#Manhiça

[beardedmrbean]

MAPUTO, Mozambique (AP) — At least 10 people were fatally shot by police and dozens of others were injured when authorities cracked down on unrest following Mozambique's presidential election, two medical groups said, as the country braced Thursday for more protests against a vote criticized as fraudulent by opposition parties and questioned by international observers.

Daniel Chapo of the ruling Front for the Liberation of Mozambique was announced as the winner of the election on Oct. 24, extending the Frelimo party's 49 years in power since independence from Portugal in 1975. Chapo is to succeed President Filipe Nyusi, who is stepping down after serving the two terms allowed under the constitution.

Frelimo has regularly been accused of rigging elections and Mozambique's security forces have previously been criticized for suppressing protests with deadly force. Opposition parties claimed fraud on the day of the election, while observers from the European Union said in a later report that there were irregularities in the vote counting and some results had been altered.

Tensions were high in the southern African country in the buildup and immediate aftermath of the Oct. 9 vote, but more unrest was stoked when two senior officials of an opposition party were killed in their car in the capital, Maputo, on Oct. 18 after being ambushed by unidentified gunmen late at night. The opposition says the attackers fired 25 bullets at the car.

The killings were widely seen in Mozambique as being politically motivated. One of the victims was the lawyer and adviser to Venancio Mondlane, the main opposition candidate for president who was second in the election.

Ten people died of gunshot wounds and another 63 were wounded by gunfire in protests between Oct. 18 and Oct. 26, the Medical Association of Mozambique and the Mozambique Order of Doctors said in a joint statement Wednesday. “In most of the shootings, especially those that resulted in death, the intention of the police was to shoot to kill," Gilberto Manhiça, the head of the Order of Doctors, was quoted as saying by local media.

In a separate statement, Human Rights Watch put the death toll at 11. It said more than 50 people sustained serious gunshot wounds in the protests and called for an investigation into the “apparently excessive use of force."

Amnesty International said police also fired on a peaceful opposition rally in the city of Nampula on Oct. 16, injuring at least one person, and “repeatedly attacked” protesters during the post-election demonstrations.

Protesters burned tires and blocked roads in some cities and authorities characterized some of the unrest as violent that had to be quelled. Police spokesperson Orlando Mudumane told state-run Radio Mozambique that the situation was now “relatively calm and controlled.”

Opposition leader Mondlane has called for a week of new protests to begin on Thursday.

[ojoaoroxo]

2024. Curatorial and Artistic intervention at UPCycles, an audiovisual creative residency that proposes the use of audiovisual archives through multidisciplinary artistic work. Promoted by Associação dos Amigos do Museu do Cinema em Moçambiquem the project is supported by Fundação Calouste Gulbenkian. In collaboration with the artists Phayra Baloi and Ângela Ferreira. Special Thanks to Diana Manhiça.

[radiochuabo01]

Cabeça de lista da RENAMO Realizou Marcha nas Artérias da Cidade em Jeito de Campanha

O Cabeça de lista da RENAMO, Manuel de Araújo, dedicou-se na tarde desta sexta-feira (29) a realização de uma marcha que partiu do bairro Manhiça, tendo prosseguido nas avenidas da cidade de Quelimane no seu quarto dia de campanha eleitoral. Segundo informações avançadas pelo gabinete de comunicação e imagem do partido, estava previsto um comício no bairro 3 fios, onde membros e simpatizantes do…

[kaimaciel]

Isaías Manhiça - "Why Don't You Do Right" | Prova Cega | The Voice Portugal

[felipeandletizia]

Queen Letizia begins her trip to Mozambique to support Spanish cooperation

Queen Letizia has started her trip to Mozambique this Sunday to know and support the work done by Spanish cooperation in a country that has been hit by two cyclones in just a month and a half.

The airplane of the Spanish Air Force in which Doña Letizia travels has left from the air base of Torrejón de Ardoz shortly after 10 AM.

The queen travels to Mozambique accompanied by the Secretary of State for International Cooperation and for Ibero-America and the Caribbean, Juan Pablo de Laiglesia, and the director of cooperation with Africa and Asia of the Spanish Agency for International Cooperation, Cristina Díaz.

With them, Doña Letizia analyzed this week, in a meeting at the la Zarzuela, the cooperation that Spain provides to Mozambique and the situation after the cyclone Idai that hit the country on March 14.

A catastrophe that caused more than 600 fatalities in the country, more than 300 in Zimbabwe and more than fifty in Malawi.

Last Thursday, another cyclone, the Kenneth, affected the North of the country and has also left, in addition to significant material damage, at least one fatality.

The queen will arrive on Sunday night in the capital, Maputo, where she will meet with the president of Mozambique, Filipe Nyusi, on Monday and with whom she will hold a working lunch in which the first Mozambican lady, Isaura Nyusi, will also be present.

On that day, doña Letizia will also visit the health research center of Manhiça, founded in 1996 with the support of the AECID and which has become an international reference center in the fight against contagious diseases such as malaria.

In addition, the queen will travel to the cooperation technical office to meet with her staff, as well as representatives of NGOs and religious congregations that carry out their work in the country.

On Tuesday, the agenda will focus on Beira, the second most populated city in Mozambique, which was particularly hit by cyclone Idai, to learn about its effects on the ground and the emergency aid that Spain has been providing.

An aid that has included the installation for the first time of an emergency hospital under the responsibility of the Spanish Emergency Response and Aid Team (STAR), made up of 71 professionals prepared to be recruited when international organizations or affected countries request health assistance after a catastrophe.

This trip to Mozambique is the fourth in support of Spanish cooperation by doña Letizia as queen after those made to the Dominican Republic and Haiti (2018), Senegal (2017) and Honduras and El Salvador (2015).

[joaotimaneart]

João Timane e a pintura de Vasco Manhiça. #artistaplasticomoçambicano https://www.instagram.com/p/CeAyqGUK5x8/?igshid=NGJjMDIxMWI=

[portalmozemprego]

Vagas recentes de emprego

Você procurando por vagas recentes de emprego? Se a resposta for sim então fique atento neste post porque compilamos várias vagas de emprego que foram disponibilizados dentro desses dias.

Portanto, nos dias de hoje possuir uma boa vaga de emprego em Moçambique é uma das coisas mais difíceis de conseguir, por isso, você visitou o nosso site principal.

Abaixo ainda neste artigo contém os dados e informações necessárias para você poder se candidatar para uma vaga de emprego. Olha, eu não sei quais são as suas características de emprego ou de trabalho, mas pode contar com o Portal Moz Emprego, pois diariamente vamos postando sempre novas oportunidade de trabalho para você.

