title: Malaria in pregnancy in the Solomon islands: barriers to prevention and control.
abstract: 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.
authors.affiliation: The Australian Centre for International and Tropical Health, a joint program of the Queensland Institute of Medical Research, Herston, Australia.
authors.forename: Bridget
authors.initials: B
authors.lastname: Appleyard
authors.forename: Makiva
authors.initials: M
authors.lastname: Tuni
authors.forename: Qin
authors.initials: Q
authors.lastname: Cheng
authors.forename: Nanhua
authors.initials: N
authors.lastname: Chen
authors.forename: Joan
authors.initials: J
authors.lastname: Bryan
authors.forename: James S
authors.initials: JS
authors.lastname: McCarthy
mesh_terms: 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