Community-based malaria screening and treatment for pregnant women receiving standard intermittent preventive treatment with sulfadoxine-pyrimethamine: A multicenter (the gambia, burkina faso, and benin) cluster-randomized controlled trial

Susana Scott, Umberto D'Alessandro, Lindsay Kendall, John Bradley, Kalifa Bojang, Simon Correa, Fanta Njie, Halidou Tinto, Maminata Traore-Coulibaly, Hamtandi Magloire Natama, Ousmane Traoré, Innocent Valea, Alain Nahum, Daniel Ahounou, Francis Bohissou, Gethaime Sondjo, Carine Agbowai, Petra Mens, Esmée Ruizendaal, Henk SchalligSusan Dierickx, Koen Peeters Grietens, Laetitia Duval, Lesong Conteh, Maxime Drabo, Jamie Guth, Franco Pagnoni

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background. We investigated whether adding community scheduled malaria screening and treatment (CSST) with artemether- lumefantrine by community health workers (CHWs) to standard intermittent preventive treatment in pregnancy with sulfadoxine- pyrimethamine (IPTp-SP) would improve maternal and infant health. Methods. In this 2-arm cluster-randomized, controlled trial, villages in Burkina Faso, The Gambia, and Benin were randomized to receive CSST plus IPTp-SP or IPTp-SP alone. CHWs in the intervention arm performed monthly CSST during pregnancy. At each contact, filter paper and blood slides were collected, and at delivery, a placental biopsy was collected. Primary and secondary endpoints were the prevalence of placental malaria, maternal anemia, maternal peripheral infection, low birth weight, antenatal clinic (ANC) attendance, and IPTp-SP coverage. Results. Malaria infection was detected at least once for 3.8% women in The Gambia, 16.9% in Benin, and 31.6% in Burkina Faso. There was no difference between study arms in terms of placenta malaria after adjusting for birth season, parity, and IPTp-SP doses (adjusted odds ratio, 1.06 [95% confidence interval, .78-1.44]; P = .72). No difference between the study arms was found for peripheral maternal infection, anemia, and adverse pregnancy outcomes. ANC attendance was significantly higher in the intervention arm in Burkina Faso but not in The Gambia and Benin. Increasing number of IPTp-SP doses was associated with a significantly lower risk of placenta malaria, anemia at delivery, and low birth weight. Conclusions. Adding CSST to existing IPTp-SP strategies did not reduce malaria in pregnancy. Increasing the number of IPTp-SP doses given during pregnancy is a priority. Clinical Trials Registration. NCT01941264; ISRCTN37259296.

Original languageEnglish
Pages (from-to)586-596
Number of pages11
JournalClinical Infectious Diseases
Volume68
Issue number4
DOIs
Publication statusPublished - 1 Feb 2019

Keywords

  • Artemether-lumefantrine
  • Community-based malaria screening
  • Malaria
  • Pregnancy
  • Sulfadoxine-pyrimethamine

Fingerprint

Dive into the research topics of 'Community-based malaria screening and treatment for pregnant women receiving standard intermittent preventive treatment with sulfadoxine-pyrimethamine: A multicenter (the gambia, burkina faso, and benin) cluster-randomized controlled trial'. Together they form a unique fingerprint.

Cite this