Evidence map›Paper›PMID 35729612›Full record

Trial reportMalaria journal2022

A cluster randomized trial of delivery of intermittent preventive treatment of malaria in pregnancy at the community level in Malawi.

Beth L Rubenstein, Jobiba Chinkhumba, Ethel Chilima, Collins Kwizombe, Ashley Malpass, Shelby Cash, Katherine Wright, Peter Troell, Humphrey Nsona, Fannie Kachale and 7 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Malaria journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03376217 (Assessing the Effectiveness of Community Delivery of Intermittent Preventive Treatment in Pregnancy), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.4field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03376217 nacompletednot on this map

Assessing the Effectiveness of Community Delivery of Intermittent Preventive Treatment in Pregnancy (IPTp) in Malawi

TypeinterventionalSponsorKamuzu University of Health SciencesRan2017 to 2020Enrolled1,447ConditionsMalaria in PregnancyArmsIPTp delivered by HSAs
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Dynamics of Persistent Submicroscopic and MicroscopicOpen forum infectious diseases · 2025
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 7 institutions in 2 countries.

Beth L Rubenstein *Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA.
Jobiba Chinkhumba *University of Malawi College of Medicine, Malaria Alert Centre, Blantyre, Malawi.
Ethel ChilimaManagement Sciences for Health (MSH), Lilongwe, Malawi.
Collins KwizombeU.S. President's Malaria Initiative, United States Agency for International Development (USAID), Lilongwe, Malawi.
Ashley MalpassU.S. President's Malaria Initiative, United States Agency for International Development (USAID), Washington, D.C, USA.
Shelby CashMalaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, U.S. President's Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Katherine WrightManagement Sciences for Health (MSH), Medford, MA, USA.
Peter TroellMalaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, U.S. President's Malaria Initiative, Centers for Disease Control and Prevention, Lilongwe, Malawi.
Humphrey NsonaMinistry of Health, Lilongwe, Malawi.
Fannie KachaleMinistry of Health, Lilongwe, Malawi.
Doreen AliMinistry of Health, Lilongwe, Malawi.
Evans KaundaMinistry of Health, Lilongwe, Malawi.
Sosten LankhulaniMinistry of Health, Lilongwe, Malawi.
Michael KayangeMinistry of Health, Lilongwe, Malawi.
Don P MathangaUniversity of Malawi College of Medicine, Malaria Alert Centre, Blantyre, Malawi.
John MunthaliManagement Sciences for Health (MSH), Lilongwe, Malawi.
Julie R GutmanMalaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA. fff2@cdc.gov.
Ministry of Health · MWDivision of Parasitic Diseases and Malaria · USPublic Health Institute of Malawi · MWUniversity of Malawi · MWU.S. President's Malaria Initiative · USManagement Sciences for Health · USUnited States Agency for International Development · US

Funding

USAID USAID
6 · The paper itself

Abstract

backgroundMalaria in pregnancy doubles the risk of low birthweight; up to 11% of all neonatal deaths in sub-Saharan Africa are associated with malaria in pregnancy. To prevent these and other adverse health consequences, the World Health Organization recommends administering intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine for all pregnant women at each antenatal care (ANC) visit, starting as early as possible in the second trimester. The target is for countries to administer a minimum of three doses (IPTp3+) to at least 85% of pregnant women.

methodsA cluster randomized, controlled trial was conducted to assess the effect of delivery of IPTp by community health workers on the coverage of IPTp3 + and ANC visits in Malawi. Community delivery of IPTp was implemented within two districts in Malawi over a 21-month period, from November 2018 to July 2020. In control sites, IPTp was delivered at health facilities. Representative samples of women who delivered in the prior 12 months were surveyed at baseline (n = 370, December 2017) and endline (n = 687, August 2020). A difference in differences analysis was conducted to assess the change in coverage of IPTp and ANC over time, accounting for clustering at the health facility level.

resultsOverall IPTp coverage increased over the study period. At baseline, women received a mean of 2.3 IPTp doses (range 0-5 doses) across both arms, and at endline, women received a mean of 2.8 doses (range 0-9 doses). Despite overall increases, the change in IPTp3 + coverage was not significantly different between intervention and control groups (6.9%, 95% CI: -5.9%, 19.6%). ANC4 + coverage increased significantly in the intervention group compared with the control group, with a difference-in-differences of 25.3% points (95% CI: 1.3%, 49.3%).

conclusionsIn order to reduce the burden of malaria in pregnancy, new strategies are needed to improve uptake of effective interventions such as IPTp. While community health workers' delivery of IPTp did not increase uptake in this study, they may be effective in other settings or circumstances. Further research can help identify the health systems characteristics that are conducive to community delivery of IPTp and the operational requirements for effective implementation.

trial registrationClinicalTrials.gov Identifier: NCT03376217. Registered December 6, 2017, https://clinicaltrials.gov/ct2/show/NCT03376217 .

Indexed as

AntimalarialsMalariaPregnancy Complications, ParasiticDrug CombinationsFemaleHumansInfant, NewbornMalawiPregnancyPrenatal CarePyrimethamineSulfadoxineAntimalarialsDrug CombinationsPyrimethamineSulfadoxineCommunity Health WorkersIntermittent preventive treatmentMalariaMalawiPregnancySulfadoxine-pyrimethamine

Identifiers

PMID35729612
PMCPMC9210049
OpenAlexW4283204548

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.