Malaria in pregnancy in the Solomon islands: barriers to prevention and control.
A study of malaria in pregnancy (MIP) was undertaken in Marovo Lagoon, Solomon Islands, to evaluate pregnancy-specific control strategies for malaria. Peripheral parasitemia was present in 18% (19/106) of women: 15 Plasmodium falciparum and 4 P. vivax. Primigravidae were twice as likely to be parasitemic as multigravidae (31% versus 14%; relative risk: 2.24; 95% confidence interval: 1.01-4.96; P = 0.05). Although ante-natal clinic attendance was high, women booked late (mean, 19.7 weeks) and attended irregularly. Free insecticide-treated nets (ITN) were not distributed despite government policy. Primigravidae were less likely to have an ITN in their homes than multigravidae (relative risk: 2.13; 95% confidence interval: 1.03-4.40). Coverage with chloroquine prophylaxis was low. This study revealed barriers to control of MIP at both the health service and client level. To develop an evidence-based malaria control policy in pregnancy for this region, further study of the epidemiology of malaria and its effects, including social and behavioral aspects, is needed.
Appleyard
Bridget
B
The Australian Centre for International and Tropical Health, a joint program of the Queensland Institute of Medical Research, Herston, Australia.
Tuni
Makiva
M
Cheng
Qin
Q
Chen
Nanhua
N
Bryan
Joan
J
McCarthy
James S
JS
D000293:Adolescent; D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control*; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000517:prevention & control*; D008542:Melanesia / Q000453:epidemiology; D008875:Middle Aged; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology* / Q000517:prevention & control*; D011795:Surveys and Questionnaires