Scientists at the Liverpool School of Tropical Medicine (LSTM) have collaborated with the Kenya Medical Research Institute, the Centers for Disease Control and Prevention, and the London School of Hygiene and Tropical Medicine recently conducted a study to find alternative preventatives to malaria for pregnant women living in Kenya.
"The clinical trial results were very promising showing that intermittent preventive treatment with dihydroartemisinin-piperaquine (DP) was a good alternative to using sulfadoxine-pyrimethamine (SP), however the test and treat approach was not a suitable alternative, and this was echoed in our study,” Dr. Jenny Hill, the first author of the study from the Malaria in Pregnancy Consortium and LSTM, said.
The study compared DP for intermittent screening with malaria rapid diagnostic tests (RDTs) or intermittent preventive treatment (IPTp-DP) or post-exposure treatment (ISTp-DP). These would be alternatives for the traditional policy from the World Health Organization that recommends IPTp with sulfadoxine-pyrimethamine (IPTp-SP).
“Health providers lacked the confidence in the reliability of the rapid diagnostic tests used in the test and treat approaches," Hill said. "While trial staff reported full adherence to the new drug in the trial setting, health providers were not as confident that women would adhere to multi-day regimes in non-trial settings as this requires a switch from a single-day regimen with SP, for which coverage is already sub-optimal, to more complicated regimens. With multi-day regimens, only the first dose can be given under direct observation at clinics and the remaining two doses will need to be taken at home."