BMC Infectious Diseases (Aug 2022)

Impact of antimalarial resistance and COVID-19 pandemic on malaria care among pregnant women in Northern Uganda (ERASE): protocol of a prospective observational study

  • Francesco Vladimiro Segala,
  • Francesco Di Gennaro,
  • Jerry Ictho,
  • Mariangela L’Episcopia,
  • Emmanuel Onapa,
  • Claudia Marotta,
  • Elda De Vita,
  • James Amone,
  • Valentina Iacobelli,
  • Joseph Ogwang,
  • Giovanni Dall’Oglio,
  • Benedict Ngole,
  • Rita Murri,
  • Lameck Olal,
  • Massimo Fantoni,
  • Samuel Okori,
  • Giovanni Putoto,
  • Carlo Severini,
  • Peter Lochoro,
  • Annalisa Saracino

DOI
https://doi.org/10.1186/s12879-022-07645-3
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 10

Abstract

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Abstract Background Uganda accounts for 5% of all malaria cases and deaths reported globally and, in endemic countries, pregnancy is a risk factor for both acquisition of P. falciparum infection and development of severe malaria. In recent years, malaria control has been threatened by COVID-19 pandemic and by the emergence, in Northern Uganda, of both resistance to artemisinin derivatives and to sulfadoxine-pyrimethamine. Methods In this facility-based, prospective, observational study, pregnant women will be recruited at antenatal-care visits and followed-up until delivery. Collected data will explore the incidence of asymptomatic parasitemia and malaria-related outcomes, as well as the attitudes towards malaria prevention, administration of intermittent preventive treatment, healthcare seeking behavior and use of insecticide-treated nets. A subpopulation of women diagnosed with malaria will be recruited and their blood samples will be analyzed for detection of genetic markers of resistance to artemisinin derivatives and sulfadoxine-pyrimethamine. Also, to investigate the impact of COVID-19 on malaria care among pregnant women, a retrospective, interrupted-time series will be conducted on at the study sites for the period January 2018 to December 2021. Discussion The present study will explore the impact of COVID-19 pandemic on incidence of malaria and malaria-related adverse outcomes, along with the prevalence of resistance to artemisinin derivatives and to sulfadoxine-pyrimethamine. To our knowledge, this is the first study aiming to explore the combined effect of these factors on a cohort of pregnant women. Trial registration: This study has been registered on the ClinicalTrials.gov public website on 26th April, 2022. ClinicalTrials.gov Identifier: NCT05348746.

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