Treatment of malaria in pregnant women with quinine

1927 ◽  
Vol 23 (3) ◽  
pp. 350-350
Author(s):  
A. Timofeev
Keyword(s):  
Pregnant Women ◽  
Malaria In Pregnancy ◽  
In Pregnancy

To refute the opinion among physicians that quinine therapy of malaria in pregnancy threatens the preservation of the latter, Canton Eliseo showed by experiments on pregnant rabbits that the administration of 2-4 centigrams of chinini muriatici pro kilo does not cause abortion.

scholarly journals Acceptability of single screening and treatment policy for the control of malaria in pregnancy: perceptions of providers and pregnant women from selected health facilities in Lindi region, Tanzania

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chonge Kitojo ◽  
Frank Chacky ◽  
Emmanuel S. Kigadye ◽  
Joseph P. Mugasa ◽  
Abdallah Lusasi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Health Facilities ◽  
Malaria In Pregnancy ◽  
National Guidelines ◽  
Qualitative And Quantitative ◽  
Main Challenge ◽  
Malaria Rapid Diagnostic Tests ◽  
Experienced Pain ◽  
Care Workers ◽  
In Pregnancy

Abstract Background Tanzania started implementing single screening and treatment (SST) for all pregnant women attending their first antenatal care (ANC) visits in 2014, using malaria rapid diagnostic tests (RDTs) and treating those who test positive according to the national guidelines. However, there is a paucity of data to show the acceptability of SST to both pregnant women and health care workers (HCWs), taking into consideration the shortage of workers and the added burden of this policy to the health system. This study assessed the perceptions and opinions of health service users and providers to determine the acceptability of SST policy. Methods Pregnant women and HCWs in eight health facilities in two districts of Lindi region (Kilwa and Lindi) were interviewed using semi-structured questionnaires with open and close-ended questions. Both qualitative and quantitative data were collected, including demographic characteristics, women’s experience, their perception on SST and challenges they face when receiving services for malaria offered at ANC. Experience of HCWs regarding the implementation of SST as part of routine services and the challenges encountered when providing ANC services for malaria in pregnancy (MIP) were also assessed. Results Of the 143 pregnant women interviewed, 97% viewed testing favourably and would wish to be tested for malaria again, while 95% were satisfied with services and reasons for testing during the first ANC visit. Nearly all (99%) would recommend their fellow pregnant women to be tested for malaria and all women recommended that the Ministry of Health should continue the SST strategy. This was despite the fact that 76% of the women experienced pain and 16% had anxiety as a result of finger prick. Sixteen HCWs (mostly nurses) were interviewed; they also viewed SST implementation favourably and reported feeling empowered to use RDTs for malaria screening. The main challenge identified by HCWs was that nurses are not allowed to prescribe anti-malarials to women who test positive and need to refer them to the outpatient department for treatment. Conclusion SST was considered an acceptable approach to control MIP by HCWs and pregnant women, and they recommended the continuation of the policy. In addition, consideration should be given to implementing a task-shifting policy to allow nurses to dispense anti-malarials to pregnant women.

Asymptomatic malaria and anemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013–2017

2020 ◽  
Author(s):  
Toussaint Rouamba ◽  
Sékou Samadoulougou ◽  
Mady Ouédraogo ◽  
Hervé Hien ◽  
Halidou Tinto ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Pregnant Women ◽  
Malaria Transmission ◽  
Malaria In Pregnancy ◽  
Asymptomatic Malaria ◽  
Cross Sectional ◽  
Transmission Season ◽  
Asymptomatic Carriage ◽  
Low Malaria Transmission ◽  
In Pregnancy

