Using antenatal care as a platform for malaria surveillance data collection: study protocol

• Published in: Malaria Journal
• Main Authors: Julie R. Gutman, Julia Nanteza Mwesigwa, Kyra Arnett, Chabu Kangale, Sijenunu Aaron, Dele Babarinde, Julie Buekens, Baltazar Candrinho, Siaka Debe, Peder Digre, Mary Drake, Adama Gansané, Christelle Gogue, Kevin S. Griffith, Joseph Hicks, Réné Kinda, Hannah Koenker, Ruth Lemwayi, Anna Munsey, Emmanuel Obi, Aurore Ogouyèmi-Hounto, Okefu Oyale Okoko, Faustin Onikpo, Ali Onoja, Travis Porter, Binete Savaio, Kenzie Tynuv, Perpetua Uhomoibhi, Joseph Wagman, Katherine Wolf, Rose Zulliger, Patrick Walker, John M. Miller, Molly Robertson
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2023
• Subjects: ANC-based surveillance; Benin; Burkina Faso; Malaria; Mozambique; Nigeria; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-023-04521-6; https://doaj.org/article/e455429e01b442cca201c9c483cea177

Abstract Background While many malaria-endemic countries have health management information systems that can measure and report malaria trends in a timely manner, these routine systems have limitations. Periodic community cross-sectional household surveys are used to estimate malaria prevalence and intervention coverage but lack geographic granularity and are resource intensive. Incorporating malaria testing for all women at their first antenatal care (ANC) visit (i.e., ANC1) could provide a more timely and granular source of data for monitoring trends in malaria burden and intervention coverage. This article describes a protocol designed to assess if ANC-based surveillance could be a pragmatic tool to monitor malaria. Methods This is an observational, cross-sectional study conducted in Benin, Burkina Faso, Mozambique, Nigeria, Tanzania, and Zambia. Pregnant women attending ANC1 in selected health facilities will be tested for malaria infection by rapid diagnostic test and administered a brief questionnaire to capture key indicators of malaria control intervention coverage and care-seeking behaviour. In each location, contemporaneous cross-sectional household surveys will be leveraged to assess correlations between estimates obtained using each method, and the use of ANC data as a tool to track trends in malaria burden and intervention coverage will be validated. Results This study will assess malaria prevalence at ANC1 aggregated at health facility and district levels, and by gravidity relative to current pregnancy (i.e., gravida 1, gravida 2, and gravida 3 +). ANC1 malaria prevalence will be presented as monthly trends. Additionally, correlation between ANC1 and household survey–derived estimates of malaria prevalence, bed net ownership and use, and care-seeking will be assessed. Conclusion ANC1-based surveillance has the potential to provide a cost-effective, localized measure of malaria prevalence that is representative of the general population and useful for tracking monthly changes in parasite prevalence, ...