A forma de encontrar emprego varia atualmente, portanto, depois e durante a pandemia e confinamento obrigatório muitas pessoas perderam os seus empregos, por isso, atualmente procurar emprego online, ou seja, na internet é uma das melhores opções.

Vagas recentes de emprego

Abaixo está a oportunidade de emprego em diversas áreas, escolhe a que você achar mais adequado e se se candidate, não deixe para amanhã o que pode fazer ainda agora.

Vagas para bombeiro profissional em Maputo

A Weliz está a contratar um Barbeiro profissional em Maputo

Funções necessárias

Cortes de cabelo masculino

Cortes de barba

Cortes infantis

Cortes de cabelo feminino

Requisitos desejados

Experiência comprovada no ramo

Boa apresentação

Disponibilidade imediata

Como se candidatar

1. Documentação – Curriculum vitae

Envie um e-mail para o e-mail welizbshop@gmail.com e escreva como assunto “Barbeiro profissional”

Vaga Para 6 Técnicos de IT em Maputo

Requisitos necessários

– Licenciatura em Tecnologias de Informação, ou areas afins.

– 2 anos de experiência na área de segurança de TI, ou, em administração de Sistemas, Administrador de aplicativos.

– Exploração CCNA (Fundamentos de Rede)

– Ter conhecimento do Sistema Operacional Linux, MySQL, Oracle.

– Experiência com comando Linux, sistema de Hardware, aplicação Java é um diferencial.

– Mente aberta e interessada em aprender coisas novas.

– Auto-motivado com uma atitude positiva de “posso fazer” e trabalho em equipe.

– Bem disciplinado e responsável pela entrega da tarefa.

Exigências do contrante

– Carta de apresentação

– Curriculum Vitae

Processo de candidatura

Submeta a sua candidatura pelo endereço eletrônico abaixo, e indique a vaga para qual se candidata. E-mail: recrutamento@movitel.co.mz Validade da candidatura: 30 de Maio de 2022

Vaga para piscicultor empreendedor

A PROMETRA – Agro pretende recrutar 01 piscicultor empreendedor para integrar a sua equipa de empreendedores a exercer as suas actividades em zonas rurais remotas dos distritos de Manhiça e/ou Moamba.

Requisitos necessários:

Dominar a piscicultura, preferencialmente da tilápia;

Ser maior de 25 anos de idade;

Estar actualmente desempregado;

Ter disponibilidade imediata para trabalhar e viver no campo, em condições extremas;

Demonstrar as suas habilidades de empreendedor na área de piscicultura durante 6 meses sem salário mas com subsídio básico de alimentação;

No acto da candidatura os interessados devem submeter:

Carta de manifestação de interesse;

Carta/resumo de apresentação da sua experiência de piscicultor;

CV;

Fotocópia do BI autenticada;

Nota: Os níveis académicos, certificados e diplomas, não são relevantes mas sim a experiência ou habilidades do saber fazer.

As candidaturas devem ser entregues entre 8:00H – 16:00H, na Maluana, distrito da Manhiça, Estrada Nacional nr. 1, Km 65, Tels: + 258 845111045 / 875111042 / 21 902274 até as 16 horas do dia 26 de Maio de 2022. Não se aceita candidaturas via E-mail!

Vagas Para 3 Assistentes de Portfólio

A DAI, uma empresa de consultoria de desenvolvimento global, está a implementar o projecto de Apoio ao Ambiente de Políticas para o Desenvolvimento Económico (SPEED) financiado pela USAID. O Projecto SPEED apoia as reformas políticas económica e estruturais em 6 componentes nomeadamente: agricultura; ambiente propício de comércio e negócio; energia; conservação da biodiversidade; Saúde e governança económica. É neste contexto que a DAI pretende recrutar imediatamente candidatos qualificados às vagas abaixo mencionadas que estarão baseadas em Maputo.

Assistente de Portfólio

Os candidatos interessados poderão obter os termos de referência a partir do endereço Submeter os seus CVs em Inglês até o dia 30 de Maio de 2022 através do: https://speed-program.applicantstack.com/x/openings Apenas os candidatos pré-seleccionados serão contactados.

Vaga Para Oficial de Programa

A Aldeias das Crianças SOS Moçambique é membro da S0S Kinderdort International, uma das maiores organizaçóes nao governamentais dedicada a apo10 de crianças sem cuidados parentais adequados ou em risco de perde-los. Em Moçambique, a organiza çăo está estabelecida em seis províncias, designadamente Maputo, Inhambane, Sofala, Manica, Tete e Cabo Delgado.

A Aldeia pretende recrutar para o seu quadro de pessoal uma (1) Oficial de Programa para o seu Programa de Desenvolvimento de Juventude da Beira. A responsabilidade da oficial da juventude é asegurar a continuidade do desenvolvimento educacional e da carreira profissional dos jovens em cuidados alternativos.

Responsabilidades do contratante:

Liderar e implementar iniciativas de desenvolvimento da juventude;

Orientar iniciativas de formação;

Acompanhar a formaçă de jovens, organizar aulas tutoriais, auxiliar os de baixo desempenho e os orienta sobre o uso da biblioteca e hábitos de estudo;

Manter-se informado sobre questões sociais conmo AIDS, drogas, etc, e compartilha regularmente essas informaçóes com os jovens para que cresçam em maturidade e respois abilidade.

Requisitos necessários:

Licenciatura em Ciências Sociais, Estudos de Desenvolvimento, Gestão de projectos ou areas relaclonadas; Experiència comprovada de trabalho na área de desenvolvimento de juventude ou áreas afins; Dominio da abordagem de gestão de projectos/financiamentos baseados em resultados, desemp enho e método de quadro lógico e planificação particip ativa; Conhecimento sobre protecção a criança, gênero, e outras areas transversais;

Os candidatos interess ados poderão submeter os seus CV’s, acompanhados pela carta de Interesse e demais documentos que possam reforçar a sua candidatura: Fotocópia do B.I., Certificado de habilitações, 3 Cartas “oficiais” de re ferências, através do seguinte correio electrónico: Recruitment.SOS@soscvs.org.mz, indicando no Assunto ” BEIRA-OJ-2022” até ao dia 2/6/2022.

