To address this issue, Prof. Maketa is evaluating the use of new ultrasensitive rapid diagnostic tests for the malaria parasite. In previous studies, she has shown that these tests are more sensitive than existing rapid diagnostic tests, so should generate fewer false negatives.

In a trial in Kinshasa, the Democratic Republic of the Congo, she is comparing pregnancy outcomes in women following the standard IPTp approach with sulfadoxine–pyrimethamine with an ISTp strategy incorporating ultrasensitive rapid diagnostic tests followed by treatment with a newly registered antimalarial, pyronaridine–artesunate (Pyramax).

The trial is embedded within the EDCTP-funded PYRAPREG study, which is assessing the safety and efficacy of pyronaridine–artesunate for treatment of uncomplicated malaria infections in pregnant women.

Notably, in 2023 Prof. Maketa was the recipient of an Early Excellence in Science Award by the Bayer Foundation, which honour the outstanding research of early-career researchers globally. Prof. Maketa was the winner in the Medical Sciences category. 

However, there is growing concern about rising levels of resistance to the drugs typically used for IPTp, sulfadoxine–pyrimethamine. An alternative approach is to screen women for P. falciparum infections during pregnancy and to provide alternative antimalarials when infections are detected. One drawback of this approach, known as ‘intermittent screening and treatment in pregnancy’ (ISTp), is that malaria parasites tend to be sequestered within the placenta, so rapid diagnostic tests using peripheral blood samples may deliver false-negative results.

Infections with the malaria parasite, typically Plasmodium falciparum, are harmful to both mother and unborn child. WHO therefore recommends that pregnant women at risk of malaria should routinely be given antimalarial drugs to protect against infection, an approach known as ‘intermittent preventive treatment in pregnancy’ (IPTp).

EDCTP Career Development Fellow Professor Vivi Maketa is assessing whether highly sensitive rapid diagnostic tests for malaria parasites can be used by pregnant women who would benefit from antimalarial treatment during pregnancy.