Abstract
In The Lancet Global Health, Silke Fernandes and colleagues1 provide an important and timely assessment of the cost-effectiveness of increasing the doses of intermittent preventive treatment for malaria during pregnancy (IPTp) from two doses to three or more doses, as currently recommended by the WHO.
Highlights
Value of additional chemotherapy for malaria in pregnancy In The Lancet Global Health, Silke Fernandes and colleagues[1] provide an important and timely assessment of the cost-effectiveness of increasing the doses of intermittent preventive treatment for malaria during pregnancy (IPTp) from two doses to three or more doses, as currently recommended by the WHO. This analysis provides compelling evidence that the incremental reduction in low birthweight noted in women who receive additional doses of sulfadoxine pyrimethamine (SP) during pregnancy[2] will be highly cost-effective when included as part of standard antenatal care in most areas of sustained malaria transmission in Africa
An estimated 32 million pregnancies occurred in such areas in 2010,3 which would have the potential to lead to an estimated 0·7 million low birthweight deliveries attributable to malaria if these women were not protected from infection.[4]
SP is no longer efficacious for case management in such settings, and perception of SP as an ineffective drug might be undermining IPTp-SP. This factor has prompted researchers to look at alternatives to IPTp-SP such as the use of more efficacious or longer-lasting artemisinin combination therapies (ACTs), either on the basis of positive diagnosis from a rapid diagnostic test (RDT) at an antenatal care visit, or as an alternative presumptive therapy.[7]
Summary
In The Lancet Global Health, Silke Fernandes and colleagues[1] provide an important and timely assessment of the cost-effectiveness of increasing the doses of intermittent preventive treatment for malaria during pregnancy (IPTp) from two doses to three or more doses, as currently recommended by the WHO. This analysis provides compelling evidence that the incremental reduction in low birthweight noted in women who receive additional doses of sulfadoxine pyrimethamine (SP) during pregnancy[2] will be highly cost-effective when included as part of standard antenatal care in most areas of sustained malaria transmission in Africa.
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