Intermittent screening and treatment or intermittent preventive therapy for control of malaria in pregnancy in Indonesia

在印度尼西亚，大约有10%的孕妇感染了疟疾。通过Eijkman分子生物学研究所和印度尼西亚Timika研究机构进行的一项新研究，印度尼西亚对孕期疟疾的控制可能会得到潜在的推动。他们将与来自英国利物浦热带医学院的专家一起，测试两种预防疟疾的新方法及其对怀孕的有害影响。当孕妇感染疟疾时，可能对妊娠造成毁灭性后果，导致发烧，从而可能引发早产甚至流产。妇女也有可能在没有任何外在迹象或症状的情况下被感染，但如果这些感染未被发现和不加以治疗，它们可能导致母亲贫血，并可能干扰胎儿的生长，导致出生体重过低，从而增加婴儿在婴儿期死亡的风险。新项目将利用快速诊断测试（RDT），在每次预定的产前检查中为有或没有疟疾症状的妇女提供疟疾检测。RDT操作简单，只需一滴血，并在15分钟内给出结果。这些检测呈阳性的妇女将接受一种称为双氢青蒿素-哌喹（DHP）的青蒿素联合药物治疗，这是印度尼西亚妊娠第二和第三个月的首选治疗方法。第二种被称为间歇性预防治疗的方法也将进行试验，这种方法已在非洲大多数国家使用，但尚未在亚洲使用。通过这种方法，将选择没有疟疾症状的妇女接受同样的药物，但事先不进行血液检查。这两种方法将与印度尼西亚的现行政策进行比较，在印度尼西亚，所有孕妇只在第一次产前检查时进行疟疾检测，结果呈阳性的孕妇接受DHP治疗。在随后的产前检查中，妇女只有在出现发烧等疟疾症状时才进行检测。这意味着一些感染不会被发现。预计这两种新方法要么比目前的方法更早地发现感染，要么完全预防感染。这项研究的结果，连同对每种方法的可行性和成本效益的评估，将用于为印度尼西亚和东南亚其他地区孕妇的疟疾预防政策提供信息。

FIGHTING MALARIA IN PREGNANCY IN INDONESIAThe control of malaria in pregnancy in Indonesia, where approximately 10% of pregnant women get infected with malaria, could receive a potential boost through a new study conducted by the Eijkman Institute for Molecular Biology and the Timika Research Facility in Indonesia. Together with experts from the Liverpool School of Tropical Medicine in the UK, they are going to test two new methods of preventing malaria and the harmful effects in pregnancy. When pregnant women contract malaria this can have devastating consequences for pregnancy, resulting in fever which may trigger preterm onset of labour or even pregnancy loss. It is also possible for women to be infected without showing any outward signs or symptoms, yet if these infections are undetected and left untreated, they can cause anaemia in the mother and can interfere with the growth of the fetus leading to low birth weight, which increases the risk of babies dying during infancy.The new project will provide malaria testing to women with or without the symptoms of malaria on every scheduled antenatal visit using a rapid diagnostic test (RDT). The RDT is simple to perform, uses a single drop of blood and gives results within 15 minutes. Those women testing positive will be treated with an artemisinin combination drug called dihydroartemisinin-piperaquine (DHP), which is the treatment of choice in the 2nd and 3rd trimester of pregnancy in Indonesia. A second method called intermittent preventive treatment, which is used in most countries in Africa but not yet in Asia, will also be tested. With this method women without symptoms of malaria will be selected to receive the same drug but without prior blood testing. Both methods will be compared with the existing policy in Indonesia, where all pregnant women are tested for malaria on the first antenatal visit only, and those with a positive result are treated with DHP. During subsequent antenatal visits, women are only tested if they have symptoms of malaria such as fever. This means that some infections will go undetected. It is anticipated that the two new methods will either detect infections much earlier than the current approach, or prevent them altogether.The findings of this study, together with an assessment of feasibility and cost effectiveness of each method, will be used to inform malaria prevention policy for pregnant women in Indonesia and other parts of South East Asia.