In 2016, there were an estimated 216 million cases of malaria worldwide and pregnant women are particularly vulnerable.¹  In their first trimester of pregnancy, women are four times as likely to contract malaria and twice as likely to die from it as other adults, due to a decreased immune response to infections.² 

Malaria during pregnancy leads to increased risks to the mother and fetus. Most studies have focused on sub-Saharan Africa; however, pregnancy-related risks are a problem throughout the world, including in Latin America, where Plasmodium vivax is the dominant causative agent.³ 

When a woman contracts malaria, two lives are at stake, not just one. To protect pregnant women living in areas of moderate-to-high malaria transmission, WHO recommends Intermittent Preventive Treatment in pregnancy (IPTp) by administering the drug sulfadoxine-pyrimethamine (SP) on a regular basis⁴. However, drug resistance to SP and fear of its declining efficacy in IPTp are causing concern.

To address the need for more research on safety of ACTs in early pregnancy, MMV is collaborating with the Liverpool School of Tropical Medicine (LSTM) to generate additional safety data for the use of DHA-PQP during first trimester of pregnancy. This work is a dual phase observational study in Indonesia carried out by the Timika Research Facility. The study started in October 2017 and will involve retrospective and prospective analysis of DHA-PQP use during the first trimester of pregnancy.

In response to the need for new medicines to treat and protect pregnant women from malaria, MMV has developed a strategy to bring forward testing of molecules done in animal models to determine which might have detrimental effects during pregnancy. This will allow us to focus resources on those that are more likely to be well tolerated by this vulnerable group.

Around the world, women play an important role in reducing the burden of malaria. For example, in Cambodia, Mom Neth from Oslev village is a qualified VMW or Volunteer Malaria Worker. Each day she goes to the homes of people suspected of having malaria. She conducts blood tests and, if needed, administers medicines. She also educates people about malaria and how to use bed nets properly. 

“During the rainy season my children usually suffer from malaria twice. When they suffer, or a close relative suffers from malaria, I have to stop everything to help care for him or her. That means all our farm and community activities are affected.”  Fatou Touray, mother and trader, The Gambia.

Mothers such as Jennifer Alwin from Awir in northern Uganda are typically the first to act against malaria, sometimes travelling long distances to the nearest health facility to get the care their children need. Jennifer’s four-year-old son Desmond had “serious fever with a lot of diarrhea and vomiting,” Jennifer explained, when she brought him to Apac District Hospital, where he tested positive for severe malaria. 

Apac’s hospital was one of the 339 health-care facilities in Uganda that received injectable artesunate for the treatment of severe malaria, through MMV-led Improving Severe Malaria Outcomes project funded by UNITAID. After three days of treatment, Desmond was released from the hospital and is shown here happily playing with his mum and baby brother.