Issue: December 2012
November 21, 2012
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Maternal malaria prevention reduced neonatal mortality, low birth weight

Issue: December 2012
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Preventing malaria during pregnancy resulted in significant reductions in neonatal mortality and low birth weight, according to recent data.

“Malaria prevention in pregnancy is associated with substantial reductions in neonatal mortality and low birth weight under routine malaria control program conditions in Africa, irrespective of parity,” Thomas Eisele, PhD, associate professor in the department of global health systems and development at Tulane University School of Public Health and Tropical Medicine, told Infectious Disease News. “Malaria control programs and donors must redouble their efforts to increase malaria prevention coverage across Africa to save the lives of young infants."

Thomas Eisele, PhD 

Thomas Eisele

Eisele and colleagues analyzed a retrospective birth cohort that included 32 national survey datasets from 25 African countries from 2000 to 2010. The analysis of malaria prevention and neonatal mortality included 141,516 live births and 3,460 neonatal deaths. The analysis of malaria prevention and low birth weight included 120,011 live births and 17,486 low birth weight events.

Full malaria prevention, including preventive therapy or insecticide-treated nets, was associated with a decreased risk for neonatal mortality, with a protective efficacy of 18% (95% CI, 4-30). In addition, full malaria prevention during pregnancy also decreased the risk for low birth weight, with a protective efficacy of 21% (95% CI, 14-27). These numbers are after exact matching and controlling for confounding factors.

Despite the benefit of these protective tactics, the use of insecticide-treated nets and preventive therapy are lagging in Africa, with an estimated 23 million pregnancies going unprotected, according to the researchers.

“This research suggests that pregnant women should receive intermittent preventive therapy with sulfadoxine-pyrimethamine during pregnancy,” Eisele said. Malaria control programs should strive to achieve full protection in pregnant women, using intermittent preventive therapy and insecticide-treated nets.”

Eisele said that future research questions include assessing the effect of sulfadoxine-pyrimethamine resistance and assessing the individual, household and health system level factors that prevent pregnant women from receiving preventive therapy and insecticide-treated nets.

Disclosure: The researchers report no relevant financial disclosures.