Operational feasibility, impact of additional screening using highly-sensitives Rapid Diagnostic Tests combined with high coverage of IPTp-SP on placental malaria and low birth weight (ASSER Malaria)
The objective of this proposal is to determine the operational feasibility and the impact of additional screening with Highly Sensitive-RDTs and treatment with dihydroartemisinin–piperaquine (DP) on placental malaria (PM) and low birth weight (LBW) in a context of IPTp-SP, in rural central Burkina Faso.
More specifically the objectives are:
- To determine the gain of additional screening with HS-RDTs and treatment with DP against PM, LBW and peripheral malaria infection at delivery
- To assess the determinants of the poor coverage and improve the number of IPTp doses received using phone call or SMS as a reminder
National malaria control strategies in pregnant women relies primarily on effective case management along with the use of long-lasting insecticide-treated nets (LLINs) throughout pregnancy and intermittent preventive treatment with sulfadoxine–pyrimethamine (IPTp-SP) in the second and third trimesters in malaria-endemic regions in sub-Saharan Africa (SSA). For the latter, 3 or more doses are recommended by the national malaria control program (NMCP) but available data suggests that only 19% of eligible women received this in 2016 despite observed high attendance to antenatal clinic (ANC). Adherence to IPTp may be affected by perceptions, acceptability and contextual factors that need to be understood and therefore improve the effectiveness of this health interventions. In addition, all malaria cases should be confirmed either by microscopy or using a rapid diagnostic test (RDTs) before any treatment. Despite the crucial role of RDTs in improving malaria case management SSA, many malaria cases are missed in pregnant women due to the power performance of recommended RDTs which are unable to detect very low parasitaemia. Identifying lower density infections in pregnant women by the use of highly-sensitive RDTs and clearing them with an effective ACT could improve the outcome of the pregnancy in addition to IPTp-SP.
To achieve these objectives, this proposal is designed as a 2-arm randomized controlled trial with a nested qualitative behavioural study.