.Background The use of dihydroartemisinin-piperaquine for the prevention of malaria in HIV-positive pregnant women was not investigated yet. Hence, we conducted systematic review and meta-analysis to discover the effectiveness of dihydroartemisinin-piperaquine for the prevention of malaria in HIV-positive pregnant women. Methodology A comprehensive search on PubMed, Google scholar, Cochrane library was conducted from inception till July 2024 and only randomized controlled trials were searched. Rev Man 5.4.1 was used to pool risk ratios of dichotomous outcomes under Random Effects models. Our primary outcome includes incidence of any malaria infection at pregnancy or during delivery diagnosed by any test. While secondary outcomes include composite birth outcome and prevalence of maternal anemia at pregnancy or during delivery. Results Statistical analysis shows that dihydroartemisinin-piperaquine significantly reduced the risk of any malaria infection at pregnancy or during delivery (RR=0.46. CI=0.33-0.64, I2=0). However, the prevalence of maternal anemia at pregnancy or during delivery (0.94, CI=0.84-1.05, I2=21%) and adverse pregnancy outcome (RR=0.95, CI=0.66-1.36, I2=32%) did not differ significantly between the two groups. Conclusion Hence, we conclude that addition of dihydroartemisinin-piperaquine to daily cotrimoxazole reduce the incidence of any malarial infection in HIV-positive pregnant women, however incidence of maternal anemia at pregnancy or during delivery and adverse pregnancy outcome did not differ between the two-treatment groups.

Disclosures

No relevant conflicts of interest to declare.

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2024
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