Treatment Latin America

Meghna Desai (CDC), Julie Gutman (CDC), Clare Medendez (CRESIB)

Objective:

In areas of low transmission, such as Latin America, women may present with symptomatic malaria, manifesting with fever, cerebral malaria, respiratory distress syndrome, premature delivery, or abortion. However, many pregnant women will have subclinical infections, which can cause moderate to severe maternal anaemia that is in turn associated with low birthweight infants, adverse effects on lactation, and increased rates of miscarriage and stillbirth.

Method:

The treatment recommendations for MiP in Latin American is either artemether-lumefantrine or mefloquine-artesunate as the first line treatment for P. falciparum (depending on country); however, no previous data exists on the efficacy of these drugs for the treatment of malaria in pregnancy in this area to support their use.   The trial was conducted over four sites in the Brazilian Amazon (Porto Velho, Coari, Anajas and Cruzeiro do Sul) to assess the safety and efficacy of the present therapies, artemether-lumefantrine (Coartem) and mefloquine-artesunate. Additional data on the drug levels in pregnant women was also collected in order to help to determine the optimal dose for use in pregnancy.

Results

This trial was stopped due to the extremely low enrollment numbers due to very low transmission rates in the study site areas. This major activity was replaced with a prevention trial in Africa.