Abstract Background: Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. In Burkina Faso, the prevalence and risk factors of asymptomatic malaria in pregnancy and its main consequence, anemia, during high and low malaria transmission seasons is underexplored at the household level.Methods: Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of malaria symptoms. Anemia was defined as hemoglobin level less than 11 g/dL.Results: Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95%CI: 20.2–28.0) during the high transmission season (October–November) in 2013. During the low transmission season, it was 12.7% (95%CI: 10.9–14.7) between December and March in 2013–2014 and halved (6.4%; 95%CI: 5.3–7.6) between April and June 2017. Anemia prevalence was estimated at 43.7% (95%CI: 39.3–48.3) during the high transmission season in 2013. During the low transmission season, it was 32.7% (95%CI: 30.1–35.5) between December and March 2013–2014 and 46.6% (95%CI: 44.3–48.9) between April and June, 2017.Conclusion: Prevalence of asymptomatic malaria in pregnancy was significantly higher during the high malaria transmission season while anemia prevalence was lower. Our study provides an opportunity to assess the prevalence of asymptomatic carriage and one of its main consequences, anemia, among pregnant women at the community level throughout the year. In order to mitigate the harmful effects of asymptomatic carriage for both the mother and fetus, health programs aimed at increasing the number of women coming into contact with health workers are necessary.

scholarly journals Antigen persistence of rapid diagnostic tests in pregnant women in Nanoro, Burkina Faso, and the implications for the diagnosis of malaria in pregnancy

2012 ◽  
Vol 17 (5) ◽  
pp. 550-557 ◽  
Author(s):  
Johanna H. Kattenberg ◽  
Christian M. Tahita ◽  
Inge A. J. Versteeg ◽  
Halidou Tinto ◽  
Maminata Traoré-Coulibaly ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Pregnant Women ◽  
Diagnostic Tests ◽  
Rapid Diagnostic Tests ◽  
Malaria In Pregnancy ◽  
Antigen Persistence ◽  
In Pregnancy

scholarly journals Malaria in Pregnancy in Nigeria: A Literature Review

2020 ◽  
Vol 3 (11) ◽  
pp. 346-348
Author(s):  
Joseph Omang ◽  
Antor O Ndep ◽  
Dominic Offiong ◽  
Fidelis Otu ◽  
Kenneth Onyejose
Keyword(s):  
Pregnant Women ◽  
Malaria Infection ◽  
Well Being ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Infected Mosquito ◽  
Insecticide Treated Nets ◽  
Health Seeking ◽  
Systematic Analysis ◽  
In Pregnancy

Malaria is caused by the parasite plasmodium which can be spread to humans through the bite of an infected mosquito. Of the five types of plasmodium (P. Falciparium, P.Ovale, P. Malaria, P. Vivax and P. Knowlesi), the plasmodium falciparium is the deadliest and affects the lives of almost  40 per cent of the world’s population with pregnant women and children  under-five years of age being the most affected. This mini-review involved the collation of findings from recent studies in regards to the prevalence of malaria infection among pregnant women and infants. A systematic analysis of recent literature on the  prevalence of malaria in pregnancy from many authors was carried out and the facts synthesized to make an easy read. From the analysis of literature, Ten Thousand women and 200,000 babies were reported to be dying annually from complications of malaria in pregnancy which recorded a prevalence of 85 per cent in sub-Saharan Africa. More so, Fifty per cent of pregnant women  were discovered to be carrying plasmodium falciparium in their placenta without even experiencing malaria signs/ symptoms, and this development was reported to have been responsible for Twenty per cent of stillbirths and 11 per cent of all maternal deaths. Malaria infection is considered a major threat to the lives and well-being of pregnant women and infants. Therefore, stakeholders should ensure that every clinical diagnosis of malaria in pregnancy is confirmed with a laboratory plasmodium falciparium-based diagnosis before the administration of antimalarial drugs. Furthermore there should be a  stepping –up on the distribution of insecticide treated nets alongside enlightenment of pregnant women on ways of preventing mosquito bite. Instituting the aforementioned approaches is key to improving the health- seeking behaviour of pregnant women in particular and the wider population in general thus enabling them to stay malaria free throughout the period of pregnancy and infancy.

scholarly journals A Socio-Ecological Approach To Understanding The Factors Influencing The Uptake Of Intermittent Preventive Treatment Of Malaria In Pregnancy (IPTp) In South Western Nigeria.

