Using antenatal care as a platform for malaria surveillance data collection: study protocol.

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Systems Research

Background:

• Routine health information systems have limitations in timely malaria trend reporting.
• Community surveys for malaria prevalence are resource-intensive and lack geographic detail.
• Integrating malaria testing into the first antenatal care visit (ANC1) offers a potential for more timely and granular data.

Purpose of the Study:

• To assess the feasibility and utility of ANC1-based surveillance for monitoring malaria burden and intervention coverage.
• To validate ANC data against traditional household survey methods.
• To evaluate the representativeness and cost-effectiveness of ANC1 surveillance.

Main Methods:

• An observational, cross-sectional study across six malaria-endemic countries (Benin, Burkina Faso, Mozambique, Nigeria, Tanzania, Zambia).
• Pregnant women at ANC1 were tested for malaria and completed a questionnaire on intervention coverage and care-seeking.
• Correlations between ANC1 data and contemporaneous household survey data were analyzed.

Main Results:

• Malaria prevalence at ANC1 will be assessed at facility and district levels, stratified by gravidity.
• Monthly trends in ANC1 malaria prevalence will be reported.
• Correlations between ANC1 and household survey estimates for malaria prevalence, bed net use, and care-seeking will be evaluated.

Conclusions:

• ANC1-based surveillance shows potential for cost-effective, localized malaria monitoring.
• It can provide timely data on parasite prevalence and intervention coverage representative of the general population.
• Further evaluation will focus on operational feasibility, programmatic utility, and scalability.