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Abstract
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.
Original language | English |
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Article number | 107258 |
Number of pages | 8 |
Journal | International Journal of Infectious Diseases |
Volume | 149 |
Early online date | 10 Oct 2024 |
DOIs | |
Publication status | Published - Dec 2024 |
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Dive into the research topics of 'Artemisinin combination therapy at delivery to prevent postpartum malaria: A randomised open-label controlled trial'. Together they form a unique fingerprint.Projects
- 1 Finished
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A study of artemisinin combination therapy given at delivery to prevent postpartum malaria and to young infants to treat uncomplicated malaria
Davis, T. (Investigator 01), Moore, B. (Investigator 02), Laman, M. (Investigator 03), Batty, K. (Investigator 04), Manning, L. (Investigator 05) & Salman, S. (Investigator 06)
NHMRC National Health and Medical Research Council
1/01/17 → 30/06/21
Project: Research