2020 ◽  
Author(s):  
Gertrude Nsorma Nyaaba ◽  
Atinuke O Olaleye ◽  
Mary O Obiyan ◽  
Oladapo Walker ◽  
Dilly OC Anumba
Keyword(s):  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Healthcare Providers ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
Bed Nets ◽  
Public Healthcare ◽  
Birth Attendants ◽  
Faith Based ◽  
In Pregnancy

Abstract Background: Malaria in pregnancy (MiP) remains a key cause of poor maternal and neonatal health outcomes. Two key strategies globally promoted to address MiP require pregnant women in malaria-endemic regions to sleep under insecticide-treated bed nets (ITNs) and take at least three doses of intermittent preventive treatment (IPTp) during pregnancy. Particularly in the African region where weak health systems grapple with prevailing socio-cultural and traditional practices, several multilevel factors influence the effective uptake of these strategies. This study explores the factors for the poor uptake of IPTp and use of ITNs in lower socio-economic communities in Nigeria. Methods: We conducted semi-structured interviews (SSI) and focus group discussions (FGD) with a total of 201 key stakeholders in 6 communities in Ogun State, South-western Nigeria. Twelve SSIs were conducted with traditional birth attendants (TBAs), faith-based birth attendants and healthcare providers operating in public health facilities. Community leaders (7), pregnant women (30) and 20 caregivers were also individually interviewed. Sixteen FGDs were conducted with multi- and first- time pregnant women grouped by location and pregnancy experiences. A thematic approach were used for data analysis. Results: At the individual and social levels, there is high general awareness of MiP, its consequences and ITNs but a low awareness of IPTp, with type of antenatal care (ANC) provider being a key factor influencing access to IPTp. Choice of type of ANC provider, which facilitates access to IPTp and ITNs, is influenced by experiences of relatives with ANC providers, attitudes of ANC providers and community perceptions of the type of ANC providers. Concurrent use of multiple ANC providers and ANC providers’ relationships further influence acceptability and coverage for IPTp and ITN use. At the health sector level, there is low awareness about preventive malarial strategies including IPTp among TBAs and faith-based birth attendants, in contrast to high IPTp awareness among public healthcare providers. Conclusion: The findings highlight several factors that influence the utilisation of IPTp services and call for greater synergy and sensitisation between the three groups of healthcare providers towards improving access to and acceptability of IPTp for improving maternal and child outcomes.

scholarly journals Prevalence of asymptomatic Plasmodium falciparuminfection, anaemia and use of ITNs among pregnant women yet to receive IPTp in parts of southern Ghana

2020 ◽  
pp. 36-42
Author(s):  
Leslie L Afutu ◽  
Johnson N Boampong ◽  
Neils B Quashie
Keyword(s):  
Pregnant Women ◽  
Parasite Density ◽  
Intermittent Preventive Treatment ◽  
Malaria In Pregnancy ◽  
Asymptomatic Malaria ◽  
Nested Polymerase Chain Reaction ◽  
Increased Risk ◽  
The Mean ◽  
To Receive ◽  
In Pregnancy

