Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK.
MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, UK.
Trends Parasitol. 2017 Jul;33(7):510-518. doi: 10.1016/j.pt.2017.03.001. Epub 2017 Mar 27.
Community chemotherapy campaigns to reduce malaria transmission often exclude pregnant women due to safety concerns related to the drugs. However, pregnant women might represent an important source of human-to-mosquito infection due to frequent parasite carriage with higher densities of parasites (often detectable by microscopy), attractiveness to mosquitoes, and modified sleeping behaviour. Accumulating evidence of the safety of artemisinin-based combination therapies for the treatment of malaria during gestation suggests that malaria elimination programmes should reconsider this exclusion. Including pregnant women will increase intervention coverage and impact, and may thereby accelerate progress towards the desired endpoint (e.g., elimination) or increase the chances of success. Studies assessing infectiousness of pregnant women and gametocyte dynamics during different trimesters of pregnancy will be valuable to support the planning of community treatment campaigns.
社区化疗运动旨在减少疟疾传播，但由于与药物相关的安全问题，通常会将孕妇排除在外。然而，由于孕妇经常携带寄生虫且寄生虫密度较高（通常通过显微镜可检测到）、对蚊子有吸引力以及睡眠行为发生改变，她们可能成为蚊虫感染人类的一个重要传染源。越来越多的证据表明，在妊娠期间使用青蒿素为基础的联合疗法治疗疟疾是安全的，这表明疟疾消除规划应重新考虑这种排除。将孕妇纳入其中将增加干预措施的覆盖范围和影响，从而可能加速向理想目标（例如消除）迈进，或增加成功的机会。评估孕妇在妊娠不同阶段的传染性和配子体动态的研究将有助于支持社区治疗运动的规划。
