Pregnant women in Indonesia will be tested for malaria at every antenatal visit using a rapid diagnostic that returns results in 15 minutes from a single drop of blood. This matters because around 10 percent of pregnant women in Indonesia contract malaria, and infections that show no symptoms can still cause maternal anaemia, stunt fetal growth, and increase infant death. The current policy tests only at the first visit and then only when symptoms appear, so many infections go undetected. The study compares two new approaches against that existing policy. In the first, all women are tested at every visit and treated with the drug dihydroartemisinin-piperaquine if positive. In the second—intermittent preventive treatment, already used across Africa but not Asia—women without symptoms receive the same drug without prior testing. If either method proves more effective and cost-efficient, it could reshape malaria prevention policy for pregnant women across Indonesia and Southeast Asia, catching infections earlier or preventing them entirely. The results will inform national guidelines, potentially reducing preterm births, pregnancy loss, and infant mortality in a region where malaria in pregnancy remains a persistent threat.
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FIGHTING MALARIA IN PREGNANCY IN INDONESIA The control of malaria in pregnancy in Indonesia, where approximately 10% of pregnant women get infected with malaria, could receive a potential boost through a new study conducted by the Eijkman Institute for Molecular Biology and the Timika Research Facility in Indonesia. Together with experts from the Liverpool School of Tropical Medicine in the UK, they are going to test two new methods of preventing malaria and the harmful effects in pregnancy. When pregnant women contract malaria this can have devastating consequences for pregnancy, resulting in fever which may trigger preterm onset of labour or even pregnancy loss. It is also possible for women to be infected without showing any outward signs or symptoms, yet if these infections are undetected and left untreated, they can cause anaemia in the mother and can interfere with the growth of the fetus leading to low birth weight, which increases the risk of babies dying during infancy. The new project will provide malaria testing to women with or without the symptoms of malaria on every scheduled antenatal visit using a rapid diagnostic test (RDT). The RDT is simple to perform, uses a single drop of blood and gives results within 15 minutes. Those women testing positive will be treated with an artemisinin combination drug called dihydroartemisinin-piperaquine (DHP), which is the treatment of choice in the 2nd and 3rd trimester of pregnancy in Indonesia. A second method called intermittent preventive treatment, which is used in most countries in Africa but not yet in Asia, will also be tested. With this method women without symptoms of malaria will be selected to receive the same drug but without prior blood testing. Both methods will be compared with the existing policy in Indonesia, where all pregnant women are tested for malaria on the first antenatal visit only, and those with a positive result are treated with DHP. During subsequent antenatal visits, women are only tested if they have symptoms of malaria such as fever. This means that some infections will go undetected. It is anticipated that the two new methods will either detect infections much earlier than the current approach, or prevent them altogether. The findings of this study, together with an assessment of feasibility and cost effectiveness of each method, will be used to inform malaria prevention policy for pregnant women in Indonesia and other parts of South East Asia.
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