Monitoring and evaluation of malaria in pregnancy - developing a rational basis for control.

Brabin, Bernard, Warsame, Marian, Wasame, Marian, Uddenfeldt-Wort, Ulrika, Dellicour, Stephanie, Hill, Jenny ORCID: https://orcid.org/0000-0003-1588-485X and Gies, Sabine (2008) 'Monitoring and evaluation of malaria in pregnancy - developing a rational basis for control.'. Malaria Journal, Vol 7, Issue Supp 1, p. S6.

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Abstract

Monitoring and evaluation of malaria control in pregnancy is essential for assessing the efficacy and effectiveness of health interventions aimed at reducing the major burden of this disease on women living in endemic areas. Yet there is no currently integrated strategic approach on how this should be achieved. Malaria control in pregnancy is formulated in relation to epidemiological patterns of exposure. Current emphasis is on intermittent preventive treatment (IPTp) during pregnancy with sulphadoxine-pyrimethamine in higher transmission areas, combined with insecticide treated bed nets (ITNs) and case management. Emphasis in lower transmission areas is primarily on case management. This paper discusses a rational basis for monitoring and evaluation based on: assessments of therapeutic and prophylactic drug efficacy; proportional reductions in parasite prevalence; seasonal effects; rapid assessment methodologies; birthweight and/or anaemia nomograms; case-coverage methods; maternal mortality indices; operational and programmatic indicators; and safety and pharmacovigilance of antimalarials in pregnancy. These approaches should be incorporated more effectively within National Programmes in order to facilitate surveillance and improve identification of high-risk women. Systems for utilizing routinely collected data should be strengthened, with greater attention to safety and pharmacovigilance with the advent of artemisinin combination therapies, and prospects of inadvertent exposures to artemisinins in the first trimester. Integrating monitoring activities within malaria control, reproductive health and adolescent-friendly services will be critical for implementation. Large-scale operational research is required to further evaluate the validity of currently proposed indicators, and in order to clarify the breadth and scale of implementation to be deployed.

Item Type:	Article
Additional Information:	The electronic version of this article is the complete one and can be found online at: http://www.malariajournal.com/content/7/S1/S6
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WQ Obstetrics > Pregnancy Complications > WQ 256 Infectious diseases
Faculty: Department:	Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI):	https://doi.org/10.1186/1475-2875-7-S1-S6
Depositing User:	Ms Julia Martin
Date Deposited:	23 Sep 2010 15:25
Last Modified:	06 Feb 2018 13:02
URI:	https://archive.lstmed.ac.uk/id/eprint/1646

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