According to the most recent Global Burden of Disease data, deaths due to malaria have decreased substantially over the past few decades. Global malaria mortality rates have dropped by 44% between 1990 – when malaria was the tenth most common cause death – and 2015 – when malaria was the 20th most common cause of death. Despite this progress, roughly half a million people died from malaria in 2015 alone, and 92% of those deaths occurred in sub-Saharan Africa. The Global Technical Strategy for Malaria (2016-2030) calls for a 40% reduction in malaria case incidence by 2020, but only half of malaria endemic countries are currently on track to achieve this goal.
Pregnant women and newborns living in malaria endemic areas are especially vulnerable. Malaria in pregnancy (MiP) continues to play a large role in global maternal deaths. In 2015, malaria was the third most common cause of death among women of reproductive age in Africa. During that year, MiP was estimated to have been responsible for more than 400,000 cases of maternal anemia and approximately 15% of maternal deaths globally. Unfortunately, the women who are most vulnerable to malaria are often the least protected against it. MiP also poses a significant threat to newborns because it can cause spontaneous abortion, stillbirth, premature delivery, low birth weight and neonatal mortality.
Coverage of malaria prevention, screening and treatment among pregnant women remains low in many areas of sub-Saharan Africa, despite investments in MiP and clear evidence of effective interventions. In order to combat MiP, intermittent preventive treatment in pregnancy (IPTp) should start early in the second trimester of pregnancy (ideally at week 13) with three or more doses of the antimalarial sulfadoxine-pyrimethamine and continue monthly over the course of the pregnancy until delivery. Based on available data, the percentage of eligible women receiving three or more doses of IPTp increased from 6% in 2010 to 31% in 2015. Still, much work is needed to ensure that pregnant women and newborns across the globe are protected against malaria.