Optimization of antimalarial treatment for pregnant women: a pharmacoepidemiological approach

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K16316
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 54030:Infectious disease medicine-related
• Research Institution: The University of Tokyo
• Principal Investigator: Saito Makoto 東京大学, 医科学研究所, 助教 (30871339)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: マラリア / 妊婦 / 疫学

Outline of Final Research Achievements

The aim of this project was to explore the impact of malaria on mothers and fetuses, and to optimize antimalarial treatment for pregnant women. Firstly, we analyzed data on severe malaria in pregnant women in six Southeast Asian countries with low malaria transmission. The risks of maternal mortality and fetal loss following severe malaria were very high. Although severe anemia and hyperparasitaemia were common among pregnant women, these two criteria alone were not associated with maternal mortality, suggesting that severe malaria criteria may need to be tailored for pregnant women. Secondly, we compared antimalarial drug levels in capillary and venous blood samples to assess whether capillary samples, which can be collected more easily and less invasively, could be used. Although antimalarial drug levels in capillary samples were highly correlated with those in venous samples, the drug levels of lumefantrine and piperaquine could not be predicted with adequate precision.

Free Research Field

感染症疫学

Academic Significance and Societal Importance of the Research Achievements

本研究の研究結果は、熱帯熱マラリアにり患した妊婦の中で、よりハイリスクな妊婦患者の識別に役立つことが期待され、早期に適切な治療を受けることは母児の高い致死率の抑制につながることが期待される。また、毛細血管血は簡便で低侵襲的な採血手段ではあるが、治療効果予測等の目的で静脈血薬物濃度の代替として個々の患者に対して用いるには薬物の種類によっては注意が必要であることが示唆された。一方で、全体としては静脈血と高い相関を示しており、薬物動態解析等に用いることは可能であると考えられ、今後の研究の推進に役に立つことが期待される。