Malaria in pregnancy

In pregnant women, severe malaria is responsible for high maternal mortality, and uncomplicated malaria results in in high morbidity. Careful documentation of treatments showed that, although not all drugs are available for pregnant women, early treatment can greatly increase the outcome of the pregnancy, and give that child a better chance at a productive life.

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Rose McGready has worked for more than 26 years at the Shoklo Malaria Research Unit on the Thailand-Myanmar border. This research program is part of the Mahidol Oxford Tropical Medicine Research Unit and Rosie is one of the world leading experts in maternal malaria. Her research work has been translated into clinical practice and has resulted in dramatic improvements in the health of women in this marginalized population of South East Asia and beyond. Developing the team has been an essential and integral component of this process.

The mother and child health (MCH) team run a network of antenatal clinics and delivery facilities for the border population and have documented over 70,000 pregnancies and their outcomes. This massive effort has resulted in a phenomenal contribution to the evidence base on the treatment of maternal malaria, the safety of the artemisinin derivatives in pregnancy including in the first trimester and the need to adapt the dosing of antimalarial drugs during gestation. This research has resulted in a paradigm shift on the effects of malaria on the women and newborns, demonstrating that single (even asymptomatic) infections with P. falciparum or P. vivax are detrimental. These infections are associated with miscarriage a difficult finding to determine in a rural and resource constrained setting.

Collaborative studies have enhanced the local research for newborn and infant neurological and developmental examination, gestational age assessment, immunological and histopathological studies and BeMONC practice. The MCH team have published widely on other infectious (HIV, Hep B, Syphilis, Scrub and Murine Typhus, Dengue, Toxoplasmosis, Soil-transmitted Helminths) and non-communicable disease, antenatal, obstetric and newborn care, and nutrition.