  Veja também: Recrutamento Banco Terra (2022)

Cervejas de Moçambique Recrutamento

Vaga de Emprego Para Banco (2022)

[zavalnews]

Vagas para Digitadores

      Contact A Contact está a recrutar para o seu cliente, uma prestigiada organização que actua na área de Saúde, Digitadores (m/f), para Manhiça, em Moçambique. Funções Será responsável por cumprir normas e procedimentos administrativos da Unidade Sanitária Por manter os PTS actualizados e com uma boa qualidade de dados Por garantir a digitação completa e correcta dos dados na base de dados…

[your-dietician]

Blood pressure thresholds in pregnancy for identifying maternal and infant risk: a secondary analysis of Community-Level Interventions for Pre-eclampsia (CLIP) trial data

New Post has been published on https://depression-md.com/blood-pressure-thresholds-in-pregnancy-for-identifying-maternal-and-infant-risk-a-secondary-analysis-of-community-level-interventions-for-pre-eclampsia-clip-trial-data/

Blood pressure thresholds in pregnancy for identifying maternal and infant risk: a secondary analysis of Community-Level Interventions for Pre-eclampsia (CLIP) trial data

Introduction

Hypertension in pregnancy has traditionally been defined as a systolic blood pressure (sBP) of at least 140 mm Hg or a diastolic blood pressure (dBP) of at least 90 mm Hg, or both.

1

Scott G

Gillon TE

Pels A

von Dadelszen P

Magee LA

Guidelines-similarities and dissimilarities: a systematic review of international clinical practice guidelines for pregnancy hypertension.

Hypertension defined in this way identifies pregnant women at increased risk of pre-eclampsia and other maternal and fetal or neonatal complications, including death, and these women are recommended to receive enhanced antenatal care and monitoring worldwide.

In 2017, the American College of Cardiology and American Heart Association recommended lowering the blood pressure thresholds for diagnosing hypertension outside of pregnancy, classified as: elevated blood pressure (or elevated sBP; defined as sBP 120–129 mm Hg and dBP

2

Whelton PK

Carey RM

Aronow WS

et al.

2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.

Although the American College of Obstetricians and Gynecologists and WHO have retained a definition of blood pressure greater than or equal to 140/90 mm Hg for hypertension in pregnancy, several studies have reported a dose-response relationship between increasing blood pressure and adverse pregnancy outcomes, across gestational ages;

3

Body of evidence in favor of adopting 130/80 mm Hg as new blood pressure cut-off for all the hypertensive disorders of pregnancy.

, 

4

Reddy M

Rolnik DL

Harris K

et al.

Challenging the definition of hypertension in pregnancy: a retrospective cohort study.

these findings provide potential support for the redefinition of hypertension in pregnancy. However, despite use of blood pressure as an essential screening test in pregnancy, no studies have yet reported the diagnostic test properties (such as sensitivity and specificity) of various blood pressure thresholds for hypertension diagnosis.

Research in context

Evidence before this study

We searched MEDLINE, PubMed, Embase, CINAHL, CNTRAL, LILACS, Web of Science, and Google Scholar databases, including reference lists of eligible studies, for studies published in English between Jan 1, 2017, and Dec 31, 2020, using the search terms “human” AND (“hypertension” OR “hypertensive disorders of pregnancy” OR “pregnancy-induced hypertension” OR “preeclampsia” OR “pregnancy toxemias” OR “gestational hypertension”) AND (“American College of Cardiology” OR “American Heart Association”) AND (“stage 1 hypertension” OR “prehypertension”) AND (“Pregnancy[mh]” OR “Pregnan*” OR “Gestation*” OR “pregnant women[mh]” OR “Pregnancy Complications[mh]” OR “Postpartum Period”[Mesh] OR “Puerperium” OR “postpartum” OR “Peripartum Period”[Mesh] OR “Peripartum*” OR “Perinatal Care[mh]” OR “perinatal”).

In 2017, the American College of Cardiology and American Heart Association recommended lowering blood pressure thresholds for diagnosing hypertension outside of pregnancy. Several studies have examined the risk of adverse pregnancy outcomes associated with these lower blood pressure values in pregnancy, compared with the established cutoff of 140/90 mm Hg or greater.

Added value of this study

Nearly all evidence for using the American College of Cardiology and American Heart Association thresholds to diagnose hypertension in pregnancy are from high-income settings and rely on retrospective, routinely collected clinical data. Furthermore, these studies have focused exclusively on associative measures (such as risk ratios) between blood pressure thresholds and adverse outcomes. By contrast, this study provides prospective blood pressure data from more than 20 000 pregnant women, in three low-income and middle-income countries (LMICs), using standardised measurement technique and a validated device, and examines not only associations between blood pressure thresholds and adverse outcomes, but also the diagnostic test properties of those thresholds. Associations were dependent on blood pressure greater than or equal to 160/110 mm Hg.

Implications of all the available evidence

Our findings suggest that there is an association between the American College of Cardiology and American Heart Association blood pressure thresholds and adverse pregnancy outcomes in LMIC settings, but there is no antenatal blood pressure threshold that is sensitive with regards to the adverse maternal, fetal, or neonatal outcomes studied, including data-driven cutoffs. However, severe stage 2 hypertension (blood pressure ≥160/110 mm Hg) is associated with a substantially increased risk of adverse maternal CNS outcomes and fetal or neonatal death, particularly stillbirth, and should be treated as per international guidance. Antenatal care must aim to provide more than accurate blood pressure measurement to achieve the Countdown 2030 goals.

We aimed to analyse the relationship between blood pressure thresholds to define hypertension in pregnancy and adverse maternal, fetal, or neonatal outcomes, as well as the diagnostic test properties of these cutoffs, in low-resource settings.

Methods

 Study design and participants

We did a secondary analysis of data from 22 intervention clusters in the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials (NCT01911494) in India (n=6), Mozambique (n=6), and Pakistan (n=10).

5

Sevene E

Sharma S

Munguambe K

et al.

Community-Level Interventions for Pre-eclampsia (CLIP) in Mozambique: a cluster randomised controlled trial.

, 

6

Qureshi RN

Sheikh S

Hoodbhoy Z

et al.

Community-Level Interventions for Pre-eclampsia (CLIP) in Pakistan: a cluster randomised controlled trial.

, 

7

Bellad MB

Goudar SS

Mallapur AA

et al.

Community Level Interventions for Pre-eclampsia (CLIP) in India: a cluster randomised controlled trial.

, 

8

von Dadelszen P

Bhutta ZA

Sharma S

et al.

The Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials in Mozambique, Pakistan, and India: an individual participant-level meta-analysis.

