Malaria

Gaps in Research

1.: Further studies are needed to determine whether standard intermittent preventive treatment (IPT) 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 HIV-positive women.
2.: Alternate efficacious drugs for intermittent preventive treatment are needed due to resistance to SP.
3.: Additional efforts are needed to offer VCT to women presenting at health care settings with malaria symptoms to identify HIV disease 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 (IPT) 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 HIV-positive women.

Gap noted generally.

Ter Kuile email, July 2, 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

Ter Kuile, F. 2009. Email to Jill Gay, July 2. Dr. ter Kuile is Professor at the Liverpool School of Tropical Medicine, Liverpool, UK.

2. Alternate efficacious drugs for intermittent preventive treatment are needed due to resistance to SP.

Gap noted generally.

Newman et al., 2003 and EANMAT, 2003 cited in Brentlinger et al., 2006, Ter Kuile, email, July 2, 2009, Slutsker, email, July 2, 2009

3. Additional efforts are needed to offer VCT to women presenting at health care settings with malaria symptoms to identify HIV disease before the development of more serious complications.

Gap noted, for example, in Uganda.

Kamya et al., 2006

Kamya, M., A. Gsasira, A. Yeka, N. Bakyaita, S. Nsyobya, D. Francis, P. Rosenthal, G. Dorsey and D. Havlir. 2006. “Effect of HIV-1 Infection on Antimalarial Treatment Outcomes in Uganda: A Population-based Study.” The Journal of Infectious Diseases 193: 9-15.

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, Brahmbatt et al., 2008b); and generally (Ayisi et al., 2003 cited in Uneke and Ogbonna, 2009, Naniche et al., 2008).

Perrault et al., 2009, van Eijk et al., 2007, Ayisi et al., 2004

Perrault, S., J. Hajek, K. Zhong, S. Owino, M. Sichangi, G. Smith, Y. Shi, J. Moore and K. Kain. 2009. “Human Immunodeficiency Virus Co-Infection Increases Placental Parasite Density and Transplacental Malaria Transmission in Western Kenya.” American Journal of Tropical Medicine and Hygiene 80 (1): 119-125.

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.