Malaria in pregnancy

Malaria in pregnancy (MiP) is a major, preventable cause of maternal morbidity and poor birth outcomes. To prevent the adverse outcomes of MiP, WHO recommends the use of insecticidetreated mosquito nets (ITNs), and effective case management of malaria and anaemia in pregnant women. In areas of moderate to high malaria transmission of sub-Saharan Africa, WHO also recommends intermittent preventive treatment in pregnancy (IPTp) with sulfadoxinepyrimethamine (SP). In recent years, an alternative preventive strategy – consisting of intermittent screening and treatment in pregnancy (ISTp) using rapid diagnostic tests (RDTs) during antenatal care (ANC) visits – has been evaluated in several countries. Moreover, multiple studies have assessed the safety of using artemisinin-based combination therapies (ACTs) in the first trimester of pregnancy. Based on this new evidence, WHO convened a group of experts to develop recommendations on the efficacy and cost-effectiveness of (ISTp) compared to IPTp-SP for prevention of MiP, and on the safety of ACTs in early pregnancy.