The unit of randomisation (cluster) was the local administrative unit. We included pregnant women aged 15–49 years (12–49 years in Mozambique), identified in their community by trained community health workers, who had data on blood pressure measurements and outcomes. All women provided written informed consent to participate. The trial was unmasked given the nature of the intervention, aimed at addressing the so-called three delays in triage, transport, and treatment related to mortality risk, particularly associated with pre-eclampsia.

9

Too far to walk: maternal mortality in context.

Ethics approvals were granted by the University of British Columbia, Canada (H12-03497) and relevant in-country research ethics boards (Aga Khan University, Pakistan, 2590-Obs-ERC-13; KLE University, India, MDC/IECHSR/2011-12/A-4, ICMR 5/7/859/12-RHN; Centro de Investigação em Saúde de Manhiça, Mozambique, CIBS-CISM/038/14; and Mozambique National Bioethic Committee, 219/CNBS/14).

 Procedures

First, community engagement addressed barriers and facilitators to accessing care. Second, existing cadres of community health workers were trained to task-share pregnancy hypertension-oriented care at CLIP contacts in women’s homes, using the CLIP Pre-eclampsia Integrated Estimate of Risk Score (PIERS) On-the-Move (POM) digital health app for risk stratification.

10

Lim J

Cloete G

Dunsmuir DT

et al.

Usability and feasibility of PIERS on the move: an mHealth app for pre-eclampsia triage.

Community health workers responded to emergency conditions (if applicable); measured women’s blood pressure and did dipstick urinalysis for proteinuria at the first and any subsequent contact where hypertension was identified; administered oral methyldopa (750 mg) if blood pressure was greater than or equal to 160/110 mm Hg and intramuscular magnesium sulphate (10 g) if severe pre-eclampsia (defined as at least one of: sBP ≥160 mm Hg, mini pre-eclampsia integrated estimate of risk [miniPIERS] probability ≥25%, eclampsia, or stroke) was suspected; and referred women to a comprehensive emergency obstetric care facility if advised by POM. Antenatal POM-guided visits (including blood pressure measurement) were scheduled monthly from enrolment.

Blood pressure measurement for all women in the intervention clusters (and, therefore, in this analysis) was standardised and taken by trained community health workers, using a semi-automated pregnancy-validated and pre-eclampsia-validated oscillometric device (Microlife 3AS1-2; Microlife, Taipei, Taiwan).

11

Nathan HL

de Greeff A

Hezelgrave NL

Chappell LC

Shennan AH

An accurate semiautomated oscillometric blood pressure device for use in pregnancy (including pre-eclampsia) in a low-income and middle-income country population: the Microlife 3AS1-2.

Women were instructed to rest for 5 min, then their blood pressure was measured at least twice, with a third measurement taken if the first two readings differed by 10 mmHg or more. All readings were entered into the POM app, with blood pressure for the visit calculated as the mean of the first two readings, or of the second and third if three readings were taken. All readings were stored electronically in REDCap databases.

Trained surveillance teams did regular household surveys (every 3–6 months) in Mozambique and Pakistan; in India, a prospective population-based surveillance system was established. The PRE-eclampsia Eclampsia Monitoring, Prevention, and Treatment (PRE-EMPT) research group, University of British Columbia, Canada, was responsible for overall trial coordination and data management.

 Outcomes

The primary CLIP composite outcome was a composite of maternal, fetal, and neonatal mortality and morbidity, and all outcomes were adjudicated by an in-country team of clinicians. Maternal death and morbidity were assessed during pregnancy or within 42 days after pregnancy; morbidity was defined as one or more life-threatening pregnancy complications (a serious end-organ complication of pre-eclampsia [ie, eclampsia, stroke, coma, antepartum haemorrhage, or disseminated intravascular coagulation], another major maternal complication [ie, obstetric sepsis, or vesicovaginal or rectovaginal fistula], or receipt of a life-saving intervention [ie, cardiopulmonary resuscitation, mechanical ventilation, blood transfusion, interventions for major post-partum haemorrhage, or dialysis]). This analysis also included a maternal CNS composite outcome of one or more of maternal eclampsia, stroke, coma, or mortality. Fetal or neonatal death included stillbirth, early neonatal mortality, or late neonatal mortality (appendix p 4).

In this analysis, we included CLIP trial participants who were from intervention groups and had at least one POM app-guided antenatal contact with blood pressure measurement done by community health workers at a clinically estimated gestation of 44 weeks or less. Analyses including post-partum and perinatal outcomes were restricted to women who had delivered and provided outcome information.

We classified the antenatal blood pressure readings for each woman at each visit, on the basis of the American College of Cardiology and American Heart Association criteria,

2

Whelton PK

Carey RM

Aronow WS

et al.

2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.

as: normal blood pressure (sBP

12

Brown MA

Magee LA

Kenny LC

et al.

Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice.

 Statistical analysis

Descriptive statistics were used to summarise baseline maternal characteristics, and maximal blood pressure categories overall and according to gestational age at measurement (<20 weeks vs ≥20 weeks).

The possible dose-response relationship between blood pressure category and adverse outcomes was assessed in two ways. First, we treated each category as mutually exclusive and calculated the risk ratio (RR) between normal blood pressure and each category, using generalised estimating equations with a Poisson link function.

13

Extension of the modified Poisson regression model to prospective studies with correlated binary data.

Second, we fit analogous models, but treated the lower limit of each category as a blood pressure cutoff for diagnosis of hypertension. For example, for stage 1 hypertension, we compared women with sBP 130 mm Hg or greater or dBP 80 mm Hg or greater (or both), with those who had sBP less than 130 mm Hg and dBP less than 80 mm Hg. All models were adjusted for maternal age, maternal basic level of education (ie, ≥8 years of schooling in India, attainment of at least grade 5 in Mozambique, or ≥5 years of schooling in Pakistan), gestational age at enrolment, and nulliparity. SEs were based on the sandwich estimator to account for clustering.

The diagnostic test properties of blood pressure categories were assessed using sensitivity, specificity, and positive and negative likelihood ratios (LRs). Positive LR was calculated as: sensitivity / (1 – specificity). Negative LR was calculated as: (1 – sensitivity) / specificity. CIs were calculated by standard methods.

14

Diagnostic tests 4: likelihood ratios.

For each calculation, women with blood pressure equal to or higher than the given blood pressure threshold were compared with those with blood pressure lower than the threshold. LRs describe the likelihood that a given test result would alter the probability of a diagnosis; positive LR values were interpreted as good if greater than or equal to 5·0 and negative LR values were interpreted as good if less than 0·2.

