Intermittent preventative treatment to reduce the risk of malaria during pregnancy
Intervention | Last updated: 9 August 2023
Malaria infection during pregnancy is a major public health problem. Pregnancy reduces a woman’s immunity, making pregnant women more susceptible to malaria infection and increasing the risk of illness, anaemia, severe disease and death. For the unborn child, maternal malaria increases the risk of spontaneous abortion, stillbirth, premature delivery and low birth weight – a leading cause of child mortality.
WHO recommends a package of interventions for preventing and controlling malaria during pregnancy, which includes promotion and use of insecticide-treated nets, appropriate case management with prompt, effective treatment, and, in areas with moderate to high transmission of P. falciparum, administration of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP).
Currently available evidence from malaria-endemic countries indicates that IPTp-SP is associated with reduced maternal parasitaemia, reduced low birth weight infants and increased mean birth weight.
WHO Recommendations
In malaria-endemic areas in Africa, intermittent preventive treatment with sulfadoxine-pyrimethamine (SP-IPTp) is recommended for all pregnant women in their first or second pregnancy. Dosing should start in the second trimester and doses should be given at least 1 month apart, with the objective of ensuring that at least three doses are received.Guidelines and guidance documents Learn More
GRC-approved guidelines
Evidence
Systematic reviews used to develop the guidelines
Kayentao K, Garner P, van Eijk AM, Naidoo I, Roper C, Mulokozi et al. JAMA. 2013;309(6):594-604.
Related Cochrane reviews
Radeva-Petrova D, Kayentao K, ter Kuile FO, Sinclair D, Garner P. Cochrane Database of Systematic Reviews. 2014; Issue 10. Art. No.: CD000169.
Summary of this reviewIntermittent preventive treatment regimens for malaria in HIV-positive pregnant women
Mathanga DP, Uthman OA, Chinkhumba J.Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD006689.
Summary of this reviewOther related systematic reviews
Eisele TP, Larsen DA, Anglewicz PA, Keating J, Yukich J, Bennett A, et al. Lancet Infect Dis. 2012;12(12):942-9.
Cost-effectiveness Learn More
Cost-effectiveness analyses
Sicuri E, Bardají A, Nhampossa T, Maixenchs M, Nhacolo A, Nhalungo D, et al.PLoS One. 2010; 5(10):e13407.
Fernandes S, Sicuri E, Halimatou D, Akazili J, Boiang K, Chandramohan D, et al.Malar J. 2016; 15(1):493.
Fernandes S, Sicuri E, Kayentao K, van Eijk AM, Hill J, Webster J, et al.Lancet Glob Health. 2015; 3(3):e143-53.
Hansen KS, Ndyomugyenyi R, Magnussen P, Clarke SE.Int Health. 2012; 4(1):38-46.
Category 1 intervention
Guidelines have been recently approved by the WHO Guidelines Review Committee
