Routine Antenatal Care Versus Screening and Treatment of Malaria in Pregnancy in Rwanda
Effectiveness of Intermittent Screening and Treatment of Malaria in Pregnancy (ISTp) on Maternal and Birth Outcomes in Selected Districts in Rwanda
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
More specifically, the primary objective is to understand the effect of ISTp in a context where routine antenatal care does not include malaria chemoprohylaxis and whether this intervention is protective against malaria during pregnancy. The secondary objective is to determine whether this intervention results in an improvement in other key maternal and newborn health outcomes including maternal anemia, low birth weight and prematurity. The third objective is to determine the feasibility, effectiveness and acceptability of ISTp among women who receive ISTp and among health workers who deliver this intervention.
This study will establish if testing and treating pregnant women is effective, feasible and whether it adds an additional burden to the work already being undertaken by facility-based health workers who provide antenatal care services. It is expected that the study will result in information to develop appropriate approaches that can be implemented in Rwanda in the prevention of malaria in pregnancy in addition to the use of preventive measures such as insecticide treated mosquito nets (ITNs) and case management. This information may potentially also be used by other countries with similar patterns of malaria transmission.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
South
-
Huye, South, Rwanda
- Busoro-Gishamvu Health Center
-
Huye, South, Rwanda
- Huye Police Health Center
-
Huye, South, Rwanda
- Maraba Health Cente
-
Huye, South, Rwanda
- Mukura Health Center
-
Huye, South, Rwanda
- Rango Health Center
-
Huye, South, Rwanda
- Rubona Health Center
-
Huye, South, Rwanda
- Rwaniro
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Huye, South, Rwanda
- Sovu Health Center
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Kamonyi, South, Rwanda
- Kamonyi Health Center
-
Kamonyi, South, Rwanda
- Kayenzi Health Center
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Kamonyi, South, Rwanda
- Mugina Health Center
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Kamonyi, South, Rwanda
- Musambira Health Center
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Kamonyi, South, Rwanda
- Nyagihamba Health Center
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Kamonyi, South, Rwanda
- Nyamiyaga Health Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Pregnant women age 18 or older who have their first ANC visit during the study recruitment period
- Willing to participate
Exclusion Criteria:
• Pregnant women below the age of 18
- Not willing to participate
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: IST using RDT
Women presenting for their first ANC visit to facilities will be consecutively enrolled after providing informed consent.
Women in the intervention group (IST+ routine care) will be tested for malaria at the health center during their ANC visits with an RDT.
If positive, they will be treated with artemisinin-based combination therapy (ACT) in second or third trimester or quinine in the first trimester.
|
Women in the control group will receive routine care, which does not include testing for malaria with a rapid diagnostic test unless symptomatic for malaria.
Women in the intervention group will receive this additional testing for malaria at each antenatal care, regardless of whether she is symptomatic for malaria.
|
|
No Intervention: Routine Antenatal Care
Women presenting for their first ANC visit to facilities will be consecutively enrolled after providing informed consent.
Women in the comparison group (routine care) will receive routine antenatal care services per the national guidelines.
They will not be tested for malaria at each antenatal care visit unless they are symptomatic for malaria.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Prevalence of placental malaria at delivery (tested by PCR)
Time Frame: at the time of delivery
|
comparison of prevalence of malaria between women in intervention and control sites
|
at the time of delivery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Prevalence of maternal anemia at delivery
Time Frame: at the time of delivery
|
comparison of prevalence of maternal anemia between women in intervention and control sites
|
at the time of delivery
|
|
Prevalence of low birth weight babies (<37 weeks gestation)
Time Frame: at the time of delivery
|
comparison of prevalence of LBW between women in intervention and control sites
|
at the time of delivery
|
|
Prevalence of preterm births
Time Frame: at the time of delivery
|
comparison of prevalence of preterm births between women in intervention and control sites
|
at the time of delivery
|
|
Episodes of clinical malaria during the course of the pregnancy
Time Frame: assessed at the time of delivery
|
description of the number of episodes of malaria detected during antenatal care visits during pregnancy
|
assessed at the time of delivery
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Adverse outcome of pregnancy - abortions, still births and neonatal deaths
Time Frame: assessed at the time of delivery
|
Description of the number of adverse outcomes by group
|
assessed at the time of delivery
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Reena Sethi, DrPH, Jhpiego
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 6829
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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