USAID, MCHIP, CDC, Roll Back Malaria | 2013
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The devastating consequences of Plasmodium falciparum malaria in pregnancy (MiP) are well documented; these include higher rates of maternal anemia and low birth weight (LBW) babies in areas of stable ma laria transmission. In areas of unstable P. falciparum malaria transmission, pregnant women are at increased risk of severe malaria, death and still birth of the fetus. Approximately 11% of neonatal deaths in malaria endemic African countries are due to low birth weight resulting from P. falciparum infections in pregnancy.

However, until recently, there was limited documented evidence of the protective effect of malaria prevention in pregnancy on neonatal mortality. A recent meta-analysis of national survey datasets by Eisele et al, 2012 showed exposure to intermittent preventive treatment during pregnancy (IPTp) with sulfadoxine pyrimethamine (SP) and insecticide treated bed nets (ITNs) to be associated with reductions of both neonatal mortality and LBW under routine program conditions. Menéndez et al, 2010 also showed the protective role of IPTp-SP in reducing neonatal mortality under trial conditions. Further, Sicuri et al, in the context of the Menéndez trial showed IPTp to be highly cost effective in the context of routine antenatal care (ANC) services. These studies highlight the critical importance of continuing IPTp as well as ITN use among pregnant women to prevent the adverse consequences of malaria in pregnancy. This paper synthesizes the information and key findings from these articles and implications for MiP programs.