The findings from the EDCTP-funded MAMAH trial, which was conducted between 2019 and 2023 in 5 sites in semi-rural areas in Gabon and Mozambique, showed that dihydroartemisinin-piperaquine (DHA-PPQ) as malaria intermittent preventive treatment during pregnancy (IPTp) administered concomitantly with prophylactic co-trimoxazole in pregnant women living with HIV is safe and reduces the risk of clinical malaria and overall Plasmodium falciparum infection.
The article which was published in January 2024 in The Lancet Infectious Diseases, highlights the potential of DHA-PPQ as a safe and effective strategy for malaria prevention in pregnant women living with HIV. An announcement of the article is available on the EDCTP website.
The 11th EDCTP Forum was held in Paris, France from 7th to 10th November 2023 at the Palais des Congrès de Paris. It marked the 20th anniversary of the EDCTP and presented the new programme EDCTP3. The EDCTP Forum is a biennial event that provides an international platform for the presentation and discussion of cutting-edge research addressing the burden of poverty-related and neglected infectious diseases in sub-Saharan Africa and the capacity development and networking activities that support this goal. At the forum, research progress and achievements of the first 20 years of EDCTP were discussed as well as scientific challenges to be addressed in the next decade.
The MAMAH consortium members attended with the following contributions:
Evaluation of the safety and efficacy of dihydroartemisinin-piperaquine for intermittent preventive treatment of malaria in HIV-infected pregnant women: a multi-centre, double-blind, placebo-controlled trial (MAMAH project) (oral presentation by Raquel Gonzalez)
A paradigm shift towards local and gender balanced leadership, promoting equitable partnerships and next generation African leaders (Symposium with oral presentation by Ghyslain Mombo-Ngoma)
More information about the 11th EDCTP Forum programme can be found here.
For the second time since the launch of the MAMAH project, investigators from all partner institutions came together in a face-to-face meeting. The meeting took place on the 29th and 30th of November 2022, in the facilities of ISGlobal in Barcelona.
“Collaborating together in a room works much better than via Zoom…”
Text by Meral Esen (EKUT)
From 29th November until 1st December 2023, the second MAMAH and first MA-CoV investigator in-person meeting took place at ISGlobal in Barcelona after four years of online meetings. Some partners participated remotely.
The first MAMAH investigator meeting had taken place already in 2018 in Lisbon and a second face-to-face meeting was scheduled for 2020. Due to the restrictions of the Covid-19 pandemic, during the last years, travelling was not possible for most of the consortium members including researchers from Mozambique, Gabon, Germany, Austria and Spain.
“Finally, we were able to meet in Barcelona, where we stayed together for almost three days, free from other commitments and disruptions that usually occur when you are at your workplace attending an online meeting” and “We had a really fruitful meeting – much more efficient than online e.g. via zoom” was stated from all the participants who joined the meeting on site.
Each site presented their achievements and challenges during the project, and all of the partners discussed any problems that had occurred and were mostly resolved during the studies. Plans for future activities were also presented and discussed. There was enough time for fruitful discussions and side meetings that resulted in new ideas for ancillary as well as for follow-up studies.
All in all, the scientists were very happy that the two studies turned out so well despite the challenges of the pandemic and its aftermath. They are keen to finalize the studies and to gain new knowledge in the field of maternal and infant health.
The 2022 Annual ASTMH Meeting took place from 30th October until 3rd November 2022 in Seattle, WA, USA. Scientists from across the globe discussed latest issues in global health and tropical medicine.
Partners from the MAMAH consortium attended in-person and virtually. Principal investigator Dr. Raquel González presented preliminary results of the MAMAH trial at the symposium on “Latest Research with Policy Relevance for the Treatment and Prevention of Malaria in Pregnancy in the Most Vulnerable, High-Risk Groups in Sub-Saharan Africa”.
Find more information on the ASTMH Annual Meetings here.
The full compilation of malaria sessions at the 2022 ASTMH annual meeting is available here.
The 10th EDCTP Forum was held as a virtual meeting hosted from the Joaquin Chissano International Conference Centre in Maputo from 17-20 October 2021. The Forum theme was Equity in research for health.
The MAMAH Consortium members attended virtually and live from Maputo, with two mini-oral presentations and posters:
Caring for African women: progress and main achievements of the EDCTP2- MAMAH project for malaria prevention among HIV-infected pregnant women from Gabon and Mozambique (presented by Raquel González)
Pharmacokinetic assessment of dihydroartemisinin-piperaquine (DHA-PPQ) administered as Intermittent Preventive treatment (IPTp) to HIV-infected pregnant women on antiretroviral drugs and cotrimoxazole prophylaxis: a sub-study of the EDCTP2- MAMAH project (presented by Lia Betty Dimesa)
On the 10th November 2019, Clara Menéndez (Project Coordinator) and Raquel González (Technical coordinator) visited Lambaréné. They participated in the 2nd African Congress of Clinical Trials (ACCT) organized by CERMEL and they visited MAMAH study sites in Lambaréné. Meetings with project team were held and trial’s procedures reviewed.