In a sensitivity analysis to determine if the sensitivity of blood pressure categories for adverse outcomes improved closer to term, we re-classified women according to the maximum blood pressure category reached within predefined gestational age categories (28 weeks to

15

R Core Team R: a language and environment for statistical computing.

 Role of the funding source

The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

Results

Between Nov 1, 2014, and Feb 28, 2017, 21 069 women (6067 in India, 4163 in Mozambique, and 10 839 in Pakistan) contributed 103 679 blood pressure measurements across the three CLIP trials (table 1). Most women were aged in their mid-20s, had less than a basic level of education, and were parous. In general, women were enrolled in CLIP late in the first trimester or early in the second trimester, with most enrolling at less than 20 weeks of gestation. About two-thirds of women had normal blood pressure throughout pregnancy. Slightly more than one-quarter of women had abnormal blood pressure classified as elevated blood pressure (2196 [10·4%] of 21 069) or non-severe stage 1 hypertension (3751 [17·8%]). Stage 2 hypertension (non-severe or severe) occurred in 1342 (6·4%) of 21 069 women. Most women delivered at term, but one-quarter delivered preterm. Another quarter suffered a maternal, fetal, or neonatal complication, which were mostly morbidity for the mother (about one in ten women) or death of the fetus (42 per 1000 livebirths) or neonate (41 per 1000 livebirths). Blood pressure was only 1–2 mmHg higher among women with adverse outcomes than in women without adverse outcomes (appendix p 5).

Table 1Baseline characteristics

Data are n (%) or median (IQR) unless otherwise stated. sBP=systolic blood pressure. dBP=diastolic blood pressure. CLIP=Community-Level Interventions for Pre-eclampsia.

Blood pressure values overall were stable, without a clinically important mid-trimester decrease, until about 30 weeks of gestation, after which both sBP and dBP increased with advancing gestational age (figure 1). Maximal blood pressure values classified as elevated blood pressure, stage 1 hypertension, and stage 2 hypertension (non-severe or severe) were more common with advancing gestational age (figure 2). Blood pressure in most women remained at the same category or decreased after 20 weeks of gestation or longer, regardless of whether blood pressure at less than 20 weeks of gestation was classified as normal blood pressure (5160 [63·0%] of 8194 women), elevated blood pressure (336 [60·8%] of 552), stage 1 hypertension (527 [75·7%] of 696), or non-severe stage 2 hypertension (91 [75·8%] of 120; table 2). If the stage 1 hypertension category cutoffs were used as the new threshold for diagnosing hypertension in pregnancy, an additional 1681 (17·5%) of 9574 women would be diagnosed; if elevated blood pressure category cutoffs were used, an additional 1021 (10·7%) of women would be diagnosed (table 2).

Figure 1Maximal blood pressure measurements by gestational age

Show full caption

Maximal blood pressure values per woman are shown, as a median with IQR for each gestational age week.

Figure 2Maximal blood pressure measurements as blood pressure categories by gestational age

Show full caption

A log-scale is used for the y-axis (number of women) for clarity. Blood pressure was categorised as: normal blood pressure (sBP <120 mm Hg and dBP <80 mm Hg), elevated blood pressure (sBP 120–129 mm Hg and dBP <80 mm Hg), stage 1 hypertension (sBP 130–139 mm Hg or dBP 80–89 mm Hg, or both), non-severe stage 2 hypertension (sBP 140–159 mm Hg or dBP 90–109 mm Hg, or both), or severe stage 2 hypertension (sBP ≥160 mm Hg or dBP ≥110 mm Hg, or both).

Table 2Maximal blood pressure categorisation according to American College of Cardiology and American Heart Association criteria, by gestational age

Data are n. Blood pressure was categorised as: normal blood pressure (sBP <120 mm Hg and dBP <80 mm Hg), elevated blood pressure (sBP 120–129 mm Hg and dBP <80 mm Hg), stage 1 hypertension (sBP 130–139 mm Hg or dBP 80–89 mm Hg, or both), non-severe stage 2 hypertension (sBP 140–159 mm Hg or dBP 90–109 mm Hg, or both), or severe stage 2 hypertension (sBP ≥160 mm Hg or dBP ≥110 mm Hg, or both). sBP=systolic blood pressure. dBP=diastolic blood pressure.

There was a dose-response relationship between higher blood pressure category and greater RR for adverse outcomes compared with normal blood pressure, for most outcomes with non-severe stage 2 hypertension and for all outcomes with severe stage 2 hypertension, which increased risk by at least two times and up to six times (table 3). When the diagnostic criteria for each blood pressure category were used as a threshold for diagnosis of an abnormal blood pressure, the risk of all adverse outcomes, other than the maternal composite, increased from elevated blood pressure onwards; however, the point estimates for elevated blood pressure, stage 1 hypertension, and non-severe stage 2 hypertension were consistently higher than they were when these blood pressure categories were each compared with normal blood pressure, and RRs were less than 2·00 for all but non-severe stage 2 hypertension and stillbirth.

Table 3Adjusted RRs for blood pressure categories and adverse outcomes

Data are RR (95% CI). Blood pressure was categorised as: normal blood pressure (sBP appendix (pp 3–4). RR=risk ratio. CLIP=Community-Level Interventions for Pre-eclampsia. sBP=systolic blood pressure. dBP=diastolic blood pressure.

The only blood pressure category that was useful as a diagnostic test for the outcomes examined was severe stage 2 hypertension; sensitivity was low, but the positive LR was good for the maternal CNS composite outcome and fetal or neonatal death, particularly stillbirth (table 4). All other blood pressure categories, including non-severe stage 2 hypertension, had low sensitivity (

Table 4Sensitivity, specificity, and LRs for adverse outcomes by American College of Cardiology and American Heart Association blood pressure categories

Diagnostic test properties are calculated for women with blood pressure at each threshold or higher (compared with women with blood pressure below that threshold, based on cumulative rates). For outcome definitions, see the appendix (pp 3–4). Blood pressure was categorised as: normal blood pressure (sBP

In sensitivity analyses restricted to blood pressure measurements in specific gestational age ranges within the third trimester, sensitivity remained low for all blood pressure categories, including the elevated blood pressure category, although sensitivity was slightly higher for measurements from 32 weeks to less than 37 weeks (appendix p 8). Also, sensitivity remained low (appendix p 6).

