Better treatments for malaria in pregnancy are needed

Jun 17, 2008

Malaria in pregnancy threatens the life of both mother and child, and yet there has been very little research on how best to treat it, say a team of malaria experts in this week's PLoS Medicine.

Nicholas J. White (Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand) and colleagues describe a dangerous "catch-22" situation that prevents the health community from knowing whether new drugs, including new malaria drugs, are effective and safe in pregnancy.

"Since the disaster of thalidomide 50 years ago," they say, "the medical profession has been rightfully very cautious about giving newly developed drugs to pregnant women, for fear that they might damage the unborn baby." The result has been that new medicines often carry a prescribing caveat that they not be used in pregnancy. In fact, there may have been no worrying results from reproductive toxicology testing to warrant this caution—simply insufficient clinical information in pregnancy. Pregnant women with potentially fatal illnesses may thus be treated with inferior drugs to avoid a hypothetical risk to the unborn child, and the consequent liability.

This situation in turn leads to a "dangerous catch-22": new medicines that might be life-saving are not prescribed in pregnancy, and since they are not prescribed it is impossible to know whether they are effective and safe. Recognizing this catch-22, regulatory authorities in developed countries have begun to encourage pharmaceutical companies to gather information on the use of new drugs in pregnancy. But in the developing world, there are few or no studies in pregnancy on most drugs used for treating tropical infections such as malaria—and so there are often no recommendations for treating these infections based on good medical research.

Establishing the efficacy and safety of new malaria medicines in pregnancy should be an urgent priority, argue White and colleagues: "International agencies and funders need to provide adequate support for quality studies in pregnancy and, in an increasingly litigious climate, to underwrite the liabilities."

Source: Public Library of Science

Explore further: American Ebola doc: 'I am thrilled to be alive'

add to favorites email to friend print save as pdf

Related Stories

Study turns parasite invasion theory on its head

Dec 23, 2012

Current thinking on how the Toxoplasma gondii parasite invades its host is incorrect, according to a study published today in Nature Methods describing a new technique to knock out genes. The findings coul ...

3 big developments make AIDS outlook more hopeful

Nov 23, 2010

(AP) -- In the nearly 30 years the AIDS epidemic has raged, there has never been a more hopeful day than this. Three striking developments took place Tuesday: U.N. officials said new HIV cases are dropping ...

Recommended for you

American Ebola doc: 'I am thrilled to be alive'

1 hour ago

Calling it a "miraculous day," an American doctor infected with Ebola left his isolation unit and warmly hugged his doctors and nurses on Thursday, showing the world that he poses no public health threat ...

User comments : 0