Background: Asymptomatic malaria in pregnancy evades most fever-based surveillance systems yet causes significant morbidities such as anaemia in the pregnant woman and low birth weight in the neonate. Objective:This study determined the prevalence of asymptomatic malaria and its association with anaemia among pregnant women who are yet to receive their first dose of Sulphadoxine-Pyrimethamine (SP) as intermittent preventive treatment of malaria in pregnancy (IPTp). Information on the use of insecticide treated nets(ITNs)as vector control by the pregnant women was also sought. Methods: This is a cross-sectional hospital-based study conducted in the Western Region of Ghana. Pregnant women at gestational ages, 16-26 wkwere included. A structured questionnaire was used to collect vital information from the participants. Plasmodiumparasitaemia was determined by rapid diagnostic test (MRDT), microscopy and species-specific nested polymerase chain reaction (PCR). Anaemia was classified using the level of haemoglobin. Results: A total of 413 antenatal clinic attendants were recruited. Prevalence of asymptomatic Plasmodium falciparuminfection was 13.1% by MRDT, 10.1% by microscopy and 13.8% by PCR. The mean haemoglobin was 10.73g/dL. Prevalence of anaemia was 40.49% and the mean parasite density was 149.6 parasite/μL. Pregnant women with asymptomatic malaria were 4 times more at risk of being anaemic (adjusted odds ratio with 95% confidence interval: 4.42, 1.82 -10.70)than those who did not have malaria. There was statistically significant negative correlation between parasite density and anaemia (r=0.0028, p=0.02). Conclusion: Asymptomatic P. falciparuminfection was found among some of the pregnant women and the presence of the parasites make them 4 times at increased risk of developing anaemia. Anaemia when occurring amongst such women was significantly worsened by increasing parasitaemia.

scholarly journals Malaria Detection using Polymerase Chain Reaction (PCR) Method in Pregnant Women’s Saliva on Several Hospitals in North Sulawesi Province

2016 ◽  
Author(s):  
Dewanto Khrisnamurti
Keyword(s):  
Pregnant Women ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Malaria In Pregnancy ◽  
Cross Sectional ◽  
North Sulawesi ◽  
Blood Smears ◽  
Pcr Method ◽  
Polymerase Chain ◽  
In Pregnancy

Objective: To detect malaria by PCR examination of saliva in pregnant women and to obtain the incidence of malaria and the type of plasmodium causing malaria in pregnant women at various hospital in North Sulawesi. Method: A descriptive cross sectional study in pregnant women during antenatal care at the Department of Obstetrics and Gynecology Faculty of Medicine University of Sam Ratulangi/Prof. Dr. R.D. Kandou General Hospital in Manado, R.W. Monginsidi Hospital in Manado, Bethesda Hospital in Tomohon, and Datoe Binangkang Hospital in Kotamobagu, from 1 April until 31 May 2008. Result: There were 43 pregnant women clinically diagnosed with malaria, 23 (53.49%) by PCR examination of saliva and 20 (46.59%) by blood smears. From 23 cases of malaria in pregnancy detected by PCR, there were 18 diagnosed as tropical malaria, 3 tertian malaria, and 2 mixed malaria. Conclusions: The incidence of malaria in pregnancy at various hospital in North Sulawesi using PCR methods for saliva examination from April 1 - May 31 2008 is 53.49%. In this study malaria are mostly caused by Plasmodium falciparum with the largest incidence in primigravida, in the first trimester. [Indones J Obstet Gynecol 2012; 36-1:14-9] Keywords: malaria, PCR, pregnancy, saliva

scholarly journals Population Pharmacokinetics of Mefloquine Intermittent Preventive Treatment for Malaria in Pregnancy in Gabon

2018 ◽  
Vol 63 (2) ◽  
pp. e01113-18 ◽  
Author(s):  
Michael Ramharter ◽  
Matthias Schwab ◽  
Ghyslain Mombo-Ngoma ◽  
Rella Zoleko Manego ◽  
Daisy Akerey-Diop ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
Pharmacokinetic Analysis ◽  
Population Pharmacokinetic ◽  
Blood Concentrations ◽  
Split Dose ◽  
Dosing Regimens ◽  
In Pregnancy