On the 1st April, Dr. Raquel González, ISGlobal project technical coordinator travelled to Gabon to meet the local team and visit the study sites. The following health facilities were visited: The Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne-Ebori, in Libreville, the Hôpital Régional de Lambéréné and the laboratory of CERMEL. Participant’s flow and study procedures were reviewed with the team. Also, challenges of project implementation were discussed.
Johannes Mischlinger, MAMAH researcher from the Bernhard-Nocht-Institut für Tropenmedizin (BNITM, Germany) visited ISGlobal on the 8th July 2019. Mischlinger met with ISGlobal team (Mireia Piqueras, Raquel González) and Mercè Brunet (Head of the Pharmacology and Toxicology Department at the Hospital Clinic of Barcelona). The laboratory facilities where the MAMAH PK sub-study samples will be processed were also visited. Procedures and details of the pharmacokinetics studies were discussed.
On the 14th February 2019, the DSMB members (Valérie Briand, Kassoum Kayentao, Antonella Bacchieri) and the ISGlobal team (Raquel González, Aina Casellas, Clara Pons, Mireia Piqueras) attended in Barcelona the First MAMAH DSMB Meeting. Markus Zeitlinger, also DMSB member, and Efrain Pantoja, safety monitor, participated remotely in the meeting. The protocol of the MAMAH trial was reviewed, as well as all safety issues concerning the study drugs and the safety monitoring procedures. The terms of reference for the board were established and agreed.
The proposal “Understanding the determinants of the effectiveness of HIV control strategies targeting HIV-infected pregnant women in Mozambique (Preg-multidrug)”, submitted by Tacilta Nhampossa was granted for funding (TMA2017CDF-1927) on November 2017 in the framework of the MAMAH project. With a 36-months duration, it is expected to share its results by the end of 2021.
Today, a first public version of a knowledge tool for research data sharing was presented at the EDCTP Forum. It was developed by a team from The Global Health Network. The session aimed to introduce the tool to an audience of clinical researchers and to receive as much feedback from them as possible.
Dr Michael Makanga, EDCTP Executive Director, introduced this EDCTP-funded project. Open data sharing, in general, is seen more and more as a key factor for progress in many areas. From banking to climate change, data and know-how are shared in professional fields to make faster progress by learning best practices and housing better data.
The welcoming session at a large conference is important in setting the pace for the remainder of the event. The Ninth Forum got off to a fine start on Monday evening, as it contained not only welcome messages from our Portuguese hosts, important updates on the progress of EDCTP and some inspiring keynote addresses, but also music and prizes!
Michael Makanga welcomed delegates and thanked both our hosts and the sponsoring organisations, before giving an outline of the scope of the presentations, discussions, workshops and plenary sessions that will be taking place. He announced that EDCTP´s fora will continue to be held every two years, but will in future alternate between African and European venues.
Clinical research and sustainable development in sub-Saharan Africa: the impact of North-South partnerships
The EDCTP Forum is a biennial event that provides an international platform for the presentation and discussion of frontier research to address the burden of poverty-related infectious diseases in sub-Saharan Africa, and also capacity development and networking activities to support these goals.
The EDCTP Forum attracts a diverse audience, including representatives from research institutions and universities, the larger scientific community, health care providers, governments, regional bodies, regulators, civil society and public and private research and development partners.
This project is aimed to develop new anti-malarial drugs in pregnancy prevention, promote European and African research collaboration and strengthen the research capacity of African institutions
Malaria in Pregnancy (MiP) is one of the most important preventable causes of low birth weight deliveries worldwide and a major cause of severe maternal anaemia contributing to maternal mortality. To find effective preventive interventions to reduce the incidence and consequences of malaria infection in pregnant women is a priority in endemic countries. As part of the planned activities of the Malaria in Pregnancy consortium, a global initiative bringing together a research consortium of 40 partner institutions in 28 countries around the world, this project aims not only to develop new anti-malaria in pregnancy prevention but also to promote European and to African research collaboration and to strengthen the capacity of African institutions to conduct clinical research..”
A cost-effective intervention for preventing maternal and newborn mortality
Plasmodium falciparum malaria during pregnancy can result in negative outcomes in maternal and child health. In malaria stable transmission areas in Africa, approximately 25 million pregnancies are exposed every year to the infection. An estimated 10,000 of these women and 200,000 of their infants die as a result of malaria infection during pregnancy, and severe malarial anaemia contributes to more than half of these deaths.
Recently, the causal relationship between prenatal Zika virus infection and microcephaly and other serious brain anomalies has been confirmed. This outbreak represents a global health emergency of devastating consequences for maternal and foetal health. Currently, Zika virus cases have been documented in a total of 75 countries and territories.
On December 13, the WHO released the World Malaria Report 2016, an annual report that tracks the progress and trends in malaria control and elimination at a global, regional and national level. Using data from 91 countries with malaria transmission and the help of numerous partners, the report indicates that children and pregnant women in sub-Saharan Africa have greater access to effective tools against malaria. “The news are very positive” says Clara Menéndez, director of the Maternal, Child and Reproductive Health Initiative at ISGlobal, “first, because it affects two of the most vulnerable populations to malaria in the world, African children and pregnant women, and secondly, because it reflects that a collaborative effort between ministries of health and many partners is possible and may achieve positive results.”
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