Evidence map›Paper›PMID 30654041›Full record

SynthesisTravel medicine and infectious disease

The safety of atovaquone-proguanil for the prevention and treatment of malaria in pregnancy: A systematic review.

Kristin L Andrejko, Romana C Mayer, Stephanie Kovacs, Emma Slutsker, Emily Bartlett, Kathrine R Tan, Julie R Gutman

Open access · greenAbstract readSystematic Review
In one paragraph

Synthesis in Travel medicine and infectious disease. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 23 citations in OpenAlex.

  1. Review
  2. Malaria Surveillance - United States, 2018.Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) · 2022
    Article
  3. Malaria in the pregnant traveler.Journal of travel medicine · 2020
    Article
  4. Article
  5. An update on prevention of malaria in travelers.Therapeutic advances in infectious disease
    Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 1 country.

Kristin L AndrejkoUniversity of Notre Dame, 120 Main Building, Notre Dame, IN, 46556, USA. Electronic address: kandrejk@nd.edu.
Romana C MayerMorehouse School of Medicine, 80 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, USA. Electronic address: romycperez@gmail.com.
Stephanie KovacsDepartment of Epidemiology, University of Washington, Seattle, WA, 98195, USA. Electronic address: stephk08@gmail.com.
Emma SlutskerUniversity of Georgia, 346 Brooks Hall, Athens, GA, 30602, USA. Electronic address: ecscavy@gmail.com.
Emily BartlettThe Pritzker School of Medicine, University of Chicago, 924 E 57th St, Chicago, IL, 60637, USA. Electronic address: emily.s.bartlett@gmail.com.
Kathrine R TanMalaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop A06, Atlanta, GA, 30329-4027, USA. Electronic address: ktan@cdc.gov.
Julie R GutmanMalaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop A06, Atlanta, GA, 30329-4027, USA. Electronic address: fff2@cdc.gov.
Division of Parasitic Diseases and Malaria · USMorehouse School of Medicine · USUniversity of Chicago · USUniversity of Georgia · USUniversity of Notre Dame · USUniversity of Washington · US

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

backgroundMalaria infection poses a significant risk in pregnancy, yet chemoprophylaxis for pregnant women is limited. A systematic review was conducted to evaluate the incidence of adverse outcomes after atovaquone-proguanil (AP) exposure during pregnancy.

methodsFollowing PRISMA guidelines, the authors searched PubMed, MEDLINE, and the Malaria in Pregnancy Consortium Library to identify relevant literature including infant outcomes after exposure to atovaquone, proguanil, or AP in pregnancy. Two authors independently screened the titles, abstracts, and full texts, and extracted data into an EpiInfo database. Overall proportions and 95% confidence intervals of adverse outcomes were determined by pooling data across studies.

resultsOf 455 records identified, 16 studies were included: ten AP studies and six proguanil studies. The overall proportions and 95% confidence intervals (CI) of adverse outcomes reported for the 446 women exposed to AP include miscarriage (8.08% CI: 5.07, 12.08%), stillbirth (1.05% CI: 0.03, 5.73%), early neonatal death (0% CI: 0, 7.4%), and congenital anomalies (2.56% CI: 1.28, 4.53%).

conclusionsThe limited available data suggest that outcomes following AP exposure during pregnancy are similar to expected rates in similar populations. AP may be a promising option for pregnant women, but further data are needed on its safety in pregnancy.

Indexed as

Abortion, SpontaneousAntimalarialsAtovaquoneDrug CombinationsDrug-Related Side Effects and Adverse ReactionsFemaleHumansInfant, NewbornMalariaMalaria, FalciparumPregnancyPregnancy Complications, ParasiticProguanilStillbirthTravelAntimalarialsAtovaquoneatovaquone, proguanil drug combinationDrug CombinationsProguanilAntimalarialsChemoprophylaxisFemaleHumansInfantNewbornsPlasmodiumPregnancy

Identifiers

PMID30654041
PMCPMC9074802
OpenAlexW2909347604

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.