Treating severe malaria in pregnancy: a review of the evidence
The article "Treating severe malaria in pregnancy: a review of the evidence" compiles many studies on the treatment of severe malaria in pregnant women and draws an informed judgment and makes suggestions.
Severe malaria during pregnancy
Severe malaria is an occurrence of P. falciparum malaria with signs of organ failure that frequently escalates from an uncomplicated case of malaria. Severe malaria during pregnancy is the leading cause of maternal and newborn mortality. Pregnant women have been found to be at a higher risk of developing severe malaria than non-pregnant women, particularly those living in areas with unstable malaria transmission, which increases their chance of miscarriage, stillbirth, premature birth, or the baby having a low weight. It is also associated with anemia, hypoglycemia, and parasitemia. Severe malaria is, therefore, a huge risk to the lives of pregnant women.
Treatment options and recommendations
The World Health Organization (WHO) in its guidelines guides that both quinine and artesunate can be used to treat severe malaria during the first trimester of pregnancy, while intravenous artesunate should be utilized over quinine in the second and third quarters. WHO further recommends that priority should be given to the life of the mother during treatment of severe malaria. The treatment method chosen should be able to balance the risk of harmful effects due to the treatment with the benefits of the treatment. The treatment of severe malaria in pregnant women should always be done early to try and fight the disease before the fetus is fully developed.
Comparison of effectiveness and safety
Various studies comparing the effectiveness and safety of use of intravenous quinine and intravenous artesunate give us an idea of which drug is best. Artesunate has shown better tolerability as compared to quinine. Many studies have also associated artesunate with better cure rates, lower gametocyte carriage, and lower failure of the treatment as compared to quinine. Aggregating the outcomes of these many studies, therefore, suggested that artesunate is the more efficient and safer drug than quinine and therefore it would be best if WHO changed its guidelines to place artesunate as the recommended drug for use in treating severe malaria during all the three trimesters of pregnancy.
Significance To Course Content
Global health is the health of people on the global scale (Crisp, 2015). To attain and maintain global health then spread of infectious diseases such as malaria must be stopped and the best way of treatment developed. The article talks about the drug that is best for use in treating severe malaria in pregnant women. Pregnant women are considered a special group in Pharmacology, just like the old, children, and persons living with HIV (Davies & O’Mahony, 2015). It is for this reason that the most effective drug with the least effects on the mother and the fetus must be chosen. Choosing the right drug to treat a disease is a critical aspect in this field. That is why randomized clinical trials are done to identify the effects of drugs on the mother as well as their efficaciousness before the drugs are employed for treating the general population. The article tries to review studies and try to suggest the best drug for treating severe malaria in women. Knowledge of this would lead to faster cures, better response to treatment, and fewer effects of administration of therapy which would ultimately lead to less mortality.
Impact on global health
By identifying artesunate as the best-suited drug for treating severe malaria in pregnant women, the article opens up debate on the topic which would then lead to WHO reviewing its guidelines on the issues. Many health practitioners world over try to follow the guidelines set by WHO for treatment of diseases. Therefore if the World Health Organization were to review its guidance on the treatment of severe malaria in women and recommend artesunate, then treatment of severe malaria would be improved which would reduce the number of mortalities worldwide. This goes a good way to improving global health.
References
Crisp, L. N. (2016) One World Health: An overview of global Heath. Boca Raton, FL: CRC Press.
Davies, E.A, & O’mahony, M. S. (2015). Adverse drug reactions in special populations-the elderly. British Journal of clinical pharmacology, 80(4), 796-807.
Kovacs, S.D., Rijiken, M. J., & Stergachis, A. (2015) Treating severe malaria in pregnancy: a review of the evidence. Drug safety, 38(2), 165-181.
https://dx.doi.org/10.1007%2Fs40264-014-0261-9
