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Artemisinin Antimalarials in Pregnancy: A Prospective Treatment Study of 539 Episodes of Multidrug‐Resistant Plasmodium falciparum
Abstract
The emergence and spread of multidrug-resistant Plasmodium falciparum compromises the treatment of malaria, especially during pregnancy, where the choice of antimalarials is already limited. Artesunate (n=528) or artemether (n=11) was used to treat 539 episodes of acute P. falciparum malaria in 461 pregnant women, including 44 first-trimester episodes. Most patients (310 [57.5%]) received re-treatments after earlier treatment with quinine or mefloquine. By use of survival analysis, the cumulative artemisinin failure rate for primary infections was 6.6% (95% confidence interval, 1.0-12.3), compared with the re-treatment failure rate of 21.7% (95% confidence interval, 15.4-28.0; P=.004). The artemisinins were well tolerated with no evidence of adverse effects. Birth outcomes did not differ significantly to community rates for abortion, stillbirth, congenital abnormality, and mean gestation at delivery. These results are reassuring, but further information about the safety of these valuable antimalarials in pregnancy is needed.
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“and the cumulative failure rate reported in only one study was 6.6% across all trimesters (n=461).118”
From Malaria in pregnancy. (2013) · cites this paper as [118]
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“Artemisinin derivatives were relatively safe (n=1937) in the first trimester of pregnancy42,118–119 and the cumulative failure rate reported in only one study was 6.6% across all trimesters (n=461).118”
From Malaria in pregnancy. (2013) · cites this paper as [118]
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Metadata
- Authors
- McGready, R., Cho, T., Keo, N. K., Thwai, K. L., Villegas, L., Looareesuwan, S., White, N. J., & Nosten, F.
- Affiliations
- Mahidol University (TH)
- Shoklo Malaria Research Unit (TH)
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-12-15
- Volume
- 33
- Issue
- 12
- Pages
- 2009-2016
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2170827091
- Cited by
- 178
- References
- 19
- Citations by year
- 2026: 2 · 2023: 10 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 5 · 2017: 3 · 2016: 6 · 2015: 6 · 2014: 5 · 2013: 6 · 2012: 9
- FWCI
- 9.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Drug Discovery › Phytochemical compounds biological activities
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pharmaceutical Quality and Counterfeiting
- Keywords
- artemether, artesunate, Plasmodium falciparum, multidrug resistance, malaria in pregnancy, antimalarial treatment failure, birth outcomes, drug safety in pregnancy
- MeSH terms
- Animals, Antimalarials, Female, Humans, Plasmodium falciparum, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Prospective Studies, Sesquiterpenes, Malaria, Falciparum, Treatment Outcome, Drug Resistance, Multiple, Artemisinins
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