Discussion

In the CLIP trial clusters in low-resource settings, women classified as having elevated blood pressure or stage 1 hypertension did not have an increased risk of adverse maternal, fetal, or neonatal outcomes compared with women with normal blood pressure (<120/80 mm Hg). Risk of adverse outcomes was increased with stage 2 hypertension, particularly with severe stage 2 hypertension, which was associated with a two to six times increased risk compared with normal blood pressure. When blood pressure categories higher than normal were used as diagnostic cutoffs for abnormal blood pressure (how 140/90 mm Hg is currently used), the risk of adverse outcomes was increased; however, this increase was driven by the risks associated with severe stage 2 hypertension. In addition, sensitivities for adverse outcomes were low (<45%), and no category other than severe stage 2 hypertension showed useful diagnostic test properties. Using optimal cutpoint analyses for false-positive rates considered clinically reasonable led to poor sensitivity (<30%) for all outcomes.

If elevated blood pressure was used as a diagnostic cutoff, an additional 28% of women would be labelled as having an abnormal blood pressure; if stage 1 hypertension was used, this would be an additional 11% of women, in addition to women already identified as having hypertension by current criteria (ie, stage 2 hypertension in this study). In our study population, the prevalence of hypertension was previously found to be 14·0% in India, 16·8% in Mozambique, and 11·6% in Pakistan, after inclusion of hypertensive diagnoses from household survey and facility records.

16

Magee LA

Sharma S

Nathan HL

et al.

The incidence of pregnancy hypertension in India, Pakistan, Mozambique, and Nigeria: a prospective population-level analysis.

Therefore, an additional 28% or 11% of women with diagnoses of hypertension (depending on the cutoff used) would substantially increase the burden on health systems under stress, and could be justified only by the ability to identify women and babies at risk.

To our knowledge, this is the first study to report on the diagnostic properties of using revised blood pressure thresholds for the diagnosis of hypertension in pregnancy, and the first to report on outcomes by specific blood pressure thresholds for women in under-resourced settings.

Numerous studies have reported that women with antenatal elevated blood pressure or stage 1 hypertension by American College of Cardiology and American Heart Association criteria, as used in our analyses, have an increased risk of adverse pregnancy outcomes;

3

Body of evidence in favor of adopting 130/80 mm Hg as new blood pressure cut-off for all the hypertensive disorders of pregnancy.

, 

4

Reddy M

Rolnik DL

Harris K

et al.

Challenging the definition of hypertension in pregnancy: a retrospective cohort study.

, 

17

Greenberg VR

Lundsberg LS

Culhane JF

et al.

143: Is stage 1 hypertension prior to 20 weeks gestation associated with adverse perinatal outcomes?.

, 

18

González-Valencia DP

Valero-Rubio SY

Fernando Grillo-Ardila C

Prehypertension as a risk factor for the development of perinatal complications: retrospective cohort study.

, 

19

Wu DD

Gao L

Huang O

et al.

Increased adverse pregnancy outcomes associated with stage 1 hypertension in a low-risk cohort: evidence from 47 874 cases.

these included pre-eclampsia and other outcomes (eg, hospitalisation) not reported in our study. Many published RRs for adverse maternal and fetal or neonatal outcomes have been higher than in our study. It is possible that the relationship between blood pressure and adverse outcomes might be different in our study setting. Furthermore, we had fewer baseline characteristics with which to adjust our RRs compared with other studies,

4

Reddy M

Rolnik DL

Harris K

et al.

Challenging the definition of hypertension in pregnancy: a retrospective cohort study.

, 

17

Greenberg VR

Lundsberg LS

Culhane JF

et al.

143: Is stage 1 hypertension prior to 20 weeks gestation associated with adverse perinatal outcomes?.

, 

18

González-Valencia DP

Valero-Rubio SY

Fernando Grillo-Ardila C

Prehypertension as a risk factor for the development of perinatal complications: retrospective cohort study.

, 

19

Wu DD

Gao L

Huang O

et al.

Increased adverse pregnancy outcomes associated with stage 1 hypertension in a low-risk cohort: evidence from 47 874 cases.

, 

20

Impact of the 2017 ACC/AHA guideline for high blood pressure on evaluating gestational hypertension-associated risks for newborns and mothers.

and we studied unselected pregnant women, not just those who were nulliparous

21

Hauspurg A

Sutton EF

Catov JM

Caritis SN

Aspirin effect on adverse pregnancy outcomes associated with stage 1 hypertension in a high-risk cohort.

, 

22

Sutton EF

Hauspurg A

Caritis SN

Powers RW

Catov JM

Maternal outcomes associated with lower range stage 1 hypertension.

or primarily nulliparous.

23

Fukushima K

Morokuma S

Tsukimori K

Murata M

Wake N

Blood pressure measurements within the JNC7 pre-hypertensive range after 32 weeks of gestation are a risk factor for decreased fetal growth.

Alternatively, the differences in RRs might have been due to methodology. Our data collection was prospective and blood pressure measurement was standardised, using a device validated for pregnancy and pre-eclampsia.

11

Nathan HL

de Greeff A

Hezelgrave NL

Chappell LC

Shennan AH

An accurate semiautomated oscillometric blood pressure device for use in pregnancy (including pre-eclampsia) in a low-income and middle-income country population: the Microlife 3AS1-2.

By contrast, most published data have been retrospective and from large urban referral centres with blood pressure measurements from routine clinical care.

4

Reddy M

Rolnik DL

Harris K

et al.

Challenging the definition of hypertension in pregnancy: a retrospective cohort study.

, 

17

Greenberg VR

Lundsberg LS

Culhane JF

et al.

143: Is stage 1 hypertension prior to 20 weeks gestation associated with adverse perinatal outcomes?.

, 

18

González-Valencia DP

Valero-Rubio SY

Fernando Grillo-Ardila C

Prehypertension as a risk factor for the development of perinatal complications: retrospective cohort study.

, 

19

Wu DD

Gao L

Huang O

et al.

Increased adverse pregnancy outcomes associated with stage 1 hypertension in a low-risk cohort: evidence from 47 874 cases.

, 

20

Impact of the 2017 ACC/AHA guideline for high blood pressure on evaluating gestational hypertension-associated risks for newborns and mothers.

, 

23

Fukushima K

Morokuma S

Tsukimori K

Murata M

Wake N

Blood pressure measurements within the JNC7 pre-hypertensive range after 32 weeks of gestation are a risk factor for decreased fetal growth.

