Malaria during Pregnancy

被引:111
|
作者
Fried, Michal [1 ]
Duffy, Patrick E. [1 ]
机构
[1] NIAID, Lab Malaria Immunol & Vaccinol, NIH, Bethesda, MD 20892 USA
来源
COLD SPRING HARBOR PERSPECTIVES IN MEDICINE | 2017年 / 7卷 / 06期
关键词
INTERMITTENT PREVENTIVE TREATMENT; FALCIPARUM-INFECTED ERYTHROCYTES; CHONDROITIN-SULFATE-A; LOW-BIRTH-WEIGHT; VARIANT SURFACE-ANTIGENS; RESISTANT PLASMODIUM-FALCIPARUM; HISTIDINE-RICH PROTEIN-2; INSECTICIDE-TREATED NETS; PLACEBO-CONTROLLED TRIAL; RAPID DIAGNOSTIC-TEST;
D O I
10.1101/cshperspect.a025551
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
One hundred and twenty-five million women in malaria-endemic areas become pregnant each year (see Dellicour et al. PLoS Med 7: e1000221 [ 2010]) and require protection from infection to avoid disease and death for themselves and their offspring. Chloroquine prophylaxis was once a safe approach to prevention but has been abandoned because of drugresistant parasites, and intermittent presumptive treatment with sulfadoxine-pyrimethamine, which is currently used to protect pregnant women throughout Africa, is rapidly losing its benefits for the same reason. No other drugs have yet been shown to be safe, tolerable, and effective as prevention for pregnant women, although monthly dihydroarte-misinin-piperaquine has shown promise for reducing poor pregnancy outcomes. Insecticide-treated nets provide some benefits, such as reducing placental malaria and low birth weight. However, this leaves a heavy burden of maternal, fetal, and infant morbidity and mortality that could be avoided. Women naturally acquire resistance to Plasmodium falciparum over successive pregnancies as they acquire antibodies against parasitized red cells that bind chondroitin sulfate A in the placenta, suggesting that a vaccine is feasible. Pregnant women are an important reservoir of parasites in the community, and women of reproductive age must be included in any elimination effort, but several features of malaria during pregnancy will require special consideration during the implementation of elimination programs.
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页数:24
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