Malaria in Pregnancy Preventive Alternative Drugs
IPTp with SP, in a context of ITNs use, has been already proved to be cost-effective in preventing both clinical malaria in pregnant women and neonatal mortality (Sicuri et al. Unpublished). Mefloquine has the potential to be more efficacious than SP but it is also more expensive and has some tolerability and potentially compliance issues. For this reason, an economic evaluation of IPTp-MQ compared to IPTp-SP is needed.
Furthermore, little is known about the economics of malaria prevention during pregnancy in HIV infected women. To our knowledge, the only economic evaluation that considered HIV status as a factor affecting the effectiveness of IPTp was Wolfe et al (Wolfe et al. 2001). MiPPAD trials offer the opportunity to undertake a cost-effectiveness analysis based on efficacy and effectiveness of preventive interventions addressed to HIV infected and HIV non-infected pregnant women in comparison to SP. More evidence is needed about the economic burden of malaria in pregnancy in Tanzania in order to understand which actual savings, from the societal prospective, can be generated by the prevention of malaria cases through a more efficacious intervention.