thailand, 1995–1998 [10] |
Pregnant women infected with P. falciparum malaria§ |
1)Quinine n = 29 2)Artesunate+ mefloquine n = 28 Artesunate overall dose: 12 mg/kg |
Time to parasite & fever clearance; anaemia; AEs; neurological examination Perinatal assessment; birth outcomes; infant physical and neurological assessment |
| TBB, 1995–1997 [12] |
Pregnant women with uncomplicated P. falciparum malaria |
1)Quinine n = 42 2)Artesunate+mefloquine n = 66 Artesunate overall dose: 12 mg/kg |
Parasite clearance; anaemia; AEs; neurological deficit Birth outcomes; infant developmental milestones |
| TBB, 1997–2000 [13] |
Pregnant women with uncomplicated P. falciparum malaria |
1)Quinine+clindamycin n = 65 2) Artesunate n = 64 Artesunate overall dose: 12 mg/kg |
Treatment failure at day 42 or before delivery; anaemia; AEs Birth outcomes; infant developmental milestones |
| TBB, 2001–2003 [11] |
Pregnant women with uncomplicated P. falciparum or mixed malaria |
1)Quinine n = 42 2) Artesunate atovaquone-proguanil n = 39 Artesunate overall dose: 12 mg/kg |
Fever, parasite clearance; treatment failure at day 63; anaemia; AEs Birth outcomes; infant developmental milestones |
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| Case series |
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| China, 1976–1980 [15] |
Pregnant women infected with P. falciparum or P vivax malaria§ Trimesters (n): 3rd (1), 2nd (5) |
Artemisinin IM or Artemether Overall artemisinins dose: 500–900 mg |
Therapeutic effects and adverse reactions for mother and child |
| TBB, 1992–1996 [17] |
Pregnant women with uncomplicated multi-drug resistant P. falciparum or mixed malarial infection Trimesters (n): 3rd & 2nd (74), 1st (16) |
Artesunate alone or with mefloquine; or Artemether+mefloquine Overall artemisinins dose: 12–16 mg/kg |
Treatment failure at day 42; anaemia; ADR; neurological deficit Birth outcome; infant neurological development |
| TBB, 1991–1996 [18] |
Pregnant women with uncomplicated multi-drug resistant P. falciparum malarial infection after treatment failure Trimesters (n): 3rd & 2nd (74), 1st (16) |
Artesunate alone or with mefloquine; or Artemether+mefloquine Overall artemisinins dose: 12–16 mg/kg |
Treatment failure at day 42; anaemia; ADR; neurological deficit Birth outcome; infant neurological development |
| TBB, 1992–2000 [16] |
Pregnant women with uncomplicated multi-drug resistant P. falciparum or mixed malarial infection Trimesters (n): 3rd (211), 2nd (201), 1st (42) |
Artesunate alone or with mefloquine; clindamycin atovaquone-proguanil;or coartemether,
artemether IM Overall artemisinins dose: 12–16 mg/kg |
Treatment failure at day 42; anaemia; ADR; neurological deficit Birth outcome; infant developmental milestones |
| TBB 1999–2001 [19] |
Pregnant women with multi-drug resistant P. falciparum or mixed malarial infection Trimesters (n): 3rd & 2nd (24), 1st (3) |
Artesunate+atovaquone-proguanil Artesunate overall dose: 12–14 mg/kg |
Treatment failure at day 42; parasite clearance; AEs Birth outcomes |
| TBB 2000–2001 [20] |
Pharmacokinetic study: pregnant women with multi-drug resistant P. falciparum or mixed malarial infection Trimesters (n): 3rd (13) & 2nd (11) |
Artesunate+atovaquone-proguanil Artesunate overall dose: 12 mg/kg |
Pharmacokinetic parameters; AEs (including ECG); parasite clearance Birth outcomes |
| Gambia, 1999 [41] |
Pregnant women participating in mass prevention campaign Trimesters (n): 1st (77) |
Artesunate + SP Artesunate overall dose: 200 mg |
MDA 1° aim: malaria transmission Pregnancy outcomes |
| Sudan, 1997–2001 [22] |
Pregnant women infected with P. falciparum malaria after treatment failure§ Trimesters (n): 3rd (15), 2nd (12), 1st (1) |
Artemether IM Artemether overall dose: 480 mg |
Treatment failure at day 28; anaemia; neurological deficit Birth outcomes |
| Sudan, 2004–2005 [23] |
Pregnant women infected with uncomplicated P. falciparum malaria§ Trimesters (n): 3rd (22), 2nd (10) |
Artesunate + SP Artesunate overall dose: 200 mg |
Treatment failure at day 28; anaemia Birth outcomes |
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* 2nd and 3rd trimesters only §100% symptomatic/febrile Abbreviation: ADR: adverse drug reaction; AE: adverse event; ECG: electrocardiograph; IM: intramuscular injection; NR: not reported; Q: quinine; A: artemisinin derivative; A+M: artesunate+mefloquine; TBB: Thai-Burmese border |
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Dellicour et al. Malaria Journal 2007 6:15 doi:10.1186/1475-2875-6-15 |
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