A rapid assessment approach for public health decision-making related to the prevention of malaria during pregnancy.
OBJECTIVE
To develop a rapid field assessment methodology to address the burden of malaria during pregnancy and the options for intervening within the existing antenatal care system in Kenya.


METHODS
Surveys consisting of questionnaires, sampling of blood for parasitaemia and anaemia, and birth outcome assessment were conducted in antenatal clinics, delivery units, and in the community in Kisumu and Mombasa, Kenya.


RESULTS
The rates of maternal anaemia and severe anaemia, were, respectively, 79% and 8% in Kisumu, and 95% and 24% in Mombasa. The rates of placental parasitaemia were 27% and 24% and the rates of low birth weight were 18% and 24% in Kisumu and Mombasa, respectively. Women with placental parasitaemia had a higher incidence of low birth weight compared with women without placental parasitaemia in both Kisumu (28% vs 16%, P=0.004) and Mombasa (42% vs 20%, P=0.004). A total of 95% and 98% of women in Kisumu and Mombasa, respectively, reported attending an antenatal clinic during their previous pregnancy.


CONCLUSIONS
This methodology can be used by ministries of health to collect data for decision-making regarding malaria control during pregnancy; it can also provide a baseline measurement on which to evaluate subsequent interventions.
Parise
Monica E
ME
Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. mep0@cdc.gov
Lewis
Linda S
LS
Ayisi
John G
JG
Nahlen
Bernard L
BL
Slutsker
Laurence
L
Muga
Richard
R
Sharif
S K
SK
Hill
Jenny
J
Steketee
Richard W
RW
D000328:Adult; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003659:Decision Making, Organizational; D005260:Female; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology* / Q000517:prevention & control; D011295:Prenatal Care; D011635:Public Health Administration