Research published in The Lancet Infectious Diseases today shows that although many countries in sub-Saharan Africa now have policies to reduce and control malaria in pregnancy, the estimated coverage of treatment was lower in areas of high-intensity malaria transmission, where women are in most need of protection. The authors say that progress made towards the World Health Organization’s (WHO) Roll Back Malaria Initiative has been slow and many pregnant women do not have access to insecticide-treated nets (ITNs) and do not receive antenatal intermittent preventive treatment (IPT).
Malarial infection during pregnancy has been shown to pose significant risks for both mother and baby. Possible complications include miscarriage and low birth weight. Advice in the Royal College of Obstetricians and Gynaecologists’ (RCOG) clinical guideline 'The prevention of malaria in pregnancy' states that women in countries with high rates of malaria should sleep under long-lasting pyrethroid1 impregnated nets, ensuring that the nets are secure (intact and without tears or holes) and tucked under mattresses or mats.
Professor James Walker, Senior Vice President (International) of the RCOG said, “A previous report2 noted that the use of insecticide-treated nets during pregnancy reduced the risk of miscarriage by one third in Africa. International organisations like UNICEF and the Red Cross have called for increased investment in this simple intervention to tackle malaria transmission in under-resourced countries.
“It is a safe, effective and a cheap means of protection which is why the Department for International Development (DFID) pledged at the end of last year to increase bed net coverage to combat malaria in pregnancy and childbirth 3. The RCOG supports the use of mosquito nets in countries where the disease burden of malaria is high, as an integral activity to help achieve the Millennium Development Goals. We need to encourage women to attend antenatal clinics so that as many pregnant women as possible get these life-saving nets.”
26 January 2011
Notes
References
Anna Maria van Eijk et al ‘Coverage of malaria protection in pregnant women in sub-Saharan Africa: a synthesis and analysis of national survey data’, The Lancet Infectious Diseases, Early Online Publication, 26 January 2011, DOI:10.1016/S1473-3099(10)70295-4
RCOG Green-top Guideline No. 54A, ‘Malaria in pregnancy prevention’. The companion piece to this guideline is RCOG Green-top Guideline No. 54B, ‘Malaria in pregnancy diagnosis & treatment’. Both guidelines were published in April 2010.
1 Pyrethroids are synthetic insecticides that have repellent properties
2 Effective Health Care Research Consortium RPC no.7 – Final five-year report (2005–10)
3 DFID, Breaking the Cycle: Saving Lives and Protecting the Future. The UK’s Framework for Results for malaria in the developing world, December 2010. To view the press release, click here.