title: Moving targets: The challenges of studying infectious diseases among pregnant women in resource limited settings.
abstract: Conducting clinical trials to prevent and treat infectious diseases in pregnancy is essential to saving maternal and newborn lives, though it is fraught with challenges. We have been conducting research in malaria treatment and prevention in children and pregnant women in Blantyre, Malawi for over a decade. Here, we review some of the unique challenges that we have faced in leading research studies that with rigor and integrity and maintaining the highest ethical standard. We conclude with concrete strategies to overcome some of the apparent obstacles that frequently focus on building trust through bidirectional communication with local health workers and communities. We also highlight the key role of local and international investigators to advocate for the health of the communities in which they work.
authors: Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi.
authors: Titus H
authors: TH
authors: Divala
authors: Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi.
authors: Randy G
authors: RG
authors: Mungwira
authors: Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: mlaufer@medicine.umaryland.edu.
authors: Miriam K
authors: MK
authors: Laufer
mesh_terms: D000068456:Clinical Studies as Topic / Q000941:ethics / Q000592:standards*; D003906:Developing Countries; D005260:Female; D058015:Health Communication; D006801:Humans; D008288:Malaria / Q000188:drug therapy* / Q000517:prevention & control*; D008295:Malawi; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000517:prevention & control*
keywords: Antenatal care; Clinical trials; Generalizability; Infectious diseases; International health; Pregnancy