Imperial College London
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DrPatrickWalker

Faculty of Medicine, School of Public Health

Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 7594 3946patrick.walker06

 
 
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Location

 

UG12Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Walker:2020:10.1038/s41467-020-17528-3,
author = {Walker, P and Cairns, M and Slater, H and Gutman, J and Kayentao, K and Williams, J and Coulibaly, S and Khairallah, C and Taylor, S and Meshnick, S and Hill, J and Mwapasa, V and Kalilani-Phiri, L and Bojang, K and Kariuki, S and Tagbor, H and Griffin, J and Madanitsa, M and Ghani, A and Desai, M and ter, Kuile F},
doi = {10.1038/s41467-020-17528-3},
journal = {Nature Communications},
pages = {1--12},
title = {Modelling the incremental benefit of introducing malaria screening strategies to antenatal care in Africa},
url = {http://dx.doi.org/10.1038/s41467-020-17528-3},
volume = {11},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Plasmodium falciparum in pregnancy is a major cause of adverse pregnancy outcomes. We combine performance estimates of standard rapid diagnostic tests (RDT) from trials of intermittent screening and treatment in pregnancy (ISTp) with modelling to assess whether screening at antenatal visits improves upon current intermittent preventative therapy with sulphadoxine-pyrimethamine (IPTp-SP). We estimate that RDTs in primigravidae at first antenatal visit are substantially more sensitive than in non-pregnant adults (OR = 17.2, 95% Cr.I. 13.8-21.6), and that sensitivity declines in subsequent visits and with gravidity, likely driven by declining susceptibility to placental infection. Monthly ISTp with standard RDTs, even with highly effective drugs, is not superior to monthly IPTp-SP. However, a hybrid strategy, recently adopted in Tanzania, combining testing and treatment at first visit with IPTp-SP may offer benefit, especially in areas with high-grade SP resistance. Screening and treatment in the first trimester, when IPTp-SP is contraindicated, could substantially improve pregnancy outcomes.
AU  - Walker,P
AU  - Cairns,M
AU  - Slater,H
AU  - Gutman,J
AU  - Kayentao,K
AU  - Williams,J
AU  - Coulibaly,S
AU  - Khairallah,C
AU  - Taylor,S
AU  - Meshnick,S
AU  - Hill,J
AU  - Mwapasa,V
AU  - Kalilani-Phiri,L
AU  - Bojang,K
AU  - Kariuki,S
AU  - Tagbor,H
AU  - Griffin,J
AU  - Madanitsa,M
AU  - Ghani,A
AU  - Desai,M
AU  - ter,Kuile F
DO  - 10.1038/s41467-020-17528-3
EP  - 12
PY  - 2020///
SN  - 2041-1723
SP  - 1
TI  - Modelling the incremental benefit of introducing malaria screening strategies to antenatal care in Africa
T2  - Nature Communications
UR  - http://dx.doi.org/10.1038/s41467-020-17528-3
UR  - https://www.nature.com/articles/s41467-020-17528-3
UR  - http://hdl.handle.net/10044/1/81220
VL  - 11
ER  -
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