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Artemisinin combination therapy for uncomplicated falciparum malaria in pregnancy (March 2016)

An artemisinin combination therapy (ACT) is the regimen of choice for treatment of pregnant women with uncomplicated chloroquine-resistant P. falciparum malaria during the second or third trimesters. This approach is supported by a recent large trial including 3428 pregnant women in four African countries (Burkina Faso, Ghana, Malawi and Zambia) randomly assigned to treatment with one of four ACT regimens (artemether-lumefantrine, amodiaquine-artesunate, mefloquine-artesunate, or dihydroartemisinin-piperaquine) with cure rates of 95 to 99 percent [5]. Dihydroartemisinin-piperaquine had the best efficacy and an acceptable safety profile, with the benefit of a longer post-treatment prophylactic effect.

Artemether-lumefantrine was associated with the fewest adverse effects and acceptable cure rates, but had the shortest post-treatment prophylactic effect; this may be particularly important in high-transmission settings where a prolonged post-treatment prophylactic effect can reduce morbidity by decreasing the frequency of new infections. (See "Prevention and treatment of malaria in pregnant women", section on 'Second and third trimesters'

     

 
     

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