EDCTP at MIM 2018
As part of its sponsoring of and contribution to the successful MIM2018 conference on malaria in Dakar, Senegal from 15-20 April 2018, EDCTP organised a symposium on malaria in pregnancy programmes. The presentations focussed on the ‘challenges and priorities in antimalarial drug development for African pregnant women’ the practical challenges, priorities, and lessons learned by researchers conducting clinical trials in pregnant women in resource-limited settings (past and present). The presentations discussed previous and current studies on malaria in pregnancy supported by EDCTP.
One of the projects featured in the symposium was the IMPROVE project coordinated from the Liverpool School of Tropical Medicine (United Kingdom) by Professor Feiko ter Kuile and funded in 2016 with an EDCTP grant of €7,39 million.
The project studies ‘Intermittent preventive treatment in pregnancy (IPTp) with dihydroartemisinin-piperaquine (DP) and azithromycin (AZ) for malaria, sexually transmitted and reproductive tract infections in pregnancy in high sulphadoxine-pyrimethamine (SP) resistance areas in Kenya, Malawi, and Tanzania.’
The World Health Organization (WHO) has recommended further research in IPTp during pregnancy in both HIV-uninfected and HIV-infected women, as the current WHO policy – though still highly cost-effective in most endemic African countries – is compromised by the risk of parasite resistance to SP and it is contraindicated in HIV-positive pregnant women receiving cotrimoxazole prophylaxis (CTXp), leaving the more vulnerable women the less protected.
The EDCTP-funded IMPROVE project has a closely aligned counterpart in a study with HIV-infected pregnant women, IMPROVE-2: ‘IPTp with dihydroartemisinin-piperaquine and azithromycin for malaria, sexually transmitted and reproductive tract infections in HIV-infected pregnancy in Kenya and Malawi: a multicentre 3-arm placebo-controlled trial’. This study is coordinated by Professor Ter Kuile as well and funded with a grant of £2.7 million by the United Kingdom Joint Global Health Trials, a collaboration of the Department for International Development, the Medical Research Council, the National Institute for Health Research and the Wellcome Trust.
The projects aim to provide WHO with definitive evidence to determine whether IPTp with DP (with or without AZ), is a viable alternative to the IPTp with SP. A positive result would improve the outcome of pregnancies in areas of the world with moderate to high malaria transmission and high parasite resistance to SP.