ABSTRACT Mefloquine was evaluated as an alternative for intermittent preventive treatment of malaria in pregnancy (IPTp) due to increasing resistance against the first-line drug sulfadoxine-pyrimethamine (SP). This study determined the pharmacokinetic characteristics of the mefloquine stereoisomers and the metabolite carboxymefloquine (CMQ) when given as IPTp in pregnant women. Also, the relationship between plasma concentrations of the three analytes and cord samples was evaluated, and potential covariates influencing the pharmacokinetic properties were assessed. A population pharmacokinetic analysis was performed with 264 pregnant women from a randomized controlled trial evaluating a single and a split-dose regimen of two 15-mg/kg mefloquine doses at least 1 month apart versus SP-IPTp. Both enantiomers of mefloquine and its carboxy-metabolite (CMQ), measured in plasma and cord samples, were applied for pharmacokinetic modelling using NONMEM 7.3. Both enantiomers and CMQ were described simultaneously by two-compartment models. In the split-dose group, mefloquine bioavailability was significantly increased by 5%. CMQ induced its own metabolism significantly. Maternal and cord blood concentrations were significantly correlated (r2 = 0.84) at delivery. With the dosing regimens investigated, prophylactic levels are not constantly achieved. A modeling tool for simulation of the pharmacokinetics of alternative mefloquine regimens is presented. This first pharmacokinetic characterization of mefloquine IPTp indicates adequate exposure in both mefloquine regimens; however, concentrations at delivery were below previously suggested threshold levels. Our model can serve as a valuable tool for researchers and clinicians to develop and optimize alternative dosing regimens for IPTp in pregnant women.

scholarly journals Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regions

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Matilda Aberese-Ako ◽  
Pascal Magnussen ◽  
Gifty D. Ampofo ◽  
Harry Tagbor
Keyword(s):  
Health System ◽  
Pregnant Women ◽  
Cultural Context ◽  
Ethnographic Study ◽  
Malaria In Pregnancy ◽  
World Health ◽  
Individual Factors ◽  
Cultural Economic ◽  
Llin Use ◽  
In Pregnancy

Abstract Background Improving maternal health remains a priority to the Ghanaian government. Consequently, it has implemented the World Health Organization recommendation of distributing free long-lasting insecticidal nets (LLINs) to pregnant women—one of the effective strategies to combating malaria in pregnancy. However, the burden of negative outcomes of malaria in pregnancy such as low birth weight and miscarriages is still high. This may be related to the health system, socio-cultural and economic dynamics that influence LLIN use, but their role is not well understood. This ethnographic study sought to understand health system, socio-cultural, economic and environmental dynamics in utilization of LLINs among pregnant women in two Ghanaian regions. Methods An ethnographic study design was used. In-depth interviews and conversations were conducted among health workers, pregnant women and opinion leaders. Observations were conducted in 12 communities and eight health facilities. Ethical clearance was obtained from the University of Health and Allied Sciences’ Research Ethics Committee. Nvivo 11 was used to support data coding. Data were triangulated and analysed using a thematic approach. Results Findings suggest health system, socio-cultural, economic, environmental and individual factors influenced LLIN use. Health facility readiness in stocking LLINs influenced ownership and use. Receiving appropriate information from health providers and encouragement from public officials improved LLIN use. Women with a history of LLIN use prior to becoming pregnant and women who had young children remained consistent users. Experiencing irritating effects of LLINs and preference for traditional methods to wade off mosquitoes, reduced LLIN use. Pregnant women whose household and family members used LLINs were influenced positively to use them. Gender power relations between husbands and wives influenced women’s use of LLINs. The type of housing and weather conditions contributed to inconsistent use. Staying out late for business purposes and to converse, exposed pregnant women to mosquito bites. Conclusion Giving out LLINs at facility level should be accompanied with comprehensive information, which is relevant to the socio-cultural context that women live in. Mass distribution should factor in individual and public information to promote community acceptance and proper use of ITNs. Facilities should be encouraged to constantly maintain LLINs stock in order to ensure that ANC registrants receive LLINs for use.

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