To treat or not to treat: Evaluation of the use of artemisinin for the treatment of malaria during pregnancy

Malaria is an enormous global burden, causing severe morbidity and mortality. Pregnant women are amongst the most vulnerable to the development of severe malaria caused by the multidrug-resistant protozoan parasite 'Plasmodium falciarum'. Artemisinin derivatives are now widely used and highly effective in treating malaria. This paper explores the safety and efficacy of artemisinin administration as a treatment option for malaria during pregnancy. Clinical trials involving animal subjects have raised concerns over the safety of artemisinin administration in early gestation. At present artemisinins are only recommended by the World Health Organization as safe for the treatment of malaria during the second and third trimesters. However, it is concluded that the risk of developing artemisinin-induced toxicity is non-inferior to comparative antimalarials, and is far outweighed by the deleterious consequences of failing to adequately clear the parasite. Therefore, artemisinins should not be disregarded as a treatment option for first-trimester infections due to a lack of research evidence. Further research into the field of artemisinin use in treating malaria during pregnancy should be an immediate priority