Artemisinin combination therapy at delivery to prevent postpartum malaria: A randomised open-label controlled trial
Objectives: Although the incidence of malaria is increased in women in endemic areas after delivery compared to non-pregnant women, no studies have assessed the benefit of presumptive antimalarial treatment given postpartum. Methods: A randomised controlled trial investigating the efficacy of antima...
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Elsevier
2024-12-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971224003291 |
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| author | Paula Tesine Sze-Ann Woon Moses Laman Gumul Yadi Phantica Yambo Bernadine Kasian Lina Lorry Leanne J. Robinson Sam Salman Kevin T. Batty William Pomat Laurens Manning Wendy A. Davis Timothy M.E. Davis Brioni R. Moore |
| author_facet | Paula Tesine Sze-Ann Woon Moses Laman Gumul Yadi Phantica Yambo Bernadine Kasian Lina Lorry Leanne J. Robinson Sam Salman Kevin T. Batty William Pomat Laurens Manning Wendy A. Davis Timothy M.E. Davis Brioni R. Moore |
| author_sort | Paula Tesine |
| collection | DOAJ |
| description | Objectives: Although the incidence of malaria is increased in women in endemic areas after delivery compared to non-pregnant women, no studies have assessed the benefit of presumptive antimalarial treatment given postpartum. Methods: A randomised controlled trial investigating the efficacy of antimalarial treatment in preventing postpartum malaria was performed in healthy Papua New Guinea mothers immediately following delivery. Participants were randomised 1:1 to no treatment (n = 90) or artemisinin combination therapy (ACT), with further 1:1 ACT randomisation to artemether-lumefantrine (AL; n = 45) or dihydroartemisinin-piperaquine (DP; n = 45). Standardised reviews were conducted monthly for 6 months, including clinical assessment, malaria screening and haemoglobin measurement. The primary endpoint was incidence of slide-positive malaria within 6 months of delivery. Results: Of 183 recruited participants, 151 completed study procedures and were included in per-protocol analyses (no treatment n = 71, AL n = 40, DP, n = 40). Those allocated to ACT were significantly less likely to develop slide-positive malaria during the 6-month follow-up period compared to those who were untreated (n = 17 (21%) vs n = 27 (38%); P = 0.016; hazard ratio 0.49 (95% confidence intervals 0.27-0.90). There was no significant difference in malaria incidence between the two ACT groups. Conclusion: A treatment course of ACT at time of delivery halved the incidence of malaria infection during the first 6-month postpartum. |
| format | Article |
| id | doaj-art-3fbd30a624044f5ab2ff4ace3a2bae39 |
| institution | DOAJ |
| issn | 1201-9712 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-3fbd30a624044f5ab2ff4ace3a2bae392025-08-20T02:49:05ZengElsevierInternational Journal of Infectious Diseases1201-97122024-12-0114910725810.1016/j.ijid.2024.107258Artemisinin combination therapy at delivery to prevent postpartum malaria: A randomised open-label controlled trialPaula Tesine0Sze-Ann Woon1Moses Laman2Gumul Yadi3Phantica Yambo4Bernadine Kasian5Lina Lorry6Leanne J. Robinson7Sam Salman8Kevin T. Batty9William Pomat10Laurens Manning11Wendy A. Davis12Timothy M.E. Davis13Brioni R. Moore14Vector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Madang Province, Papua New GuineaMedical School, The University of Western Australia, Perth, Western Australia, AustraliaVector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Madang Province, Papua New GuineaVector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Madang Province, Papua New GuineaVector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Madang Province, Papua New GuineaVector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Madang Province, Papua New GuineaVector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Madang Province, Papua New GuineaVector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Madang Province, Papua New Guinea; Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia; Burnet Institute, Melbourne, Victoria, AustraliaMedical School, The University of Western Australia, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; Clinical Pharmacology and Toxicology Unit, PathWest, Perth, Western Australia, AustraliaCurtin Medical School, Curtin University, Perth, Western Australia, Australia; Curtin Heath Innovation Research Institute, Curtin University, Perth, Western Australia, AustraliaVector Borne Disease Unit, Papua New Guinea Institute of Medical Research, Madang, Madang Province, Papua New GuineaMedical School, The University of Western Australia, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, AustraliaMedical School, The University of Western Australia, Perth, Western Australia, AustraliaMedical School, The University of Western Australia, Perth, Western Australia, AustraliaMedical School, The University of Western Australia, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; Curtin Medical School, Curtin University, Perth, Western Australia, Australia; Curtin Heath Innovation Research Institute, Curtin University, Perth, Western Australia, Australia; Corresponding author: Brioni Moore, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.Objectives: Although the incidence of malaria is increased in women in endemic areas after delivery compared to non-pregnant women, no studies have assessed the benefit of presumptive antimalarial treatment given postpartum. Methods: A randomised controlled trial investigating the efficacy of antimalarial treatment in preventing postpartum malaria was performed in healthy Papua New Guinea mothers immediately following delivery. Participants were randomised 1:1 to no treatment (n = 90) or artemisinin combination therapy (ACT), with further 1:1 ACT randomisation to artemether-lumefantrine (AL; n = 45) or dihydroartemisinin-piperaquine (DP; n = 45). Standardised reviews were conducted monthly for 6 months, including clinical assessment, malaria screening and haemoglobin measurement. The primary endpoint was incidence of slide-positive malaria within 6 months of delivery. Results: Of 183 recruited participants, 151 completed study procedures and were included in per-protocol analyses (no treatment n = 71, AL n = 40, DP, n = 40). Those allocated to ACT were significantly less likely to develop slide-positive malaria during the 6-month follow-up period compared to those who were untreated (n = 17 (21%) vs n = 27 (38%); P = 0.016; hazard ratio 0.49 (95% confidence intervals 0.27-0.90). There was no significant difference in malaria incidence between the two ACT groups. Conclusion: A treatment course of ACT at time of delivery halved the incidence of malaria infection during the first 6-month postpartum.http://www.sciencedirect.com/science/article/pii/S1201971224003291PostpartumMalariaArtemisinin combination therapyPresumptive treatment |
| spellingShingle | Paula Tesine Sze-Ann Woon Moses Laman Gumul Yadi Phantica Yambo Bernadine Kasian Lina Lorry Leanne J. Robinson Sam Salman Kevin T. Batty William Pomat Laurens Manning Wendy A. Davis Timothy M.E. Davis Brioni R. Moore Artemisinin combination therapy at delivery to prevent postpartum malaria: A randomised open-label controlled trial International Journal of Infectious Diseases Postpartum Malaria Artemisinin combination therapy Presumptive treatment |
| title | Artemisinin combination therapy at delivery to prevent postpartum malaria: A randomised open-label controlled trial |
| title_full | Artemisinin combination therapy at delivery to prevent postpartum malaria: A randomised open-label controlled trial |
| title_fullStr | Artemisinin combination therapy at delivery to prevent postpartum malaria: A randomised open-label controlled trial |
| title_full_unstemmed | Artemisinin combination therapy at delivery to prevent postpartum malaria: A randomised open-label controlled trial |
| title_short | Artemisinin combination therapy at delivery to prevent postpartum malaria: A randomised open-label controlled trial |
| title_sort | artemisinin combination therapy at delivery to prevent postpartum malaria a randomised open label controlled trial |
| topic | Postpartum Malaria Artemisinin combination therapy Presumptive treatment |
| url | http://www.sciencedirect.com/science/article/pii/S1201971224003291 |
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