Corine Karema1, William R. Brieger2, Aline Uwimana1, Beata Mukarugwiro3, Irenee Umulisa1 1Malaria and Other Parasitic Diseases Program, Rwanda Ministry of Health, Kigali, Rwanda, 2The Johns Hopkins University, Baltimore, MD, United States, 3Jhpiego/Maternal and Child Health Integrated Project, Kigali, Rwanda
Rwanda has made strides toward lowering malaria transmission with universal coverage of long-lasting insecticide treated nets and easy access to artemisinin based combination treatment. National prevalence is estimated at 1.4% among children 6-59 months and 0.7% among women aged 15-49 years according to the 2010 DHS. Slide positivity rates from the national health management information system continue to drop and yet malaria persists. Pregnant women thus remain vulnerable even as prevalence drops.
dscn7129asm.jpgWhile Rwanda no longer practices IPTp it is concerned it is interested in offering the best malaria protection to pregnant women. In order to plan appropriately, there is need for a malaria in pregnancy revalence study. Pregnant women were studied at first antenatal care registration visit in low, moderate and relatively higher transmission areas using rapid diagnostic test and microscopy. Ethical clearance was provided by the ethical review board within the Ministry of Health. ANC staff were trained to obtain data during normal client visits.
Among nearly 4000 women studied, prevalence with RDT was 2.5% ranging from 6.8% in the higher border districts in the east to 0% in the areas designated as low transmission based on the HMIS. For microscopy the overall prevalence was 1.6% and also varied from 4.5% to 0.1%.
RDT positivity showed reducing trend with increasing parity and with LLIN use the night before the interview. Positive RDTs were associated with younger maternal age, anemia and current higher temperature.
Results show need to continue to protect pregnant women and their unborn children in Rwanda through increased use of LLINs and identification and tracking women of low parity.