Chloroquine sulfate 68mg/5ml oral solution

BackgroundMalaria during pregnancy poses significant risks to both the mother and the developing fetus. For pregnant women, the infection can result in severe illness and even death. Parasite sequestration in the placenta can cause maternal anemia and increase the risk of mortality both during and after childbirth. Malaria is also a major contributor to stillbirths and preterm births. Infected placental tissue can impede fetal growth, resulting in low birth weight, which is linked to delayed growth and cognitive development in the child. Furthermore, malaria during pregnancy remains a major contributor to perinatal, neonatal, and infant mortality.ObjectivesTo review the epidemiological patterns of malaria in pregnancy and its impact on maternal and neonatal health, and to analyze the availability and effectiveness of drug treatment options.MethodsRelevant articles published only in English were searched using electronic databases such as PubMed, Web of Science, Scopus, and Pro-Quest. Keywords including "'malaria in pregnancy", "placental malaria", "congenital malaria", "treatment options", and "nutrition intervention and intermittent preventive treatment" were used in combination. Of the total of 4,486 articles identified, 139 articles were ultimately included. Whereas, others were excluded due to duplication, irrelevant abstract, title, and quality assessment.ResultsFrom 139 included studies, 47 focused on epidemiology of malaria in pregnancy, 58 on its impact and 16 on treatment options and 18 on nutrition intervention and intermittent treatment. Plasmodium falciparum is the leading cause of complications in pregnant women and is primarily found in Africa, while P.vivax is recognized as an emerging global threat, and causing serious consequences. Other species, such as P.knowlesi, P.ovale, and P.malariae are less common. Malaria prevalence in pregnancy can reach 60% in sub-Saharan Africa and 36% globally, with placental malaria affecting up to 28% of cases. The disease causes serious complications such as maternal anemia, premature birth, and low birth weight, severe anemia and increased maternal and infant mortality. Prevention strategies like intermittent preventive treatment (IPTp), insecticide-treated nets (ITNs) and Indoor residual spray (IRS) are essential. Early diagnosis and treatment can reverse adverse effects on placental and congenital function. Artesunate is recommended for severe malaria in all trimesters. Even resistance to chloroquine reported in some areas, it is the drug of choice for uncomplicated P.vivax infections.ConclusionsMalaria during pregnancy significantly impacts maternal and fetal health, leading to anemia, growth restriction, preterm birth, and neonatal death. Infants born to mothers with malaria are more likely to contract the disease. Further research and improved treatment strategies are needed to address this issue effectively.

Abstract licence: CC BY-NC-ND

Abstract Background The COVID-19 pandemic has required clinicians to urgently identify new treatment options or the repurposing of existing drugs. Several drugs are now being repurposed with the aim of identifying if these drugs provide some level of disease resolution. Of particular interest are chloroquine (CQ) and hydroxychloroquine (HCQ), first developed as an antimalarial therapy. There is increasing concern with regards to the efficacy and safety of these agents. The aims of this review are to systematically identify and collate studies describing the use of CQ and HCQ in human clinical trials and provide a detailed synthesis of evidence of its efficacy and safety. Methods and Findings Searches for (“COVID” AND “chloroquine”[title/abstract] AND “outcomes”[full text]) and two (“COVID” AND “hydroxychloroquine”[title/abstract] AND “outcomes”[full text]) yielded 272 unique articles. Unique articles were manually checked for inclusion and exclusion criteria and also subjected to a quality appraisal assessment. A total of 19 articles were included in the systematic review. Seventy-five percent of observational studies employing an endpoint specific to efficacy recorded no significant difference in the attainment of outcomes, between COVID-19 patients given a range of CQ and/or HCQ doses, and the control groups. All clinical trials and 82% of observational studies examining an indicator unique to drug safety discovered a higher probability of adverse events in those treated patients suspected of, and diagnosed with, COVID-19. Seventy-five percent of the total papers focusing on cardiac side-effects found a greater incidence among patients administered a wide range of CQ and/or HCQ doses, with QTc prolongation the most common finding, in addition to its consequences of VT and cardiac arrest. Of the total studies using mortality rate as an end-point, 60% reported no significant change in the risk of death, while 30% showed an elevation, and 10% a depression, in treated relative to control patients. Conclusion The strongest available evidence suggests that, relative to standard in-hospital management of symptoms, the use of CQ and HCQ to treat hospitalised COVID-19 patients has likely been unsafe. At the very least, the poor quality of data failing to find any significant changes in the risk of VT should preclude definitive judgment on drug safety until the completion of high-quality randomised clinical trials.

Abstract licence: CC BY-NC-ND