Background
Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is an important malaria control strategy in sub-Saharan Africa. Indeed, it overcomes the risk of misdiagnosis due to low peripheral parasitemia during pregnancy by treating women with SP on predetermined schedules. However, over time, the spread of Plasmodium-resistant strains has threatened this strategy in many countries. As an alternative, the intermittent screening and treatment for pregnancy (ISTp) aims at a monthly screening of pregnant women, preferably by using very sensitive tests such as ultrasensitive rapid diagnostic tests (us-RDTs) and the treatment of positive cases with artemisinin-based combination therapy (ACT) regardless of the presence of symptoms. Unlike IPTp-SP, ISTp prevents overuse of antimalarials limiting the drug pressure on parasites, an advantage which can be potentiated by using an ACT like pyronaridine-artesunate (Pyramax®) that is not yet used in pregnant women in the field.
Methods
This study aims to compare the non-inferiority of ISTp using us-RDTs and Pyramax® versus IPTp-SP on malaria in pregnancy through a randomized clinical trial performed in Kisenso, Kinshasa, the Democratic Republic of the Congo, a malaria perennial transmission area.
Discussion
The results will be essential for the National Malaria Control Program to update the malaria prevention policy in pregnant women in the Democratic Republic of the Congo.
Trial registration
ClinicalTrials.gov NCT04783051
Background and Objectives: Mosquito-borne viral diseases (MBVDs) create a dramatic health situation worldwide. There is a need to improve the understanding of factors to be addressed in intervention programmes. This study explored community knowledge, attitudes, and practices (KAP) regarding MBVD in Kinshasa. Materials and Methods: A cross-sectional survey was carried out between January and April 2019. The socio-demographic and KAP data collected through a questionnaire were analysed using Epi Info 7. Results: The study included 1464 male and female respondents aged from 18 to 70 years old. Open garbage cans and outdoor water storage units were found in 61.2% and 33.4% of respondent residences, respectively. Polluted water bodies (80.3%) were the most mentioned as mosquito breeding places. Among 86.6% of the respondents that had heard about yellow fever, 12% knew that it is an MBVD. The majority of respondents (72.5%) were perceived to be at risk of contracting MBVD. Environment sanitation (58%) and insecticide use (25%) were among the measures implemented to control mosquitoes. The greater overall knowledge score and attitude were not associated with good practice. Conclusion: The residents of Kinshasa had limited knowledge of MBVD. Raising awareness and educational sessions are essential in empowering the community regarding the correct attitudes and practices to effectively manage the risk posed by MBVD.
Background
Intermittent Preventive Treatment in pregnancy (IPTp) with Sulfadoxine-Pyrimethamine (SP) is an important malaria control strategy in sub-Saharan Africa. Indeed it overcomes the risk of misdiagnosis due to low peripheral parasitemia during pregnancy by treating women with SP on predetermined schedules. However, over time, the spread of Plasmodium resistant strains has threaten this strategy in many countries. As an alternative, the Intermittent Screening and Treatment for pregnancy (ISTp) aims at a monthly screening of pregnant women, preferably by using very sensitive tests such as ultrasensitive rapid diagnostic tests (us-RDT) and the treatment of positive cases with artemisinin-based combination therapy (ACT) regardless of the presence of symptoms. Unlike IPTp-SP, ISTp prevents overuse of antimalarials limiting the drug pressure on parasites, an advantage which can be potentiated by using an ACT like Pyronaridine - Artesunate (Pyramax®) that is not yet used in pregnant women in the field.
Methods
This study aims to compare the non-inferiority of ISTp using us-RDTs and Pyramax® versus IPTp-SP on malaria in pregnancy through a randomized clinical trial performed in Kisenso, Kinshasa, the Democratic Republic of the Congo, a malaria perennial transmission area.
Discussion
The results will be essential for the National Malaria Control Program to update malaria prevention policy in pregnant women in the Democratic Republic of the Congo.
Trial registration:
ClinicalTrials.gov ID: NCT04783051
Background Mosquito-borne viral diseases (MBVD) are among the important human and animal health threats globally. Gaining insights on behaviours and practices of local population on MBVD can improve understanding of socio-demographic and cultural factors to be addressed in intervention packages. This study was carried out to explore community knowledge, attitudes and practices regarding mosquito and MBVD in Kinshasa, the Democratic Republic of the Congo (DRC).Methods A cross sectional survey involving heads of household was carried out in Kinshasa, DRC, between January and April 2019. Information on socio-demographic characteristics, knowledge, attitudes and practices on mosquito and MBVD was collected through a questionnaire. Data analysis was performed using Epi Info 7 software.Results A total of 1,464 individuals were involved in the study. Of these, 69% were under 44 years of age, 60.7% were females and the majority (90.2%) were educated. One-third of the houses had insect window screens, 61.2% had open garbage cans, 33.4% had outdoor water storage units, 25.1% had stagnant water collection and 22.5% water containers. The majority (80.3%) of the respondent mentioned polluted water bodies as the main mosquito breeding places. Yellow fever (86.6%) was the most commonly known MBVD. Overall, 12% of the respondents knew that mosquitoes are vectors of these viruses. Majority of respondents (72.5%) felt to be at risk of contracting MBVD. Drainage and blocked draining water channels, dirty, agriculture, house and road construction, animal rearing and automobile garages were associated with mosquito abundance. Health professionals, family member, radio/television and/or school/university were the main source of information. Cleaning environment (58%) and/or use of insecticides (25%) were the main measures implemented in controlling of mosquitoes. Mosquito net ownership (87.4%) and use (67%) were high.Conclusion Most of the residents of Kinshasa had limited knowledge on the roles of mosquitoes in the transmission of pathogenic viruses in both humans and animals. Raising awareness and educational sessions are essential in empowering the community on the correct attitudes and practices in order to effectively manage the risk posed by MBVD.
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