title: Malaria control aimed at the entire population in KwaZulu-Natal negates the need for policies to prevent malaria in pregnancy.
abstract: BACKGROUND
  South Africa has no policy to prevent malaria in pregnancy, despite the adverse effects of the disease in pregnancy. However, malaria control measures consisting of indoor residual spraying and specific antimalarial treatment have been in place since the 1970s. Information on the burden of malaria in pregnancy in South Africa is needed to indicate whether a specific policy for malaria prevention in pregnancy is necessary.
  
  
  OBJECTIVE
  To determine the burden of malaria in pregnancy in KwaZulu-Natal (KZN) province, South Africa.
  
  
  METHODS
  Pregnant women were enrolled at their first antenatal care visit to three health facilities in Umkhanyakude health district in northern KZN during May 2004 - September 2005 and followed up until delivery. Data collection included demographic details, current and previous malaria infection during pregnancy, haemoglobin concentrations and birth outcomes.
  
  
  RESULTS
  Of the 1 406 study participants, more than a quarter were younger than 20 years of age, and more than 90% were unemployed and unmarried. Although 33.2% of the women were anaemic, this was not related to malaria. The prevalence and incidence of malaria were very low, and low birth weight was only weakly associated with malaria (1/10).
  
  
  CONCLUSIONS
  The low burden of malaria in these pregnant women suggests that they have benefited from malaria control strategies in the study area. The implication is that additional measures specific for malaria prevention in pregnancy are not required. However, ongoing monitoring is needed to ensure that malaria prevalence remains low.
authors.affiliation: Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa. tsokagwegweni@ukzn.ac.za
authors.forename: J M
authors.initials: JM
authors.lastname: Tsoka-Gwegweni
authors.forename: I
authors.initials: I
authors.lastname: Kleinschmidt
mesh_terms: D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D003140:Communicable Disease Control / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data; D004338:Drug Combinations; D005260:Female; D006801:Humans; D015994:Incidence; D007306:Insecticides; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D017063:Outcome Assessment, Health Care; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000302:isolation & purification; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D011256:Pregnancy Outcome / Q000453:epidemiology; D011295:Prenatal Care / Q000379:methods / Q000706:statistics & numerical data; D015995:Prevalence; D011739:Pyrimethamine / Q000627:therapeutic use*; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D013413:Sulfadoxine / Q000627:therapeutic use*
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D007306:Insecticides; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine