By Sharon Atieno

A group of researchers have found that a new drug combination could substantially reduce malaria risk among HIV pregnant women, especially in sub-Saharan Africa. The new treatment includes the addition of the monthly antimalarial drug dihydroartemisinin–piperaquine to the daily co-trimoxazole antibiotic.

This is against the backdrop that the efficacy of the World Health Organization (WHO) recommended daily co-trimoxazole antibiotic is being threatened by malaria parasite resistance.

According to the findings of the study published in The Lancet, the new combination reduced malaria cases by 68% in pregnant women with HIV compared to the use of co-trimoxazole alone.

The study dubbed IMPROVE-2 was led by the Liverpool School of Tropical Medicine (LSTM) in partnership with the Kenya Medical Research Institute, the Kamuzu University of Health Sciences and the Malawi University of Science and Technology.

“These are promising findings, and potentially welcome news in the future of prevention malaria among pregnant women living with HIV in areas where the prevalence of the disease is high,” Feiko ter Kuile, Professor of Tropical Epidemiology at LSTM, and the study lead, said.

According to Dr. Hellen Barsosio, a Clinical Research Scientist from the KEMRI’s Centre for Global Health Research (CGHR), and lead author on the new paper published in The Lancet, not only did they find that adding dihydroartemisinin–piperaquine to co-trimoxazole was safe and prevented two out of every three malaria infections during pregnancy, it was also very well tolerated by pregnant women, which is very important when a drug is given for prevention.

“The study could lead to a much-needed policy change that could make a real difference in improving maternal and newborn health in Africa,” she said.

Dr. Simon Kariuki, Head of Malaria Program from the KEMRI-CGHR said: “We hope that these findings, along with a similar trial being conducted in Gabon and Mozambique, will inform the malaria prevention guidelines from the World Health Organization and national health policies.”

The study also involved investigators from the University of Copenhagen, Denmark, from the US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.

The study was funded through the European & Developing Countries Clinical Trials Partnership (EDCTP2) programme, a public–public partnership between 15 European and 28 African countries, supported by the European Union, and by a joint initiative of the UK Foreign, Commonwealth and Development Office; Medical Research Council; National Institute for Health Research and the Wellcome Trust; and by the Swedish International Development Cooperation Agency.