The main aim of this study is to test the primary hypothesis that the addition of intermittent screening and treatment of malaria in pregnant women (ISTp) who receive routine antenatal care (ANC) in health facilities in high malaria transmission areas in Rwanda will reduce malaria prevalence among pregnant women when compared to routine antenatal cares services alone.
More specifically, the primary objective is to understand the effect of ISTp in a context where routine antenatal care does not include malaria chemoprohylaxis and whether this intervention is protective against malaria during pregnancy. The secondary objective is to determine whether this intervention results in an improvement in other key maternal and newborn health outcomes including maternal anemia, low birth weight and prematurity. The third objective is to determine the feasibility, effectiveness and acceptability of ISTp among women who receive ISTp and among health workers who deliver this intervention. This study will establish if testing and treating pregnant women is effective, feasible and whether it adds an additional burden to the work already being undertaken by facility-based health workers who provide antenatal care services. It is expected that the study will result in information to develop appropriate approaches that can be implemented in Rwanda in the prevention of malaria in pregnancy in addition to the use of preventive measures such as insecticide treated mosquito nets (ITNs) and case management. This information may potentially also be used by other countries with similar patterns of malaria transmission.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
1,786
Women in the control group will receive routine care, which does not include testing for malaria with a rapid diagnostic test unless symptomatic for malaria. Women in the intervention group will receive this additional testing for malaria at each antenatal care, regardless of whether she is symptomatic for malaria.
Busoro-Gishamvu Health Center
Huye, South, Rwanda
Huye Police Health Center
Huye, South, Rwanda
Maraba Health Cente
Huye, South, Rwanda
Prevalence of placental malaria at delivery (tested by PCR)
comparison of prevalence of malaria between women in intervention and control sites
Time frame: at the time of delivery
Prevalence of maternal anemia at delivery
comparison of prevalence of maternal anemia between women in intervention and control sites
Time frame: at the time of delivery
Prevalence of low birth weight babies (<37 weeks gestation)
comparison of prevalence of LBW between women in intervention and control sites
Time frame: at the time of delivery
Prevalence of preterm births
comparison of prevalence of preterm births between women in intervention and control sites
Time frame: at the time of delivery
Episodes of clinical malaria during the course of the pregnancy
description of the number of episodes of malaria detected during antenatal care visits during pregnancy
Time frame: assessed at the time of delivery
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Mukura Health Center
Huye, South, Rwanda
Rango Health Center
Huye, South, Rwanda
Rubona Health Center
Huye, South, Rwanda
Rwaniro
Huye, South, Rwanda
Sovu Health Center
Huye, South, Rwanda
Kamonyi Health Center
Kamonyi, South, Rwanda
Kayenzi Health Center
Kamonyi, South, Rwanda
...and 4 more locations