A comprehensive approach to optimizing malaria prevention in pregnant women: evaluating the efficacy, cost-effectiveness, and resistance of IPTp-SP and IPTp-DP
Open accessAbstract
Malaria during pregnancy is a major global health concern, with approximately 10,000 pregnant women dying from malaria-related anaemia each year. The World Health Organization has suggested intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) to avert malaria infection in pregnant women in malaria-endemic areas, but this intermittent preventive (IP) treatment is at risk of becoming ineffective due to parasite resistance and the contraindication in HIV-infected women. This paper argues that alternative IP treatments such as dihydroartemisinin-piperaquine (DP) should be explored, alongside the urgent need to investigate antimalarial cycling strategies. Additionally, the cost-effectiveness of IPTp-DP should be evaluated, as well as potential barriers to IP treatment such as medication stockouts, late attendance at antenatal clinics, lack of autonomy and freedom among women, and lack of knowledge about malaria prevention. Health education focusing on malaria prevention should be incorporated into routine antenatal care programmes to improve patient compliance. A comprehensive approach that includes the administration of IPTp-DP alone along with other measures such as insecticide-treated nets and medical education is the key to addressing the devastating effects of malaria infection in pregnant women.
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Some countries are exploring alternative drugs or combination therapies for IPT.
“However, some countries are now exploring alternative drugs or combination therapies for IPT [209–211].”
From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [210]
The Introduction’s ‘Advantages and disadvantages of IPTp-SP and IPTp-DP’ section identifies DP as a potential alternative for IPT in pregnant women, and the ‘Antimalarial cycling strategy’ section considers rotating DP and SP. But the paper proposes exploring these approaches; the cited passages do not establish that some countries are now doing so. Its example of Malawi describes a switch made in 1993, not current exploration. (LLM, conf=0.83)
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- Authors
- Eisenberg, S.-L., & Krieger, A. E.
- Affiliations
- Technion – Israel Institute of Technology (IL)
- University of Southern California (US)
- Corresponding author
- Eisenberg, Sarah-Leah
- Venue
- Global Health Action
- Publisher
- Informa UK Limited
- Published
- 2023-07-17
- Volume
- 16
- Issue
- 1
- Pages
- 2231257-2231257
- ISSN
- 1654-9716 (ISSN-L)
- 1654-9880
- PMC
- PMC10353317
- OpenAlex
- W4384498981
- Cited by
- 12
- References
- 20
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 4
- FWCI
- 3.06
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Global Health Action (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- no funding
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- malaria in pregnancy, intermittent preventive treatment, sulfadoxine-pyrimethamine, dihydroartemisinin-piperaquine, antimalarial drug resistance, cost-effectiveness, prenatal care, health education, insecticide-treated nets, medication stockouts, medication adherence, anemia in pregnancy
- MeSH terms
- Antimalarials, Cost-Benefit Analysis, Drug Combinations, Female, Humans, Malaria, Piperazines, Pregnancy, Pyrimethamine, Quinolines, Sulfadoxine, Artemisinins, Pregnant People
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