The Malaria Burden: A South African Perspective

Table 4

Treatment options for uncomplicated malaria infection in pregnancy [50, 101].

Malaria species	Trimester	Treatment	Directions for use	Special notes
P. falciparum	First	Quinine and clindamycin	7-day treatment	Quinine can be used alone and can be used if clindamycin is not available. In cases of failure or unavailability, artemisinin-based combination therapy or oral artesunate with clindamycin can be used for 7 days, as artemisinin derivatives have not shown risk for major congenital defects
Non-falciparum malaria	First	Chloroquine	As described in Table 3	Can be replaced with quinine for chloroquine-resistant infections
P. falciparum	Second and third	ACTs as the first-line treatment, the same as for nonpregnant adults	Any ACTs can be used in pregnancy	The mean birthweight was significantly higher in patients using ACTs, as ACTs might clear parasites (including placental parasites) more efficiently than other treatments