Malaria prevention in pregnancy, birthweight, and neonatal mortality: a meta-analysis of 32 national cross-sectional datasets in Africa

Eisele, Thomas P.; Larsen, David A.; Anglewicz, Philip; Keating, Joseph; Yukich, Josh; Bennett, Adam; Hutchinson, Paul; Steketee, Richard W.

doi:10.1016/s1473-3099(12)70222-0

Cited by 218 publications

(163 citation statements)

References 19 publications

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“…Communities targeted for ITN distributions could still differ in a manner not measured by the covariates included in the analysis. Matching has been previously used to adjust for selection bias, 2,25 and it was used to assess the degree of protection that household ITN ownership provides at varying degrees of ITN coverage. For the community-level protection analyses, matching was not used; rather, stratifying by ITN ownership removed selection bias at the individual level, and including community as a random effect in the parasite prevalence analysis allowed the intercept estimates to vary among communities and thereby, capture unobserved heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

Community Coverage with Insecticide-Treated Mosquito Nets and Observed Associations with All-Cause Child Mortality and Malaria Parasite Infections

Larsen

Hutchinson

Bennett

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Randomized trials and mathematical modeling suggest that insecticide-treated mosquito nets (ITNs) provide community-level protection to both those using ITNs and those without individual access. Using nationally representative household survey datasets from 17 African countries, we examined whether community ITN coverage is associated with malaria infections in children 5 years old and all-cause child mortality (ACCM) among children 5 years old in households with one or more ITNs versus without any type of mosquito net (treated or untreated). Increasing ITN coverage ( 50%) was protective against malaria infections and ACCM for children in households with an ITN, although this protection was not conferred to children in households without ITNs in these data. Children in households with ITNs were protected against malaria infections and ACCM with ITN coverage 30%, but this protection was not significant with ITN coverage 30%. Results suggest that ITNs are more effective with higher ITN coverage. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Community Coverage with Insecticide-Treated Mosquito Nets and Observed Associations with All-Cause Child Mortality and Malaria Parasite Infections

Larsen

Hutchinson

Bennett

et al. 2014

The American Society of Tropical Medicine and Hygiene

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“…IPTp-SP consists in the administration of SP during the second and third trimester when the women attend the antenatal care clinic (ANC), 2 and has proven effective in preventing placental malaria and low birth weight. 3 The World Health…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Malaria Screening during Pregnancy with Rapid Diagnostic Tests Performed by Community Health Workers in Burkina Faso

Ruizendaal

Schallig

Scott

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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Abstract.One of the current strategies to prevent malaria in pregnancy is intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP). However, in order for pregnant women to receive an adequate number of SP doses, they should attend a health facility on a regular basis. In addition, SP resistance may decrease IPTp-SP efficacy. New or additional interventions for preventing malaria during pregnancy are therefore warranted. Because it is known that community health workers (CHWs) can diagnose and treat malaria in children, in this study screening and treatment of malaria in pregnancy by CHWs was evaluated as an addition to the regular IPTp-SP program. CHWs used rapid diagnostic tests (RDTs) for screening and artemether-lumefantrine was given in case of a positive RDT. Overall, CHWs were able to conduct RDTs with a sensitivity of 81.5% (95% confidence interval [CI] 67.9-90.2) and high specificity of 92.1% (95% CI 89.9-93.9) compared with microscopy. After a positive RDT, 79.1% of women received artemether-lumefantrine. When treatment was not given, this was largely due to the woman being already under treatment. Almost all treated women finished the full course of artemether-lumefantrine (96.4%). In conclusion, CHWs are capable of performing RDTs with high specificity and acceptable sensitivity, the latter being dependent on the limit of detection of RDTs. Furthermore, CHWs showed excellent adherence to test results and treatment guidelines, suggesting they can be deployed for screen and treat approaches of malaria in pregnancy.BACKGROUND

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“…Although guidelines recommend that HIV-positive women who are pregnant receive CTX without SP, real-world application of HIV and malaria guidelines in pregnancy suggests that HIV-positive women are receiving both ART and SP, with or without CTX. 15 SP has been associated with a decreased risk of low birth weight (LBW) among pregnant women in general [16][17][18] and among HIV-infected pregnant women in specific. 19 A Cochrane review of trials comparing dosing regimens found that infants born to HIV-positive pregnant women receiving three or more doses of SP weighed more than those born to mothers receiving two doses.…”

Section: Introductionmentioning

confidence: 99%

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

Stoner

Vwalika

Smid

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. In Lusaka, Zambia, where malaria prevalence is low, national guidelines continue to recommend that all pregnant women receive sulfadoxine-pyrimethamine (SP) for malaria prophylaxis monthly at every scheduled antenatal care visit after 16 weeks of gestation. Human immunodeficiency virus (HIV)-positive women should receive co-trimoxazole prophylaxis for HIV and not SP, but many still receive SP. We sought to determine whether increased dosage of SP is still associated with a reduced risk of low birth weight (LBW) in an area where malaria transmission is low. Our secondary objective was to determine whether any association between SP and LBW is modified by receipt of antiretroviral therapy (ART). We analyzed data routinely collected from a cohort of HIV-positive pregnant women with singleton births in Lusaka, Zambia, between February 2006 and December 2012. We used a logPoisson model to estimate the risk of LBW by dosage of SP and to determine whether the association between SP and LBW varied by receipt of ART. Risk of LBW declined as the number of doses increased and appeared lowest among women who received three doses (adjusted risk ratio [ARR] = 0.78; 95% confidence interval [CI] = 0.64-0.95). In addition, women receiving combination ART had a higher risk of delivering an LBW infant compared with women receiving no treatment or prophylaxis (ARR = 1.18; 95% CI = 1.09-1.28), but this risk was attenuated among women who were receiving SP (risk ratio = 1.09; 95% CI = 0.99-1.21). SP was associated with a reduced risk of LBW in HIVpositive women, including those receiving ART, in a low malaria prevalence region.

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Malaria prevention in pregnancy, birthweight, and neonatal mortality: a meta-analysis of 32 national cross-sectional datasets in Africa

Cited by 218 publications

References 19 publications

Community Coverage with Insecticide-Treated Mosquito Nets and Observed Associations with All-Cause Child Mortality and Malaria Parasite Infections

Community Coverage with Insecticide-Treated Mosquito Nets and Observed Associations with All-Cause Child Mortality and Malaria Parasite Infections

Evaluation of Malaria Screening during Pregnancy with Rapid Diagnostic Tests Performed by Community Health Workers in Burkina Faso

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

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