Antenatal screening prevents malaria deaths

Results of an extensive analysis suggest that antenatal screening for malaria has dramatically reduced the number of deaths among pregnant women on the Thailand-Myanmar border.

Researchers analyzed 25 years’ worth of data on 50,981 women and found that deaths from Plasmodium falciparum malaria decreased drastically after the introduction of antenatal screening.

“We have seen a massive reduction in malaria-related maternal mortality,” said Rose McGready, MD, of the Shoklo Malaria Research Unit, which is based in the refugee camps on the Thailand-Myanmar border. “This gives us hope and shows that deaths from malaria are preventable.”

Dr McGready and her colleagues analyzed medical records from women treated at the Shoklo Malaria Research Unit between May 1986 and the end of 2010. About 72% of the women (n=36,827) were in refugee camps, and nearly 28% (n=14,151) were migrant women.

The overall estimated maternal mortality ratio (MMR) was 184 per 100,000 live births. In the refugee camps, there was a 6-fold decline in the MMR, from 499 between 1986 and 1990 to 79 between 2006 and 2010. In migrants, there was a 2.3-fold decline in MMR, from 588 between 1996 and 2000 to 252 between 2006 and 2010.

Mortality from P falciparum malaria in pregnancy dropped sharply upon the introduction of systematic screening and treatment. In addition, the median number of antenatal visits, which is equivalent to the number of screens for malaria, was significantly lower in women who died compared to those who did not, at 7 and 12, respectively.

“Even though treatment options for pregnant women infected with malaria are limited, frequent antenatal screening clearly works, and, as such, we believe it should play a larger role in tackling the disease,” Dr McGready said. “However, there are still significant rates of maternal death in the more mobile migrant populations, and this is something that needs to be addressed.”

Dr McGready and her colleagues reported these findings in PLoS ONE.

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