One prospective study restricted blood pressure observations to women at less than 20 weeks of gestation,

21

Hauspurg A

Sutton EF

Catov JM

Caritis SN

Aspirin effect on adverse pregnancy outcomes associated with stage 1 hypertension in a high-risk cohort.

, 

22

Sutton EF

Hauspurg A

Caritis SN

Powers RW

Catov JM

Maternal outcomes associated with lower range stage 1 hypertension.

by contrast to our blood pressure measurements that were done throughout pregnancy, the majority of which were done after 20 weeks of gestation. One prospective study in South Africa reported that, among 1116 women, an additional 37·1% would be classified as having abnormal blood pressure by the American College of Cardiology and American Heart Association criteria; although pregnancy outcomes were not reported separately for these women compared with those with stage 2 hypertension,

24

Bengtson AM

Phillips TK

le Roux SM

et al.

High blood pressure at entry into antenatal care and birth outcomes among a cohort of HIV-uninfected women and women living with HIV initiating antiretroviral therapy in South Africa.

it has been reported among pregnant teenagers in the same setting that eclampsia might follow antenatal blood pressure values of less than 140/90 mm Hg.

25

Maternal deaths due to eclampsia in teenagers: lessons from assessment of maternal deaths in South Africa.

Importantly, none of the aforementioned studies have reported the diagnostic test properties of various blood pressure categories to define abnormal blood pressure in pregnancy. As blood pressure measurement in pregnancy is a screening test, it should have high sensitivity for the adverse outcomes of interest, which can then lead to the established therapeutic care pathways for hypertension in pregnancy. However, blood pressure measurement is not sensitive, whether American College of Cardiology and American Heart Association categories are used (even elevated blood pressure) or an optimal blood pressure cutoff is estimated from the data and chosen. Perhaps this poor sensitivity is unsurprising, as the hypertensive disorders of pregnancy are one of three leading causes of adverse maternal outcomes (along with obstetric haemorrhage and sepsis), including spontaneous preterm birth, fetal growth restriction, and intrapartum complications for fetal or neonatal outcomes,

26

Kassebaum NJ

Barber RM

Bhutta ZA

et al.

Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015.

and these other conditions could not be predicted by abnormal blood pressure. Nevertheless, although blood pressure measurement is regarded by WHO as good clinical practice that does not require evidence review,

27

WHO WHO recommendations on antenatal care for a positive pregnancy experience.

measurement is but one part of quality antenatal care and when normal, might provide minimal reassurance that adverse outcomes are less likely to occur.

The one blood pressure category that was useful in identifying women at increased risk of adverse outcomes (ie, maternal CNS outcomes and fetal or neonatal death) was severe stage 2 hypertension. This finding endorses severe stage 2 hypertension as a condition that should be avoided, as have previous data from well resourced settings,

28

Magee LA

von Dadelszen P

Singer J

et al.

The CHIPS randomized controlled trial (Control of Hypertension In Pregnancy Study): is severe hypertension just an elevated blood pressure?.

by contrast to regarding severe hypertension as a condition that can be treated if it occurs.

29

Magee LA

von Dadelszen P

Rey E

et al.

Less-tight versus tight control of hypertension in pregnancy.

Our study has several strengths, including our large sample size, community-based recruitment of unselected pregnant women in south Asia and sub-Saharan Africa, and the standardisation of blood pressure readings across the sample, using a pregnancy-validated device.

11

Nathan HL

de Greeff A

Hezelgrave NL

Chappell LC

Shennan AH

An accurate semiautomated oscillometric blood pressure device for use in pregnancy (including pre-eclampsia) in a low-income and middle-income country population: the Microlife 3AS1-2.

These factors help to provide evidence for hypertension diagnostic thresholds that is applicable to a large set of pregnant women in these settings.

This study has several limitations. First, many women in Pakistan and Mozambique were enrolled after 20 weeks of gestation, consistent with timing of booking for antenatal care in these settings; therefore, a diagnosis of chronic hypertension could not be evaluated when blood pressure was measured after 20 weeks of gestation. Second, only basic maternal characteristics were available for our adjusted analyses. Third, many women did not have weekly blood pressure measurements from 36 weeks of gestation to delivery as specified in the CLIP protocol, so although the household survey and facility records ultimately informed diagnoses of hypertension, we did not have all relevant blood pressure values for this analysis, particularly from close to term. Women with stage 2 hypertension, whether severe or non-severe, were referred to facilities for antihypertensive treatment (about which we have no further information) and facility care; although not the focus of our analyses, such management is likely to have attenuated the relationship between stage 2 hypertension and outcomes and overestimated the strength of association between lower levels of blood pressure and adverse outcomes. Finally, we did not include in our analysis the outcome of pre-eclampsia given our community setting, and so could not evaluate this as an outcome with the revised hypertension definitions embedded in it.

Pregnant women in under-resourced settings with higher-than-normal blood pressure are at increased risk of adverse outcomes, due to the risks associated with blood pressure of 140/90 mm Hg or higher, particularly with severe stage 2 hypertension. No antenatal blood pressure threshold is sensitive with regards to the adverse maternal, fetal, or neonatal outcomes studied, including data-driven cutoffs. However, the occurrence of severe stage 2 hypertension (≥160/110 mm Hg) is associated with a substantially increased risk of adverse maternal CNS outcomes and fetal or neonatal death, particularly stillbirth, and should be treated as per international guidance.

30

WHO WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia.

Antenatal care must aim to provide more than accurate blood pressure measurement to achieve the Countdown 2030 goals.

PvD designed the concept of the CLIP trials. ZAB and LAM were the co-principal investigators of the overall CLIP trials project. MBB, ZAB, SSG, AAM, RNQ, KM, CS, and ES were co-principal investigators of the individual CLIP trials. AS and HN designed the blood pressure device used and assisted with its implementation and some analyses. MV coordinated the CLIP trials. The analysis plan was conceived by JNB and JS. JNB did the data analysis and wrote the first draft of the manuscript with LAM. JNB and LAM accessed and verified the data. All authors had full access to all the data in the study, and read and approved the final version of the manuscript. JNB had access to all data and had responsibility for its integrity and the data analysis. The corresponding author had final responsibility for the decision to submit for publication.

