The prevalence of XXXX at first antenatal visit in Blantyre, Malawi declined following a universal bed net campaign.

@entity1 @entity311 @entity417 @entity281
BACKGROUND: Preventing @entity311 during pregnancy is important for the health of mothers and newborns. Interventions, which include distribution of bed nets and administration of intermittent preventive treatment (IPT), typically occur at the first antenatal visit, usually in the second or third trimester of pregnancy. In 2012, during the course of ongoing clinical studies of @entity311 among pregnant @entity1 in Malawi, a universal bed net campaign was implemented by the Government. This study tested the hypothesis that a universal bed net campaign would decrease the prevalence of @entity311 among pregnant @entity1 at their first antenatal visit. METHODS: Some 1661 @entity1 were recruited for two studies from 2009 to 2014. Quantitative PCR (qPCR) was conducted from dried blood spots collected at the first antenatal care visit (prior to administration of IPT or any study interventions) from @entity1 who were in their first or second pregnancy and less than 28  weeks gestation by clinical assessment. RESULTS: Overall, 320 of 1629 (19.6  %) @entity1 tested for @entity311 at their first antenatal visit were infected. @entity281 rates declined from 28.4  % before the universal bed net campaign, to 18.5  % in 2012, to 15.0  % in the years following the universal bed net campaign. The odds of @entity281 at the time of first antenatal visit in 2012 and the years following the bed net campaign were significantly lower than in the years prior to the intervention (OR 0.6, 95  % CI 0.4-0.8; and OR 0.4, 95  % CI 0.3-0.6, respectively). A similar pattern was observed for the prevalence of clinical @entity311 . The inverse trend was observed for reported bed net use. However bed net use and @entity281 were not significantly associated on the individual level. CONCLUSIONS: @entity281 in pregnant @entity1 is common even after a bed net campaign in Malawi, though prevalence rates declined. These early infections may cause maternal @entity417 and placental @entity311 resulting in adverse maternal and fetal outcomes. Infection early in pregnancy may also contribute to @entity311 transmission as pregnant @entity1 represent a significant untreated reservoir of parasites. Universal bed net distribution appears to have moderate success in preventing @entity311 early in pregnancy and these findings support continued efforts to target @entity1 early in pregnancy and all @entity1 of childbearing age.
