Guidelines and considerations for testing malaria vaccines in pregnant women.

Malaria during pregnancy continues to be an important cause of maternal and infant morbidity and mortality in endemic areas, where at least 50 million pregnancies are exposed to the infection every year. Important progress has been made in the last years especially in sub-Saharan Africa, with the introduction of strategies to prevent malaria in pregnancy consisting of intermittent preventive treatment and insecticide treated nets. However, their coverage is still unacceptably low and malaria continues to demand a huge toll on pregnant women and their newborns. Thus, there is a need to explore other preventive strategies such as a vaccine against malaria, which combined with the current tools would maximize the protection efficacy. Given the specific and complex characteristics of the pregnancy status, it is important to review all the issues that would need to be considered in the evaluation of a vaccine against malaria in pregnancy while waiting for it to become available.