Drugs for treating uncomplicated malaria in pregnant women

Abstract

Background: Women are more vulnerable to malaria during pregnancy, and malaria infection may have adverse consequences for the fetus. Identifying safe and effective treatments is important.

Objectives: To compare the effects of drug regimens for treating uncomplicated falciparum malaria in pregnant women.

Search strategy: We searched the Cochrane Infectious Diseases Group Specialized Register (May 2005), Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2005), MEDLINE (1966 to May 2005), EMBASE (1974 to May 2005), LILACS (May 2005), reference lists, and conference abstracts. We also contacted researchers in the field, organizations, and pharmaceutical companies.

Selection criteria: Randomized and quasi-randomized controlled trials of antimalarial drugs for treating uncomplicated malaria in pregnant women.

Data collection and analysis: Both authors assessed trial eligibility and methodological quality, and extracted data. We performed a quantitative analysis only where we could combine the data. We combined dichotomous data using relative risk (RR) with 95% confidence intervals (CI).

Main results: Six trials (513 participants) met the inclusion criteria. Two were quasi-randomized, and none described allocation concealment. Data were scarce for the primary outcome, treatment failure. One trial compared artesunate plus mefloquine with quinine and reported fewer treatment failures at day 63 with the combination (RR 0.09, 95% CI 0.02 to 0.38; 106 participants).

Authors' conclusions: There is insufficient reliable research on malaria treatment options in pregnancy.