Drug prevents malaria complications in pregnancy

WASHINGTON, June 20 (Reuters) A drug given to pregnant African women in malaria-endemic regions remains effective at preventing malaria's harm to developing babies even as it loses its ability to treat children with the disease, experts said.

Writing in the Journal of the American Medical Association, the researchers analysed nine studies published in the past decade and concluded that sulfadoxine-pyrimethamine still has significant value in warding off malaria pregnancy complications like anaemia and low birth weight in babies.

Malaria, a mosquito-borne disease caused by a parasite, occurs throughout tropical and sub-tropical regions of the world, killing at least a million people annually, most of them young children in sub-Saharan Africa.

But malaria's burden also falls heavily on pregnant women and their unborn babies.

Women with malaria, even those not showing outward symptoms of the disease, face an increased risk of spontaneous abortion, stillbirth, premature delivery and having a low birth weight baby, a leading cause of child mortality.

Dr Scott Filler of the US Centers for Disease Control and Prevention, writing with two other malaria experts, said the drug has rising rates of failure in treating children with malaria, as the organism acquires resistance to it.

''The drug is losing its effectiveness in treating malaria in kids. But it's maintaining its effectiveness for prevention of the adverse effects of malaria in pregnancy,'' Filler said in a telephone interview.

About 50 million women in malaria-endemic regions become pregnant each year, 30 million of them in sub-Saharan Africa. The UN World Health Organisation said malaria in pregnancy causes up to 200,000 newborn deaths each year.

ONLY VIABLE OPTION Sulfadoxine-pyrimethamine is considered the only viable option for use in preventing malaria complications in pregnancy because of its low cost, documented safety and ease of use, the researchers said.

Public health campaigns in malaria regions aim to have all pregnant women get doses of the drug after their first trimester to prevent complications in the event they get the disease.

It most frequently has been given in two doses, in the second and then third trimester. An alternative approach has been monthly doses starting in the second trimester, for an average of five doses.

Women infected with the AIDS virus are at even higher risk for negative effects of malaria in pregnancy. Some research has indicated increasing the frequency of doses may help these women and HIV-uninfected women as well, Filler said.

Malaria has become resistant to some drugs, and work on a vaccine has been slow. Bed nets to protect against mosquito bites, insecticides and antimalarial drugs are effective ways to combat malaria.

REUTERS RJ PM0950