New Strides in Prevention of Malaria during Pregnancy Present Multitudinous Opportunities.

IF 4 2区 医学 Q2 CHEMISTRY, MEDICINAL ACS Infectious Diseases Pub Date : 2024-11-08 Epub Date: 2024-10-15 DOI:10.1021/acsinfecdis.4c00566
Jasmita Gill, Anupkumar R Anvikar
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Abstract

Pregnant women are at a higher risk of developing complications from malaria, a mosquito-borne disease caused by Plasmodium parasites, resulting in considerable maternal and infant morbidity and mortality. Malaria in pregnancy causes unfavorable and life-threatening outcomes for both the mother and fetus not limited to maternal anemia, hypoglycaemia, cerebral malaria, pulmonary edema, and puerperal sepsis. WHO recommends wide-ranging strategies for this detrimental but preventable disease; however, numerous challenges persist in ensuring high uptake of preventive therapies, effective usage of insecticide-treated bed nets, and early initiation and optimal antenatal care coverage for pregnant women. This work distils recent global advances in preventive strategies for malaria in pregnancy. We discuss three mainstay interventions by WHO, viz. intermittent preventive treatment of malaria in pregnancy (IPTp), utilization and outcomes of insecticide-treated bed nets (ITNs), and headways in malaria case management using therapeutic drugs. We cover multitudinous facets of antenatal care, WHO-advised community-based delivery of IPTp (c-IPTp), intermittent screening and treatment for malaria in pregnancy (ISTp), a malaria vaccine for pregnant women, and auxiliary factors that are crucial for improving prevention outcomes. Despite the reduction in malaria globally, malaria in pregnancy remains a prevalent issue in endemic areas, which warrants strengthening of preventative strategies. This work attempts to consolidate pivotal observations of the prevention of malaria during pregnancy by highlighting key advances, priority areas, new opportunities, research gaps, and challenges that need to be addressed to ensure improved outcomes in pregnant women infected with malaria.

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预防孕期疟疾的新进展带来了众多机遇。
疟疾是一种由疟原虫引起的蚊媒疾病,孕妇患上疟疾并发症的风险较高,会导致相当高的母婴发病率和死亡率。妊娠期疟疾会对母亲和胎儿造成不利和危及生命的后果,不仅限于母亲贫血、低血糖、脑型疟疾、肺水肿和产褥败血症。世卫组织针对这种有害但可预防的疾病提出了广泛的策略建议;然而,在确保预防性疗法的高吸收率、驱虫蚊帐的有效使用、孕妇产前护理的早期启动和最佳覆盖率等方面仍存在诸多挑战。这项工作总结了近期全球在妊娠期疟疾预防策略方面取得的进展。我们讨论了世界卫生组织的三种主要干预措施,即妊娠期疟疾间歇预防性治疗(IPTp)、驱虫蚊帐(ITNs)的使用和效果,以及使用治疗药物进行疟疾病例管理的进展。我们的研究涉及产前护理、世界卫生组织建议的基于社区的妊娠期疟疾间歇疗法(c-IPTp)、妊娠期疟疾间歇筛查和治疗(ISTp)、孕妇疟疾疫苗以及对提高预防效果至关重要的辅助因素等多个方面。尽管全球疟疾发病率有所下降,但在疟疾流行地区,妊娠期疟疾仍是一个普遍问题,因此需要加强预防策略。这项工作试图通过强调关键进展、优先领域、新机遇、研究差距以及为确保改善感染疟疾的孕妇的治疗效果而需要应对的挑战,来整合孕期疟疾预防方面的关键观察结果。
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来源期刊
ACS Infectious Diseases
ACS Infectious Diseases CHEMISTRY, MEDICINALINFECTIOUS DISEASES&nb-INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.80%
发文量
213
期刊介绍: ACS Infectious Diseases will be the first journal to highlight chemistry and its role in this multidisciplinary and collaborative research area. The journal will cover a diverse array of topics including, but not limited to: * Discovery and development of new antimicrobial agents — identified through target- or phenotypic-based approaches as well as compounds that induce synergy with antimicrobials. * Characterization and validation of drug target or pathways — use of single target and genome-wide knockdown and knockouts, biochemical studies, structural biology, new technologies to facilitate characterization and prioritization of potential drug targets. * Mechanism of drug resistance — fundamental research that advances our understanding of resistance; strategies to prevent resistance. * Mechanisms of action — use of genetic, metabolomic, and activity- and affinity-based protein profiling to elucidate the mechanism of action of clinical and experimental antimicrobial agents. * Host-pathogen interactions — tools for studying host-pathogen interactions, cellular biochemistry of hosts and pathogens, and molecular interactions of pathogens with host microbiota. * Small molecule vaccine adjuvants for infectious disease. * Viral and bacterial biochemistry and molecular biology.
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