Assessing the utility of pregnant women as a sentinel surveillance population for malaria in Geita, Tanzania, 2019-2021
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objectives
Estimates of malaria burden and intervention uptake in Africa are primarily based on household surveys. However, their expense and infrequency limit their utility. We investigated whether data collected during antenatal care (ANC) can provide relevant information for decision-makers.
Methods
Malaria test positivity rates and questionnaire data from ANC attendees at 39 health facilities were compared to questionnaire data and positivity rates among children from two cross-sectional surveys in the facilities’ corresponding catchment areas.
Results
Trends in parasitemia among ANC attendees were predictive of trends in parasitemia among children at the council level (mean absolute error 6.0%). Primigravid ANC attendees had the lowest rates of net ownership (modeled odds ratio [OR] 0.28, 95% CI 0.19-0.40) and use (OR 0.58, 95% CI 0.42-0.79). ANC attendees reported higher levels of care-seeking (OR 1.78, 95% CI 1.48-2.14), malaria testing (OR 4.16, 95% CI 3.44-5.04), and treatment for children with fever (OR 7.66, 95% CI 4.89-11.98) compared to women surveyed in households, raising concerns about social desirability bias disproportionately impacting ANC surveys.
Conclusion
ANC surveillance is an effective strategy for tracking trends in malaria burden. More work is required to elucidate the value of administering questionnaires to ANC attendees.
Estimates of malaria burden and intervention uptake in Africa are primarily based on household surveys. However, their expense and infrequency limit their utility. We investigated whether data collected during antenatal care (ANC) can provide relevant information for decision-makers.
Methods
Malaria test positivity rates and questionnaire data from ANC attendees at 39 health facilities were compared to questionnaire data and positivity rates among children from two cross-sectional surveys in the facilities’ corresponding catchment areas.
Results
Trends in parasitemia among ANC attendees were predictive of trends in parasitemia among children at the council level (mean absolute error 6.0%). Primigravid ANC attendees had the lowest rates of net ownership (modeled odds ratio [OR] 0.28, 95% CI 0.19-0.40) and use (OR 0.58, 95% CI 0.42-0.79). ANC attendees reported higher levels of care-seeking (OR 1.78, 95% CI 1.48-2.14), malaria testing (OR 4.16, 95% CI 3.44-5.04), and treatment for children with fever (OR 7.66, 95% CI 4.89-11.98) compared to women surveyed in households, raising concerns about social desirability bias disproportionately impacting ANC surveys.
Conclusion
ANC surveillance is an effective strategy for tracking trends in malaria burden. More work is required to elucidate the value of administering questionnaires to ANC attendees.
Date Issued
2023-11-01
Date Acceptance
2023-08-07
Citation
International Journal of Infectious Diseases, 2023, 136, pp.57-63
ISSN
1201-9712
Publisher
Elsevier
Start Page
57
End Page
63
Journal / Book Title
International Journal of Infectious Diseases
Volume
136
Copyright Statement
Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/37567552
PII: S1201-9712(23)00691-4
Subjects
Antenatal care
BURDEN
CARE
CHILDBIRTH
Infectious Diseases
Life Sciences & Biomedicine
Malaria
Science & Technology
Surveillance
Tanzania
Publication Status
Published
Coverage Spatial
Canada
Date Publish Online
2023-08-10