ArticleMalaria journal2026
Extreme weather events and malaria prevention in pregnancy: a mediation analysis of antenatal care and sulfadoxine-pyrimethamine use in two malaria-endemic counties of Kenya.
Article in Malaria journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundClimate change threatens maternal, and newborn health, particularly by exacerbating climate-sensitive diseases like malaria. Malaria in pregnancy (MiP) contributes to maternal anaemia, stillbirth, preterm delivery, and low birth weight. In Kenya's Lake Victoria basin, recurrent floods and droughts disrupt antenatal care (ANC), the main delivery platform for intermittent preventive treatment of MiP with sulfadoxine-pyrimethamine (IPTp-SP). The extent to which these extreme weather events affect IPTp-SP uptake through ANC attendance remains unexplored.
methodsData are drawn from a cross-sectional household survey conducted under the revive IPTp-SP project among women who had given birth to a live baby in the last 24 months preceding the interview in malaria-endemic counties of Kisumu and Migori. Exposure was self-reported extreme weather events in the past 12 months; the outcome was completion of three or more IPTp-SP doses (IPTp₃ +); and the mediator was attendance of ≥ 4 ANC visits (ANC4
resultsIPTp₃ + coverage was lower among shock-exposed pregnancies (49.5%) versus unexposed (58.8%). Extreme weather events were associated with reduction in ANC4
conclusionsExtreme weather events reduced IPTp₃ + uptake primarily through ANC disruption in unadjusted models, with effects concentrated in Kisumu. However, these associations attenuated after adjustment, suggesting the role of underlying socioeconomic and contextual vulnerabilities.
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