Intermittent screening and treatment in pregnancy and the safety of ACTs in the first trimester

Malaria in pregnancy is a major, preventable cause of maternal morbidity and poor birth outcomes. To prevent these adverse outcomes, WHO recommends the use of insecticide treated mosquito nets 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 sulphadoxine-pyrimethamine (SP). In recent years an alternative strategy, consisting of intermittent screening and treatment in pregnancy (ISTp) using rapid diagnostic tests (RDTs) and treatment with artemisinin-based combination therapies (ACTs) during antenatal care (ANC) visits, has been evaluated in several countries. Moreover, multiple studies have assessed the safety of using ACTs in the first trimester of pregnancy.