Article type
Year
Abstract
Background: Malaria in pregnancy is one of the serious global problems of our time. There were wide concerns about dihydroartemisinin-piperaquine versus sulphadoxine-pyrimethamine for prevention of malaria during pregnancy.
Objectives:To assess the current latest evidence on the efficacy and safety of dihydroartemisinin-piperaquine versus sulfadoxine-pyrimethamine for malaria in pregnancy.
Methods:The Cochrane Library, EMBASE, PubMed and Web of science were searched from the earliest publication date available to July 4, 2019. We included randomized controlled trials comparing dihydroartemisinin-piperaquine with sulfadoxine-pyrimethamine for malaria in pregnancy. Outcomes were analyzed using Risk ratios (RR) and 95% confidence intervals (CI). We did subgroup analysis about different intervals, including 4-6 or 8 weeks.
Results:A total of five studies with 4660 HIV-uninfected pregnant women in area of high malaria-transmission intensity were included in final synthesis. Meta-analysis showed dihydroartemisinin-piperaquine for intermittent preventive treatment resulted in lower rates of placental malaria (RR=0.50; 95%CI, 0.43–0.59) and infection with malaria parasites at delivery (RR=0.05; 95%CI, 0.01–0.24). In the subgroup analysis, dihydroartemisinin-piperaquine for intermittent preventive treatment at 4-6 weeks of administration was associated with a better effect for infection with malaria parasites at delivery.
Conclusions:Dihydroartemisinin-piperaquine was a promising alternative drug to sulfadoxine-pyrimethamine for intermittent preventive treatment in settings with high sulfadoxine-pyrimethamine resistance, especially at 4-6 weeks of administration. Based on real-world and other epidemiological settings, more data will be needed to identify the risk of adverse effects.
Patient or healthcare consumer involvement: No
Objectives:To assess the current latest evidence on the efficacy and safety of dihydroartemisinin-piperaquine versus sulfadoxine-pyrimethamine for malaria in pregnancy.
Methods:The Cochrane Library, EMBASE, PubMed and Web of science were searched from the earliest publication date available to July 4, 2019. We included randomized controlled trials comparing dihydroartemisinin-piperaquine with sulfadoxine-pyrimethamine for malaria in pregnancy. Outcomes were analyzed using Risk ratios (RR) and 95% confidence intervals (CI). We did subgroup analysis about different intervals, including 4-6 or 8 weeks.
Results:A total of five studies with 4660 HIV-uninfected pregnant women in area of high malaria-transmission intensity were included in final synthesis. Meta-analysis showed dihydroartemisinin-piperaquine for intermittent preventive treatment resulted in lower rates of placental malaria (RR=0.50; 95%CI, 0.43–0.59) and infection with malaria parasites at delivery (RR=0.05; 95%CI, 0.01–0.24). In the subgroup analysis, dihydroartemisinin-piperaquine for intermittent preventive treatment at 4-6 weeks of administration was associated with a better effect for infection with malaria parasites at delivery.
Conclusions:Dihydroartemisinin-piperaquine was a promising alternative drug to sulfadoxine-pyrimethamine for intermittent preventive treatment in settings with high sulfadoxine-pyrimethamine resistance, especially at 4-6 weeks of administration. Based on real-world and other epidemiological settings, more data will be needed to identify the risk of adverse effects.
Patient or healthcare consumer involvement: No