Compartmental Modelling of Antenatal-care Interventions for Malaria in Pregnancy, Makurdi, Benue State, Nigeria

Malaria remains a serious public health concern contributing significantly to maternal and neonatal morbidity and mortality. Impact of malaria infection seems high in pregnant women due to their immunological changes that increases susceptibility to plasmodium falciparum infections and can be controlled with preventive interventions. This study evaluates antenatal-care (ANC) impact in mitigating malaria in pregnancy using SIRS-SI deterministic compartmental model that accounts for malaria interventions at different uptake of intermittent preventive treatment in pregnancy (IPTp). The equilibrium states and effective reproduction number were obtained using next-generation matrix while numerical simulations were done via RStudio in R using Makurdi data extracted from District Health Information Systems (DHIS-2) covering 2021 to 2023. The various interventions mitigated malaria in pregnancy with insecticide treated net (ITN) effective usage having the highest impact at early stage of IPTp uptake. Pregnant women were more proactive in taking IPTp first dose (IPTp-1) during ANC (average of 67.7%) than subsequent doses (50.8% and 30.9% respectively). Artemisinin-based combination therapy (ACT) aids recovery of those infected while IPTp significantly reduced susceptibility of pregnant women. Infected cases were reduced from 43.1% to 38.3%, 38.7% and 31.5% in proportion to the susceptible that took IPTp-1, IPTp-2 and IPTp-3 respectively. Mixed intervention generated better outcome for malaria control in pregnancy relative to the impact of each intervention done singly. Consequently, early preventive interventions during ANC, especially ITN effective usage and IPTp uptake should be strongly encouraged to minimize malaria infection risk and ACT support given to those infected whenever necessary.