title: Pregnant Women: An Overlooked Asset to Plasmodium falciparum Malaria Elimination Campaigns?
abstract: 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.
authors.affiliation: Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Bronner P
authors.initials: BP
authors.lastname: Gonçalves
authors.affiliation: MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, UK.
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Walker
authors.affiliation: MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Cairns
authors.affiliation: Department of Public Health, Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso.
authors.forename: Alfred B
authors.initials: AB
authors.lastname: Tiono
authors.affiliation: Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK; Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Teun
authors.initials: T
authors.lastname: Bousema
authors.affiliation: Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: Chris.Drakeley@lshtm.ac.uk.
authors.forename: Chris
authors.initials: C
authors.lastname: Drakeley
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D060740:Disease Eradication; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000517:prevention & control*; D011247:Pregnancy; D011314:Preventive Health Services / Q000592:standards* / Q000639:trends
chemical_list: D000962:Antimalarials
keywords: elimination; gametocytes; malaria; pregnancy; transmission