Evaluation of malaria screening during pregnancy with rapid diagnostic tests performed by community health workers in Burkina Faso

Esmee Ruizendaal, Henk D. F. H. Schallig, Susana Scott, Maminata Traore-Coulibaly, John Bradley, Palpouguini Lompo, Hamtandi M. Natama, Ousmane Traore, Innocent Valea, Susan Dierickx, Koine M. Drabo, Franco Pagnoni, Umberto d' Alessandro, Halidou Tinto, Petra F. Mens

Research output: Contribution to journalA1: Web of Science-article

Abstract

One of the current strategies to prevent malaria in pregnancy is intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP). However, in order for pregnant women to receive an adequate number of SP doses, they should attend a health facility on a regular basis. In addition, SP resistance may decrease IPTp-SP efficacy. New or additional interventions for preventing malaria during pregnancy are therefore warranted. Because it is known that community health workers (CHWs) can diagnose and treat malaria in children, in this study screening and treatment of malaria in pregnancy by CHWs was evaluated as an addition to the regular IPTp-SP program. CHWs used rapid diagnostic tests (RDTs) for screening and artemether-lumefantrine was given in case of a positive RDT. Overall, CHWs were able to conduct RDTs with a sensitivity of 81.5% (95% confidence interval [CI] 67.9-90.2) and high specificity of 92.1% (95% CI 89.9-93.9) compared with microscopy. After a positive RDT, 79.1% of women received artemether-lumefantrine. When treatment was not given, this was largely due to the woman being already under treatment. Almost all treated women finished the full course of artemether-lumefantrine (96.4%). In conclusion, CHWs are capable of performing RDTs with high specificity and acceptable sensitivity, the latter being dependent on the limit of detection of RDTs. Furthermore, CHWs showed excellent adherence to test results and treatment guidelines, suggesting they can be deployed for screen and treat approaches of malaria in pregnancy.

Original languageEnglish
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume97
Issue number4
Pages (from-to)1190-1197
Number of pages8
ISSN0002-9637
DOIs
Publication statusPublished - 2017

Keywords

  • INTERMITTENT PREVENTIVE TREATMENT
  • SULFADOXINE-PYRIMETHAMINE RESISTANCE
  • LOW-BIRTH-WEIGHT
  • DRUG-RESISTANCE
  • INFECTIONS
  • METAANALYSIS
  • WOMEN
  • PARASITES
  • AFRICA
  • IMPACT

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