Malaria poses a significant health risk in regions where it is endemic, particularly for pregnant women and their fetuses. In these areas, Plasmodium falciparum infections are predominant, leading to substantial childhood morbidity and mortality. Historically, artemisinin-based combination therapy (ACT) has been the frontline treatment for uncomplicated P. falciparum malaria, recommended even for pregnant women in their second and third trimesters since 2006. However, due to safety concerns, WHO previously advised using a combination of quinine and clindamycin for those in their first trimester.
Recently, a comprehensive review conducted in 2022 prompted WHO to revise its guidelines. Artemether-lumefantrine, an ACT supported by robust human safety data, is now recommended as the preferred treatment for uncomplicated P. falciparum malaria during the first trimester of pregnancy. This updated guidance synthesizes findings from animal experiments and observational studies in humans, providing a thorough assessment of the effects and safety profiles of artemisinins and their partner medicines in early pregnancy.
This revision aims to optimize maternal and fetal health outcomes by ensuring effective and safe treatment options for pregnant women facing malaria infections in the first trimester.
