Intermittent preventive treatment of malaria in pregnancy: Evaluation of a new delivery approach and the policy implications for malaria control in Uganda

Mbonye, Anthony K.; Bygbjerg, Ib Christian; Magnussen, Pascal

doi:10.1016/j.healthpol.2006.05.018

Cited by 25 publications

(40 citation statements)

References 30 publications

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“…However, there was evidence that community-based distribution may concurrently reduce women's attendance at ANCs, though this was not consistent across the four studies: two studies showed reduced ANC attendance in the intervention sites [86],[87], and two showed increased ANC attendance [88],[89]. An alternative to delivering IPTp through community-based programmes is to employ community-based resource persons to promote IPTp, while referring women to ANCs to be given SP.…”

Section: Resultsmentioning

confidence: 97%

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Factors Affecting the Delivery, Access, and Use of Interventions to Prevent Malaria in Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

et al. 2013

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Section: Resultsmentioning

confidence: 97%

“…Women's access to an ANC was a barrier in remote settings, where community-based distribution or outreach services may be required to supplement ANC services. Four studies evaluating community-based distribution of IPTp were identified in the review, using a combination of existing [87],[88] or new community resource persons [86],[89].…”

Section: Resultsmentioning

confidence: 99%

Factors Affecting the Delivery, Access, and Use of Interventions to Prevent Malaria in Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

et al. 2013

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“…These studies have highlighted that in a variety of settings SP was viewed as harmful during pregnancy [13–15]. However, in some contexts, in spite of concerns about SP, women took the IPTp-SP because of the confidence that they placed in those delivering it [16, 17]. Moreover, a multi-site study of the social and cultural context of MiP interventions highlighted how women generally attended ANC and, apart from a few exceptions, adhered to IPTp-SP as part of a general acceptance of the package of ANC intervention, even though they disliked the side effects that they associated with it (often vomiting) [18].…”

Section: Introductionmentioning

confidence: 99%

The acceptability of intermittent screening and treatment versus intermittent preventive treatment during pregnancy: results from a qualitative study in Northern Ghana

Pell

Meñaca

Chatio

et al. 2014

Malar J

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BackgroundAffecting mother and child, malaria during pregnancy (MiP) provokes a double morbidity and mortality burden. Within a package of interventions to prevent MiP in endemic areas, the WHO currently recommends intermittent preventive treatment (IPTp). Concerns about anti-malarial resistance have however prompted interest in intermittent screening and treating (IST) as an alternative approach to IPTp. IST involves screening for malaria infection at scheduled antenatal care (ANC) clinic visits and treating malaria cases. In light of the need to comprehensively evaluate new interventions prior to roll out, this article explores the acceptability of IST with artemether-lumefantrine (AL) compared to IPTp with sulphadoxine-pyrimethamine (SP) and in Upper East Region, northern Ghana.MethodsData were collected alongside an open-label, randomized, controlled trial of IST-AL and IPTp-SP in Kassena-Nankana District. Thirty pregnant women enrolled in the clinical trial participated in six focus group discussions. Ten in-depth interviews were carried out with clinical trial staff. Observations were also made at the health facilities where the clinical trial took place.ResultsTrial participants were generally willing to endure the discomfort of the finger prick necessary for a rapid diagnostic test for malaria and this reflected a wider demand for diagnostic techniques. Reports of side effects were however linked to both trial anti-malarials. Direct complaints about SP were particularly severe with regard to women’s experience of vomiting. Although the follow-up treatment doses of AL for IST were not supervised, based on blister inspection and questioning trial, staff were confident about participants’ adherence to the treatment course. One case of partial adherence to the AL treatment course was reported.ConclusionDespite the discomfort of the finger prick required to perform the intermittent malaria screening, trial participants generally expressed more positive sentiments towards IST-AL than IPTp-SP. Nonetheless, questions remain about adherence to a multiple dose anti-malarial regimen during pregnancy, particularly in endemic areas where MiP is often non-symptomatic. Any implementation of IST must be accompanied by appropriate health messages on adherence and the necessary training for health staff regarding case management.

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“…Les straté-gies de lutte reposent actuellement sur le TPI et l'utilisation des moustiquaires imprégnées. Ces deux méthodes de lutte (en particulier le TPI) s'avèrent efficaces pour protéger la femme enceinte et le nouveau-né [1,17,21]. Au Sénégal, la prévention du paludisme chez la femme enceinte associe le TPI à la SP et la promotion de l'usage de la moustiquaire imprégnée d'insecticide.…”

Section: Discussionunclassified

“…Des études menées en Ouganda [21] et au Kenya [1] ont montré que le TPI est efficace pour prévenir l'anémie maternelle, le faible poids de naissance et l'infection palustre placentaire.…”

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Influence du traitement présomptif intermittent par la sulfadoxinepyriméthamine sur l’acquisition d’anticorps anti-VAR2CSA chez la femme enceinte vivant en zone hypoendémique au Sénégal

Diouf

Tine

Ndiaye

et al. 2011

Bull. Soc. Pathol. Exot.

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The impact of intermittent presumptive treatment (IPT) on the immunity of pregnant women in Senegal is still not very well known. We conducted a prospective study at the Roi-Baudouin maternity of Guediawaye in Senegal to assess IgG antibodies production against MSP1, GLURP and DBL5 in pregnant women under IPT. Blood samples were collected from the participating women at inclusion and delivery. Samples were analyzed after centrifugation for the detection of IgG antibodies in sera by Elisa. Informed consent was given by each study participant prior to their inclusion. A total of 101 eligible women aged from 18 to 44 were included in this study. Multigravidae women represented 70.3% of the study population, whereas primigravidae accounted for 29.7%. The IgG level decreased slightly from inclusion to delivery for the women with regard to anti-MSP1 (83.1at inclusion versus 79.5 at delivery, p = 0.52) as well as anti-GLURP-R2 (84.1 at inclusion versus 75.9 at delivery, p = 0.16). After adjustment for number of pregnancies, there was a significant decrease in the production of anti-VAR2CSA between inclusion and delivery (p < 0.05). By reducing the incidence of malaria during pregnancy, IPT reduced the acquisition of placental parasites antibodies suppressors which could delay the development of protective immunity against malaria. The application of IPT in pregnant women would thus be more appropriate in hypoendemic areas where malaria exposure is lower.

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Intermittent preventive treatment of malaria in pregnancy: Evaluation of a new delivery approach and the policy implications for malaria control in Uganda

Cited by 25 publications

References 30 publications

Factors Affecting the Delivery, Access, and Use of Interventions to Prevent Malaria in Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Factors Affecting the Delivery, Access, and Use of Interventions to Prevent Malaria in Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

The acceptability of intermittent screening and treatment versus intermittent preventive treatment during pregnancy: results from a qualitative study in Northern Ghana

Influence du traitement présomptif intermittent par la sulfadoxinepyriméthamine sur l’acquisition d’anticorps anti-VAR2CSA chez la femme enceinte vivant en zone hypoendémique au Sénégal

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