MALARIA CONSORTIUM UK - UGANDA

Parasite based diagnosis of malaria in Uganda: Effectiveness of rapid diagnostic test in diagnosis of malaria in pregnancy in Uganda.

Malaria infection during pregnancy may cause maternal anaemia, placental malaria, and subsequently low birth weight. These adverse consequences put the health of the mother, her foetus, and the neonate at substantial risk. It is estimated that malaria infection during pregnancy causes 75,000 - 200,000 infant deaths each year.

Pregnant women are known to harbour placental parasites not detectable in peripheral blood smears by routine light microscopy. In an effort to improve the quality of management of malaria, Ministry of Health of Uganda now recommends parasite-based malaria diagnosis for all fever cases, shifting away from presumptive treatment. However there is a contradiction in the treatment guidelines as they still recommend treatment of all fevers in pregnancy with anti-malarial drugs, possibly as a cautious measure not to miss placental malaria.

In order for the new diagnosis interventions to become embedded firmly as an integrated part of the health system in Uganda, they must be available, acceptable, accessible and affordable to those who need them, used appropriately and become a part of the disease prevention, as well as treatment seeking culture. Currently little is known about the acceptability of Rapid Diagnostic Tests (RDTs) for malaria among pregnant mothers and health workers, and how it influences their practices in Uganda.

This study will investigate the acceptability, health workers practices and accuracy of RDTs in pregnancy. This study shall evaluate maternal and foetal outcomes and describe the use of malaria preventive measures among the study population including use of intermittent presumptive treatment (IPT) and mosquito nets. The outcomes of the study will inform practitioners and policy makers of RDT's role in diagnosis of placental malaria, and promote rational use of anti-malarial drugs during pregnancy.