What is the Link between Malaria Prevention in Pregnancy and Neonatal Survival in Nigeria?

Ikeola A. Adeoye, Adeniyi F. Fagbamigbe


Neonatal mortality has been recognized as a global public health challenge and Nigeria has the highest prevalence in Africa. Malaria during pregnancy jeopardizes neonatal survival through placental parasitaemia, maternal anaemia, and low birth weight. This study investigated association between the malaria prevention in pregnancy and neonatal survival using a nationally representative data - Nigeria Demographic Health Survey 2013. Child recode data was used and the outcome variable was neonatal death. The main independent variables were the use of at least 2 doses of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPT-SP) and proportion of pregnant women who reported Insecticide Treated Net (ITN) use the night before the survey. Data were analyzed using Pearson Chi-square (x2) test of association and survival analysis techniques. Total neonatal mortality rate was 38 per1000 live births. Cox proportional hazard model showed that low birth weight (HR 1.49, 95% CI (1.15 – 1.93 p=0.003) and adequate number of ANC visits (≥ 4 visits) (HR 0.68, 95% CI (0.53 – 0.93) were associated with neonatal survival. The use of at least 2 doses of IPT-SP was not an independent factor for neonatal survival (HR 0.72, 95% CI (0.53 – 1.15). Malaria prevention in pregnancy is crucial for neonatal survival through the prevention of low birth weight. (Afr J Reprod Health 2019; 23[1]: 139-149).

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Lawn JE, Cousen S and Zupan J. Four million neonatal deaths: when? Where? Why? Lancet 2005; 365:891 - 900.

Malaria Prevention and Neonatal Survival

UNICEF and WHO levels and trends in child mortality.

Report 2015 http://www.who.int/maternal_child_adolescent/doc uments/levels_trends_child_mortality_2015.pdf?ua =1 (accessed Mar 2017).

Lawn J, Kerber K, Enweronu-Laryea C and Massee Bateman O. Newborn survival in low resource settings—are we delivering? BJOG 2009;16 (Suppl. 1):49–59.

Ezeh OK. Trends and population-attributable risk estimates for predictors of early neonatal mortality in Nigeria, 2003–2013: a cross sectional analysis. BMJ Open 2017;7: e013350. doi:10.1136/bmjopen-2016-013350

Darmstadt GL, Bhutta, ZA, Cousens S, Adam T, Walker N and de Bernis L, Evidence-based, cost-effective interventions: how many newborn babies can we save? www.thelancet.com.2005 ; 365:9463:977-


Doku DT and Neupane S. Survival analysis of the association between antenatal care attendance and neonatal mortality in 57 low and middle-income countriesInternationalJournalofEpidemiology;2017, 1668–16771–10 doi: 10.1093/ije/dyx125.

Guyatt HLand Snow RW. Malaria in pregnancy as an in direct cause of infant mortality in sub‐Saharan Africa. Trans R. Soc Trop Med Hyg; 2001 (95)569‐76.

Desai M, terKuile, FO, Nosten F, McGready R, Asamoa K, Brabin B. and Newman R D. Epidemiology and burden of malaria in pregnancy. Lancet Infect Dis 2007; 7:93-104.

World Health Organization Regional Office for Africa: A strategic framework for malaria prevention and control during pregnancy in the African region.

WHO/AFRO.AFR/MAL/04/01.Brazzaville (Congo). http://www.afro.who.int/en/clusters-a-programmes/dpc/malaria/mal-publications.html

O. terKuile F, van Eijk MA and Filler SJ. Effect of sulphadoxine-pyrimethamine resistance on the efficacy of intermittent preventive therapy for malaria control during pregnancy. A systematic review. JAMA. 2007; 297:2603-2616

Orobaton N, Austin AM, Abegunde D, Ibrahim M, Mohammed Z, Abdul-Azeez J , Ganiyu H , Nanbol Z , Fapohunda B and Beal K. Scaling-up the use of sulfadoxine-pyrimethamine for the preventive treatment of malaria in pregnancy: results and lessons on scalability, costs and programme impact from three local government areas in Sokoto State, Nigeria. Malar J.; 2016 (15 ):533

Falade CO, Yusuf B, Fadero FF, Mokuolu OA, Hamer DH and Salako LA. Intermittent preventive treatment with sulphadoxine-pyrimethamine is effective in preventing maternal and placental


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