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. 2017 Mar 8;177(6):884–895. doi: 10.1111/bjh.14584

Table 3.

Efficacy and coverage of key interventions recommended by the World Health Organization (WHO) to prevent malariaa in African pregnant women

Intervention Policy Protective efficacy against malaria Coverage
Insecticide‐treated mosquito nets In endemic areas with intense malaria transmission, all pregnant women should receive, as early as possible in pregnancy, one long‐lasting insecticidal net through immunisation and antenatal care visitsb Compared with no nets (Gamble et al, 2006):

  • Risk of peripheral parasitaemia at delivery reduced by 23% (95% CI: 14–48%; I 2: 0%)

  • Parasite density reduced by 7% (95% CI: −11% to 23%, I 2: 42%)

  • Placental parasitaemia reduced by 21% (95% CI: 2–37%, I 2: 35%)

 In 2015, 55% of the population of sub‐Saharan Africa was sleeping under an impregnated mosquito net (WHO, 2015)
Intermittent preventive treatment (IPT) with sulfadoxine‐pyrimethamine In areas with moderate to high malaria transmission in Africa, delivery of sulfadoxine‐pyrimethamine is recommended at each of the three recommended antenatal care visits after the first trimester, with a minimum of three doses received during each pregnancy (WHO, 2014) Reduction in risk compared to placebo/no intervention (Radeva‐Petrova et al, 2014):b

  • Maternal parasitaemia (i.e. presence of asexual stage parasites in thick smears in peripheral, placental, or cord blood): 62% (95% CI: 41–76%, I 2: 86%)

  • Malarial illness (history of fever episodes prior to delivery): 76% (95% CI: −12% to 95%, 1 study only)

  • Placental parasitaemia: 55% (95% CI: 39–67%, I 2: 54%)

  • Cord blood parasitaemia: 53% (95% CI: −1% to 78%, I 2: 40%)

 Only 52% of eligible pregnant women received at least one dose of IPT in pregnancy in 2014, while 40% received two or more doses and 17% received three or more doses (WHO, 2015)
a

Effects on malaria‐associated outcome such as maternal anaemia, birth weight and perinatal mortality are not listed because they were outside the scope of the current review.

b

Universal access to and use of long‐lasting insecticidal nets remains the goal for all people at risk of malaria.