ArticleThe Lancet. Global health2019
Estimating malaria burden among pregnant women using data from antenatal care centres in Tanzania: a population-based study.
Article in The Lancet. Global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Prevalence of Pregnancy Associated Malaria in India.Frontiers in global women's health · 2022Pooled it
- Effectiveness of Intermittent Screening and Treatment of Malaria in Pregnancy on Maternal and Birth Outcomes in Selected Districts in Rwanda: A Cluster Randomized Controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Trial
- Beyond national household surveys: routine and alternative approaches to sustain robust evidence-based decision making.Malaria journal · 2026Review
- Indoor residual spraying household visits as a platform for engaging pregnant women in malaria prevention on Bioko Island, Equatorial Guinea.BMC pregnancy and childbirth · 2025Article
- Facilitators and barriers of malaria prevention and treatment services to pregnant women in Ethiopia: a multi-level health system analysis, 2025.Malaria journal · 2025Article
- Prevalence and risk factors associated with infections caused by Plasmodium parasites at micro-geographic level in three villages of Muheza district in Tanga region, north-eastern Tanzania.Malaria journal · 2025Article
- Antenatal care surveillance for monitoring malaria prevalence and intervention coverage: a multicountry analysis.BMJ global health · 2025Article
- Temporal and spatial trends of the prevalence of infections caused by Plasmodium parasites among rural community members in three regions with varying transmission intensities in Mainland Tanzania.Malaria journal · 2025Article
- Pregnant women as a sentinel population for genomic surveillance of malaria in the Democratic Republic of the Congo: a population-based study.The Lancet. Global health · 2025Observational
- Comparison of fine-scale malaria strata derived from population survey data collected using RDTs, microscopy and qPCR in South-Eastern Tanzania.Malaria journal · 2024Article
- Risk of Aedes-borne diseases in and around the Tanzanian seaport of Tanga despite community members being more concerned about malaria.Parasites & vectors · 2024Article
- Prevalence and attributable health burdens of vector-borne parasitic infectious diseases of poverty, 1990-2021: findings from the Global Burden of Disease Study 2021.Infectious diseases of poverty · 2024Article
- Sampling for malaria molecular surveillance.Trends in parasitology · 2023Review
- Assessing the utility of pregnant women as a sentinel surveillance population for malaria in Geita, Tanzania, 2019 - 2021.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023Article
- Detecting temporal and spatial malaria patterns from first antenatal care visits.Nature communications · 2023Article
- Spatio-temporal modelling of routine health facility data for malaria risk micro-stratification in mainland Tanzania.Scientific reports · 2023Article
- Using antenatal care as a platform for malaria surveillance data collection: study protocol.Malaria journal · 2023Article
- Women attending antenatal care as a sentinel surveillance population for malaria in Geita region, Tanzania: feasibility and acceptability to women and providers.Malaria journal · 2023Article
- Detecting temporal and spatial malaria patterns from first antenatal care visits.Research square · 2023Article
- Routine Healthcare Facility- and Antenatal Care-Based Malaria Surveillance: Challenges and Opportunities.The American journal of tropical medicine and hygiene · 2023Article
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10 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundMore timely estimates of malaria prevalence are needed to inform optimal control strategies and measure progress. Since 2014, Tanzania has implemented nationwide malaria screening for all pregnant women within the antenatal care system. We aimed to compare malaria test results during antenatal care to two population-based prevalence surveys in Tanzanian children aged 6-59 months to examine their potential in measuring malaria trends and progress towards elimination.
methodsMalaria test results from pregnant women screened at their first antenatal care visits at health-care facilities (private and public) in all 184 districts of Tanzania between Jan 1, 2014, and Dec 31, 2017, were collected from the Health Management Information Systems and District Health Information System 2. We excluded facilities with no recorded antenatal care attendees during the time period. We standardised results to account for testing uptake and weighted them by the timing of two population-based surveys of childhood malaria prevalence done in 2015-16 (Demographic and Health Survey) and 2017 (Malaria Indicator Survey). We assessed regional-level correlation using Spearman's coefficient and assessed the consistency of monthly district-level prevalence ranking using Kendall's correlation coefficient.
findingsCorrelation between malaria prevalence at antenatal care and among children younger than 5 years was high (r≥0·83 for both surveys), although declines in prevalence at antenatal care were generally smaller than among children. Consistent heterogeneity (p<0·05) in antenatal care prevalence at the district level was evident in all but one region (Kilimanjaro). Data from antenatal care showed declining prevalence in three regions (Arusha, Kilimanjaro, and Manyara) where surveys estimated zero prevalence.
interpretationRoutine antenatal care-based screening can be used to assess heterogeneity in transmission at finer resolution than population-based surveys, and provides sample sizes powered to detect changes, notably in areas of low transmission where surveys lack power. Declines in prevalence at antenatal care might lag behind those among children, highlighting the value of monitoring burden and continuing prevention efforts among pregnant women as transmission declines. The pregnancy-specific benefits and cost-effectiveness of antenatal care-based screening remain to be assessed.
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