e-Library of Evidence for Nutrition Actions (eLENA)


An online library of evidence-informed guidelines for nutrition interventions and single point of reference for the latest nutrition guidelines, recommendations and related information.

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Insecticide-treated nets to reduce the risk of malaria in pregnant women

Intervention | Last updated: 17 May 2023


Pregnancy reduces a woman’s immunity, making pregnant women more susceptible to malaria infection and increasing the risk of illness, anaemia, severe disease and death. For the unborn child, maternal malaria increases the risk of spontaneous abortion, stillbirth, premature delivery and low birth weight – a leading cause of child mortality.

Evidence shows that in malaria-endemic areas, sleeping under mosquito nets treated with an insecticide is beneficial to the health of the pregnant woman, her fetus and the newborn infant. Long-lasting insecticidal nets are designed to maintain their effectiveness against mosquitoes that carry malaria and other diseases for at least three years. Studies have shown that long-lasting insecticidal nets may be less expensive to use than conventionally treated nets.

Insecticide-treated nets are safe for use as a personal protection method during pregnancy. Women should start using them as early in pregnancy as possible, and continue to use them throughout pregnancy and in the postpartum period for both mother and child.

WHO Recommendations


Universal access to and use of long-lasting insecticidal nets remains the goal for all people at risk of malaria.

In endemic areas with intense malaria transmission (stable malaria), all infants at their first immunization and all pregnant women as early as possible in pregnancy should receive one long-lasting insecticidal net through immunization and antenatal care visits.

WHO recommendations on deployment of mosquito nets treated with a pyrethroid and piperonyl butoxide can be found in Conditions for deployment of mosquito nets treated with a pyrethroid and piperonyl butoxide under ‘WHO documents’ below.



Evidence


Related Cochrane reviews


Insecticide-treated nets for preventing malaria in pregnancy

Gamble CL, Ekwaru PJ, ter Kuile FO. Cochrane Database of Systematic Reviews. 2006; Issue 2. Art. No.: CD003755.

Summary of this review Alternate Text

Other related systematic reviews


Malaria prevention in pregnancy, birthweight, and neonatal mortality: a meta-analysis of 32 national cross-sectional datasets in Africa

Eisele TP, Larsen DA, Anglewicz PA, Keating J, Yukich J, Bennett A, et al. Lancet Infect Dis. 2012;12(12):942-9.


Insecticide-treated nets for the prevention of malaria in pregnancy: a systematic review of randomized control trials

Gamble CL, Ekwaru PJ, Garner P, ter Kuile FO. PLoS Med. 2007, 4(3) e107.


Cost-effectiveness Learn More Alternate Text


Cost-effectiveness analyses


Cost-effectiveness analysis of three health interventions to prevent malaria in pregnancy in an area of low transmission in Uganda

Hansen KS, Ndyomugyenyi R, Magnussen P, Clarke SE. Int Health. 2012; 4(1):38-46.


Cost-effectiveness of adding bed net distribution for malaria prevention to antenatal services in Kinshasa, Democratic Republic of the Congo

Becker-Dreps SI, Biddle AK, Pettifor A, Musuamba G, Imbie DN, Meshnick S, Behets F. Am J Trop Med Hyg. 2009; 81(3):496-502.