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EFFECT OF COMMUNITY-BASED SCHEDULED SCREENING AND TREATMENT (CSST) OF MALARIA IN PREGNANCY ON INFANT MALARIA INFECTION IN A SEASONAL MALARIA TRANSMISSION SETTING

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Background Children born to mothers who had malaria in pregnancy have an increased risk of malaria infection in the first 24 months of life and they also experience earlier episodes… Click to show full abstract

Background Children born to mothers who had malaria in pregnancy have an increased risk of malaria infection in the first 24 months of life and they also experience earlier episodes of malaria compared to their counterparts. This study compared the pre- and post-seasonal prevalence of P. falciparum infection and anti-malarial antibodies among children whose mothers received either intermittent preventive treatment in pregnancy using sulphadoxine-pyrimethamine (IPTp-SP) plus community-based scheduled screening and treatment (CSST) of malaria in pregnancy or standard IPTp-SP. Methods In 2015, two cross-sectional surveys were conducted before and after the malaria transmission season among children aged 0–24 months, born to women who participated in a 2-arm cluster-randomised trial to compare CSST plus IPTp-SP vs IPTp-SP alone in the Upper River Region of The Gambia. For each survey, finger prick samples were collected for slide microscopy and indirect ELISA to compare prevalence of malaria parasitaemia and IgG antibodies to 19-kDa merozoite surface protein 1. Results Of 905 children recruited in the pre malaria transmission survey, the prevalence of malaria in the overall population, IPTp-SP alone and CSST plus IPTp-SP arms were 1.07%, 2.30% and 0%, respectively. Nearly 70% of children with parasitaemia were aged 1–5 months old. The seroprevalence in children whose mothers received CSST plus IPTp-SP compared to IPTp-SP alone was 10.54% vs 11.85%. Seroprevalence analysis and reading of slide microscopy for 1172 children recruited in the second survey as well as final statistical analysis are currently on-going. Final results will be available by November 2016. Conclusions Infants whose mothers received CSST plus 1PTp-SP appear to be less likely to have malaria infection compared to those whose mothers received IPTp-SP only. Community scheduled screening and treatment of malaria in pregnancy may also be protective against malaria in children.

Keywords: pregnancy; malaria; treatment; malaria pregnancy; malaria infection

Journal Title: BMJ Global Health
Year Published: 2017

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