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Not all pregnant women with symptoms of malaria seek care from their formal healthcare system, and those that do may be given inappropriate treatment because healthcare providers often fail to adhere to the standard diagnostic and treatment guidelines from the World Health Organization, according to new research published in .

Researchers from the °®ÍþÄÌapp of Hygiene & Tropical Medicine and the Liverpool School of Tropical Medicine reviewed all relevant studies that investigated the factors that affect pregnant women's access to malaria treatment and healthcare provider practices for case management of malaria during pregnancy.

In the 37 included studies, mostly from Africa, the authors found that one-quarter to three-quarters of women reported malaria episodes during pregnancy and more than 85% of the women who reported a malaria episode during pregnancy sought some form of treatment.

Senior author of the °®ÍþÄÌapp of Hygiene & Tropical Medicine said: "The study findings show that pregnant women are not accessing and not being given appropriate care when they have malaria. This is all the more disturbing as malaria in pregnancy tends to be predominantly a disease of socio-economically disadvantaged women. The study highlights the critical need to develop, test and implement interventions to ensure that pregnant women are given effective malaria case management of malaria during pregnancy."

Barriers to access to WHO-recommended treatment among women included poor knowledge about drug safety, and the use of self-treatment practices such as taking herbal remedies. Among healthcare providers, barriers included reliance on clinical diagnosis of malaria and poor adherence to the treatment policy.

Although limited by the sparseness of data and by inconsistencies in study methodologies, the authors say these findings highlight the need to develop interventions to improve access to and delivery of quality case management of malaria among pregnant women.

The study was funded by the Bill & Melinda Gates Foundation.

Publication

• Jenny Hill, Lauren D'Mello-Guyett, Jenna Hoyt, Anna M. van Eijk, Feiko O. ter Kuile, Jayne Webster. PLOS Medicine. DOI: 10.1371/journal.pmed.1001688