Malaria
Gaps in Research
- 1.
- Further studies are needed to determine whether standard intermittent preventive treatment and antiretroviral therapy regimens are medically and operationally compatible in pregnancy and to determine safe and effective protocols for management of concurrent HIV and malarial infections in pregnant and non-pregnant women living with HIV.
- 2.
- Alternate efficacious drugs for intermittent preventive treatment are needed due to resistance to SP.
- 3.
- Additional efforts are needed to reduce HIV stigma so that women will present at health care settings with malaria symptoms and be willing to test for HIV before the development of more serious complications.
- 4.
- Further research is needed on infant transmission risks of malaria and/or HIV in pregnant women who have malaria-HIV co-infection.
- 5.
- Young women, in particular, need access to services and treatment for HIV and malaria during the perinatal period because they are more likely to be pregnant for the first time.
1. Further studies are needed to determine whether standard intermittent preventive treatment and antiretroviral therapy regimens are medically and operationally compatible in pregnancy and to determine safe and effective protocols for management of concurrent HIV and malarial infections in pregnant and non-pregnant women living with HIV. A study found that alternative malarial drug regimens should be considered for HIV/malaria co-infected patients receiving nevirapine.
Gap noted generally (Ter Kuile, 2009; Uneke and Ogbonna, 2009; Meshnick et al., 2006 cited in Uneke and Ogbonna, 2009; Brentlinger et al., 2007; Ward et al., 2008; Slutsker and Marston, 2007; Brentlinger et al., 2006) .
2. Alternate efficacious drugs for intermittent preventive treatment are needed due to resistance to SP. In Tanzania, a country with high rates of SP resistance, SP during pregnancy increased the risk of fetal anemia and decreased cord hemoglobin levels. IPTp did not decrease the risk of placental malaria, maternal anemia, or low birth weight. (Harrington et al., 2011).
Gap noted generally (Newman et al., 2003 and EANMAT, 2003 cited in Brentlinger et al., 2006; Ter Kuile, 2009; Slutsker, 2009); Tanzania (Harrington et al., 2011); Mozambique (Menendez et al., 2008); Malawi (Feng et al., 2010).
3. Additional efforts are needed to reduce HIV stigma so that women will present at health care settings with malaria symptoms and be willing to test for HIV before the development of more serious complications.
Gap noted, for example, in Uganda (Kamya et al., 2006); Kenya (Sande et al., 2010).
4. Further research is needed on infant transmission risks of malaria and/or HIV in pregnant women who have malaria-HIV co-infection.
Gap noted, for example, in Kenya (Perrault et al., 2009; van Eijk et al., 2007; Ayisi et al., 2004); Malawi, Tanzania and Zambia (Msamanga et al., 2009); Uganda (Brahmbhatt et al., 2008a); and generally (Ayisi et al., 2003 cited in Uneke and Ogbonna, 2009; Naniche et al., 2008).
5. Young women, in particular, need access to services and treatment for HIV and malaria during the perinatal period because they are more likely to be pregnant for the first time.
Gap noted, for example, in Kenya (Ter Kuile et al., 2003 cited in Brabin and Brabin, 2005; Brabin and Brabin, 2005).