The Project

Since the beginning of the COVID-19 pandemic in November 2019, there is growing evidence that COVID-19 threatens maternal and perinatal health, putting pregnant women at higher risk of severe complications and death compared to age-matched non-pregnant women. At the same time, the number of confirmed COVID-19 cases reported in sub-Saharan Africa (SSA) continues to increase, where the highest maternal mortality rates in the world are registered. While in other parts of the world progresses are made to contain the pandemic, particularly through safe and effective vaccines, the continuing spread of SARS-CoV-2 in SSA is threatening the already fragile health services, affecting mainly the most vulnerable populations such as pregnant women.

Importantly, malaria during pregnancy constitutes a major driver of maternal and neonatal health in endemic areas. Furthermore, pregnant women with HIV infection have the highest risk for malaria and its consequences leading to even poorer maternal and infant health. The potential impact of SARS-CoV-2 infections in the context of malaria and HIV in pregnancy is still poorly understood.

Leveraging on the ongoing MAMAH clinical trial on the evaluation of antimalarial drugs for malaria prevention among HIV-infected pregnant women from Gabon and Mozambique, the goal of MA-CoV is to contribute to the understanding of COVID-19 burden and natural history among pregnant women living in malaria endemic areas and high prevalence of HIV infection from SSA. The study further aims to characterise clinical presentation of COVID-19 in pregnancy, evaluate the incidence of infection during pregnancy, identify risk factors of maternal and neonatal morbidity and mortality associated with SARS-CoV-2 infection as well as the risk of mother-to-child transmission of SARS-CoV-2.

The findings of this project will contribute to the understanding of the impact of SARS-CoV-2 and COVID-19 among pregnant women and guide case management strategies to improve maternal and neonatal health in SSA countries where diseases such as malaria and HIV are highly prevalent. This project is funded by the European and Developing Countries Clinical Trials Partnership (EDCTP) through an emergency call (RIA2020EF), which supports research projects in Sub-Saharan Africa in response to the COVID-19 pandemic. It has been planned a duration of 21 months (until 31st March 2023) and it will recruit about 1000 women.