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International Research Partnership and EDCTP to Invest €44m in Next-generation Antimalarials to Combat Drug-resistant Malaria in Africa

The European & Developing Countries Clinical Trials Partnership (EDCTP) awarded a new grant to the new PAMAfrica research consortium led by Medicines for Malaria Venture (MMV). The consortium will support the development of new treatments for malaria in the most-at-risk populations, including babies, patients with severe malaria, and those with drug-resistant infections. The EDCTP grant of €21.9 million is to be matched by funding from MMV, Novartis and partners. Over a period of five years, the grant will support the development of a portfolio of projects executed under the umbrella of the PAMAfrica research consortium. Clinical trial capabilities in Africa will also be strengthened to ensure each site involved can effectively operate to ICH-GCP regulatory standards. The consortium includes seven research organizations from Burkina Faso, Gabon, Germany, Mozambique, Spain and Uganda. In addition to Novartis, other pharmaceutical company partners may join the consortium.

The PAMAfrica research consortium will conduct three clinical trials, supporting efforts to build clinical capacity and train scientists across Africa. One trial will explore new combinations of compounds, including new chemical classes, for the treatment of uncomplicated malaria in adults and children. These compounds are all known to be fully active against all drug-resistant strains, including the artemisinin-resistant Kelch13 strains.

The second trial will evaluate a new generation, rapid-acting treatment for severe malaria, cipargamin, also known as KAE609, which is being developed by Novartis, supported by a grant from the Wellcome Trust. In the third study, a novel formulation/ratio from Novartis of the current gold standard treatment artemether-lumefantrine will be tested in newborn infants weighing less than 5 kg or who are malnourished.

Dr Timothy Wells, Chief Scientific Officer of MMV and the coordinator of the PAMAfrica group, said: “All three of these research projects address areas of urgent need in malaria treatment. Antimalarial drug resistance, originally seen in Southeast Asia, is being reported in Africa and may threaten current treatments. It is important to have new therapies that are active against this emerging threat of resistance. The work on newborn infants and in severe malaria is groundbreaking in bringing medicines to this neglected group. Thanks to this critical support from EDCTP we are not only able to bring together the necessary African and European expertise to conduct these projects to address unmet needs, but in doing so, we are also able to support the training and development of the next-generation of leaders in clinical malaria research in Africa.”

Dr Michael Makanga, Executive Director of EDCTP, said: “Malaria continues needlessly to take 405,000 lives a year and must remain a global and national priority in endemic countries. We hope our funding for PAMAfrica will contribute to the development of successful new treatments that will support malaria eradication, while supporting the development of African research capacity.”

Caroline Boulton, Global Program Head, Malaria, Novartis, said: “Despite advances in malaria control, we still have a long way to go. New antimalarials are urgently needed to tackle rising parasite resistance to current therapies. In response, Novartis has committed to advance research and development of a number of next-generation antimalarial treatments. Partnerships play a critical role in helping to bring these novel agents forward and we sincerely appreciate the crucial support of EDCTP to this process.”

The PAMAfrica consortium

Recent reports from the World Health Organization (WHO) and the Lancet Commission on Malaria Eradication have made clear that defeating malaria will demand new tools, including new and better medicines. The 2019 WHO World Malaria Report states that global malaria deaths are declining at a slower rate than in recent years and highlights the need for improved interventions to treat the most vulnerable populations, including babies.

The PAMAfrica consortium was created to take up this challenge and implements a flexible portfolio approach to the development of new malarials. It brings together expertise from its various African and European partners. The consortium activities will be publicised under a dedicated logo.

The following organisations are partners in the PAMAfrica consortium:

Centre de Recherches Médicales de Lambaréné (CERMEL), Gabon

https://cermel.org

Dr Ghyslain Mombo-Ngoma, Head of Clinical Operations Department

Centre National de la Recherche Scientifique et Technologique (CNRST) - Institut de Recherche en Sciences de la Santé (IRSS) - Unité de Recherche Clinique de Nanoro (IRSS-URCN), Burkina Faso

http://www.urcn.net/index.php/en/

Prof. Halidou Tinto, Regional Director

    Eberhard Karls Universität Tübingen (EKUT), Germany

www.medizin.uni-tuebingen.de/de/startseite

Prof. Peter Kremsner Director Institute of Tropical Medicine

Manhiça Health Research Centre, Mozambique

http://manhica.org/wp/

Dr Eusebio Macete, Director

Fundación Privada Instituto de Salud Global de Barcelona (ISGlobal), Spain

https://www.isglobal.org/en/

Dr Quique Bassat, Head of the Malaria Programme

Groupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina Faso

https://gras.bf/

Dr Alfred Tiono, Clinician and Senior Scientist

Infectious Diseases Research Collaboration (IDRC), Tororo, Uganda

http://idrc-uganda.org/

Dr Yeka Adoke, Epidemiologist

Medicines for Malaria Venture, Geneva, Switzerland

www.mmv.org

Dr Timothy Wells, Chief Scientific Officer

Novartis, Basel, Switzerland

www.novartis.com/global-health/malaria

Caroline Boulton, Global Program Head , Malaria, Global Health Development Unit

About MMV

Medicines for Malaria Venture (MMV) is a leading product development partnership (PDP) in antimalarial drug research in its 20th year. Its mission is to reduce the burden of malaria in disease-endemic countries by discovering, developing and facilitating delivery of new, effective and affordable antimalarial drugs. Since its foundation, MMV and partners have developed and brought forward eleven new medicines estimated to have saved around 2.2. million lives.

For more information visit www.mmv.org or contact Elizabeth Poll, Interim Director of Communications, via +41 79 709 59 92 or polle@mmv.org

About EDCTP

EDCTP aims to support collaborative research that accelerates the clinical development of new or improved interventions to prevent or treat HIV/AIDS, tuberculosis, malaria and neglected infectious diseases in sub-Saharan Africa.The second EDCTP programme is implemented as part of the European Framework Programme for Research and Innovation, Horizon 2020.

For more information visit www.edctp.org or contact Gert Onne van de Klashorst, Communication Officer via +31 70 344 0885 or media@edctp.org

About Novartis

Novartis is reimagining medicine to improve and extend people’s lives. As a leading global medicines company, we use innovative science and digital technologies to create transformative treatments in areas of great medical need. In our quest to find new medicines, we consistently rank among the world’s top companies investing in research and development. Novartis products reach more than 750 million people globally and we are finding innovative ways to expand access to our latest treatments. About 109,000 people of more than 145 nationalities work at Novartis around the world.

For more information visit www.novartis.com or contact media.relations@novartis.com

source: https://www.csrwire.com/press_releases/43817-International-Research-Partnership-and-EDCTP-to-Invest-44m-in-Next-generation-Antimalarials-to-Combat-Drug-resistant-Malaria-in-Africa?tracking_source=rss