Malaria in pregnancy (MIP) is a major threat to the lives of pregnant women, fetuses, and infants. Pregnant women are particularly vulnerable because pregnancy reduces a woman’s immunity to malaria, making her more susceptible to malaria infection and increasing the risk of anemia, severe illness, and death. For the unborn child, maternal malaria is associated with premature delivery and low birth weight, a leading cause of newborn deaths.
In areas with moderate to high transmission of the malaria parasite species Plasmodium falciparum—mainly countries in Africa—the World Health Organization (WHO) recommends a three-part package of interventions for controlling malaria and its effects during pregnancy:
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The promotion and use of insecticide-treated bed nets (ITNs);
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Administration of intermittent preventive treatment (IPTp); and
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Prompt diagnosis and appropriate treatment of malaria.
IPTp is a full therapeutic course of antimalarial medicine given to pregnant women at routine antenatal care (ANC) visits, regardless of malaria infection. In 2012, WHO revised its IPTp guidelines to recommend providing the drug sulfadoxine-pyrimethamine (SP) at every scheduled ANC visit after the first trimester, with doses administered as early as possible in the second trimester and at least one month apart until delivery.
Since then, WHO published new ANC guidelines that recommend an increase in the number of contacts between health providers and pregnant women, effectively ensuring more opportunities to expand IPTp-SP coverage.