Protection of pregnant women against malaria still inadequate

January 26, 2011, Liverpool School of Tropical Medicine

A study published today in The Lancet Infectious Diseases finds that methods to protect pregnant women from malaria are still underutilised in sub-Saharan Africa (SSA). A review of national control strategies by a team of international researchers, led by the Malaria in Pregnancy Consortium and funded by the Consortium and the Wellcome Trust, has concluded that despite major efforts, coverage is still inadequate in many areas and needs to be scaled up.

Malaria infection in pregnancy can lead to devastating consequences for both mother and child. The World Health Organization's (WHO) recommended policy for prevention and control is a package of intermittent preventive treatment (IPTp) and insecticide treated nets (ITNs). These interventions have the potential to substantially reduce the disease burden and adverse outcomes of malaria in pregnancy. The Roll Back Malaria initiative (RBM) has ambitions to ensure that 100% of receive IPTp and at least 80% of people at risk from malaria are using ITNs in areas of high transmission by 2010.

Specific strategies for in pregnant women were extracted from national malaria policies and the most recent national household cluster-sample surveys recording IPTp and ITN use were reconciled to sub-national administrative units to compute the numbers of protected pregnancies. Malaria maps generated by the Malaria Atlas Project (MAP, www.map.ox.ac.uk) meant these estimates could be stratified against different levels of malaria risk.

The study found that 45 of 47 SSA countries had an ITN policy for pregnant women and that estimated coverage was 17% among the nearly 28 million pregnancies at risk of malaria in the 32 countries with information. Among 39 countries with an IPTp policy, 25% of pregnant women had received some IPTp, despite 77% visiting an antenatal clinic (ANC), the main delivery channel for reaching pregnant women with ITNs and IPTp.

Professor Feiko ter Kuile, MiP Consortium leader and co author said: "Ten years after the Abuja declaration, it is encouraging that the majority of malaria endemic countries in SSA have now adopted ITNs and IPTp and the number of countries with nationally representative coverage data has increased to 40 out of 47. However, very few countries have reached either the Abuja targets or their own policy ambition, and countries are even further away from the more recent RBM targets set for 2010. In addition, coverage was lowest in areas with high malaria transmission, where the need is greatest.

"In general, low coverage with IPTp and ITNs contrasts with correspondingly high ANC attendance, indicating that there are missed opportunities for coverage and the attainment and maintenance of high coverage of ITNs remains challenging.

"In summary, whilst most countries have adopted national policies aimed at reducing and controlling malaria in pregnancy, it is clear that, with some notable exceptions, not enough progress has been made towards the new RBM goals or the policy ambitions of each country.

"With only five years in which to meet the Millennium Development Goals it is sobering that in countries with a national policy for IPT and/or ITN, an estimated 23 million pregnancies remain unprotected by an ITN and 19 million remain unprotected by IPTp. Greater effort to fully understand
the reasons why coverage is so low and to develop strategies to combat this is urgently needed to protect the tens of millions of pregnancies in sub-Saharan Africa threatened by malaria every year."

Related Stories

Recommended for you

Flu infection study increases understanding of natural immunity

January 23, 2018
People with higher levels of antibodies against the stem portion of the influenza virus hemagglutinin (HA) protein have less viral shedding when they get the flu, but do not have fewer or less severe signs of illness, according ...

Onions could hold key to fighting antibiotic resistance

January 22, 2018
A type of onion could help the fight against antibiotic resistance in cases of tuberculosis, a UCL and Birkbeck-led study suggests.

New long-acting approach for malaria therapy developed

January 22, 2018
A new study, published in Nature Communications, conducted by the University of Liverpool and the Johns Hopkins University School of Medicine highlights a new 'long acting' medicine for the prevention of malaria.

Virus shown to be likely cause of mystery polio-like illness

January 22, 2018
A major review by UNSW researchers has identified strong evidence that a virus called Enterovirus D68 is the cause of a mystery polio-like illness that has paralysed children in the US, Canada and Europe.

Creation of synthetic horsepox virus could lead to more effective smallpox vaccine

January 19, 2018
UAlberta researchers created a new synthetic virus that could lead to the development of a more effective vaccine against smallpox. The discovery demonstrates how techniques based on the use of synthetic DNA can be used to ...

Study ends debate over role of steroids in treating septic shock

January 19, 2018
The results from the largest ever study of septic shock could improve treatment for critically ill patients and save health systems worldwide hundreds of millions of dollars each year.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.