Intermittent Screening and Treatment versus Intermittent Preventive Treatment of Malaria in Pregnancy: Provider Knowledge and Acceptability
Identifieur interne : 000816 ( Main/Exploration ); précédent : 000815; suivant : 000817Intermittent Screening and Treatment versus Intermittent Preventive Treatment of Malaria in Pregnancy: Provider Knowledge and Acceptability
Auteurs : Lucy Smith Paintain [Royaume-Uni] ; Gifty D. Antwi [Ghana] ; Caroline Jones [Royaume-Uni] ; Esther Amoako [Ghana] ; Rose O. Adjei [Ghana] ; Nana A. Afrah [Ghana] ; Brian Greenwood [Royaume-Uni] ; Daniel Chandramohan [Royaume-Uni] ; Harry Tagbor [Royaume-Uni, Ghana] ; Jayne Webster [Royaume-Uni]Source :
- PLoS ONE [ 1932-6203 ] ; 2011.
Abstract
Malaria in pregnancy (MiP) is associated with increased risks of maternal and foetal complications. The WHO recommends a package of interventions including intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP), insecticide-treated nets and effective case management. However, with increasing SP resistance, the effectiveness of SP-IPT has been questioned. Intermittent screening and treatment (IST) has recently been shown in Ghana to be as efficacious as SP-IPT. This study investigates two important requirements for effective delivery of IST and SP-IPT: antenatal care (ANC) provider knowledge, and acceptance of the different strategies. Structured interviews with 134 ANC providers at 67 public health facilities in Ashanti Region, Ghana collected information on knowledge of the risks and preventative and curative interventions against MiP. Composite indicators of knowledge of SP-IPT, and case management of MiP were developed. Log binomial regression of predictors of provider knowledge was explored. Qualitative data were collected through in-depth interviews with fourteen ANC providers with some knowledge of IST to gain an indication of the factors influencing acceptance of the IST approach. 88.1% of providers knew all elements of the SP-IPT policy, compared to 20.1% and 41.8% who knew the treatment policy for malaria in the first or second/third trimesters, respectively. Workshop attendance was a univariate predictor of each knowledge indicator. Qualitative findings suggest preference for prevention over cure, and increased workload may be barriers to IST implementation. However, a change in strategy in the face of SP resistance is likely to be supported; health of pregnant women is a strong motivation for ANC provider practice. If IST was to be introduced as part of routine ANC activities, attention would need to be given to improving the knowledge and practices of ANC staff in relation to appropriate treatment of MiP. Health worker support for any MiP intervention delivered through ANC clinics is critical.
Url:
DOI: 10.1371/journal.pone.0024035
PubMed: 21887367
PubMed Central: 3161113
Affiliations:
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Antwi</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Jones, Caroline" sort="Jones, Caroline" uniqKey="Jones C" first="Caroline" last="Jones">Caroline Jones</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Amoako, Esther" sort="Amoako, Esther" uniqKey="Amoako E" first="Esther" last="Amoako">Esther Amoako</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Adjei, Rose O" sort="Adjei, Rose O" uniqKey="Adjei R" first="Rose O." last="Adjei">Rose O. 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The WHO recommends a package of interventions including intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP), insecticide-treated nets and effective case management. However, with increasing SP resistance, the effectiveness of SP-IPT has been questioned. Intermittent screening and treatment (IST) has recently been shown in Ghana to be as efficacious as SP-IPT. This study investigates two important requirements for effective delivery of IST and SP-IPT: antenatal care (ANC) provider knowledge, and acceptance of the different strategies. Structured interviews with 134 ANC providers at 67 public health facilities in Ashanti Region, Ghana collected information on knowledge of the risks and preventative and curative interventions against MiP. Composite indicators of knowledge of SP-IPT, and case management of MiP were developed. Log binomial regression of predictors of provider knowledge was explored. Qualitative data were collected through in-depth interviews with fourteen ANC providers with some knowledge of IST to gain an indication of the factors influencing acceptance of the IST approach. 88.1% of providers knew all elements of the SP-IPT policy, compared to 20.1% and 41.8% who knew the treatment policy for malaria in the first or second/third trimesters, respectively. Workshop attendance was a univariate predictor of each knowledge indicator. Qualitative findings suggest preference for prevention over cure, and increased workload may be barriers to IST implementation. However, a change in strategy in the face of SP resistance is likely to be supported; health of pregnant women is a strong motivation for ANC provider practice. If IST was to be introduced as part of routine ANC activities, attention would need to be given to improving the knowledge and practices of ANC staff in relation to appropriate treatment of MiP. Health worker support for any MiP intervention delivered through ANC clinics is critical.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Brabin, Bj" uniqKey="Brabin B">BJ Brabin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Menendez, C" uniqKey="Menendez C">C Menendez</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Newman, Rd" uniqKey="Newman R">RD Newman</name></author><author><name sortKey="Parise, Me" uniqKey="Parise M">ME Parise</name></author><author><name sortKey="Slutsker, L" uniqKey="Slutsker L">L Slutsker</name></author><author><name sortKey="Nahlen, B" uniqKey="Nahlen B">B Nahlen</name></author><author><name sortKey="Steketee, Rw" uniqKey="Steketee R">RW Steketee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ter Kuile, Fo" uniqKey="Ter Kuile F">FO ter Kuile</name></author><author><name 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Deming</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wasunna, B" uniqKey="Wasunna B">B Wasunna</name></author><author><name sortKey="Zurovac, D" uniqKey="Zurovac D">D Zurovac</name></author><author><name sortKey="Bruce, J" uniqKey="Bruce J">J Bruce</name></author><author><name sortKey="Jones, C" uniqKey="Jones C">C Jones</name></author><author><name sortKey="Webster, J" uniqKey="Webster J">J Webster</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Anders, K" uniqKey="Anders K">K Anders</name></author><author><name sortKey="Marchant, T" uniqKey="Marchant T">T Marchant</name></author><author><name sortKey="Chambo, P" uniqKey="Chambo P">P Chambo</name></author><author><name sortKey="Mapunda, P" uniqKey="Mapunda P">P Mapunda</name></author><author><name sortKey="Reyburn, H" uniqKey="Reyburn H">H Reyburn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Marchant, T" uniqKey="Marchant T">T Marchant</name></author><author><name sortKey="Nathan, R" uniqKey="Nathan R">R Nathan</name></author><author><name sortKey="Jones, C" uniqKey="Jones C">C Jones</name></author><author><name sortKey="Mponda, H" uniqKey="Mponda H">H Mponda</name></author><author><name sortKey="Bruce, J" uniqKey="Bruce J">J Bruce</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hill, J" uniqKey="Hill J">J Hill</name></author><author><name sortKey="Kazembe, P" uniqKey="Kazembe P">P Kazembe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Maestad, O" uniqKey="Maestad O">O Maestad</name></author><author><name sortKey="Torsvik, G" uniqKey="Torsvik G">G Torsvik</name></author><author><name sortKey="Aakvik, A" uniqKey="Aakvik A">A Aakvik</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Ghana</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Smith Paintain, Lucy" sort="Smith Paintain, Lucy" uniqKey="Smith Paintain L" first="Lucy" last="Smith Paintain">Lucy Smith Paintain</name></region><name sortKey="Chandramohan, Daniel" sort="Chandramohan, Daniel" uniqKey="Chandramohan D" first="Daniel" last="Chandramohan">Daniel Chandramohan</name><name sortKey="Greenwood, Brian" sort="Greenwood, Brian" uniqKey="Greenwood B" first="Brian" last="Greenwood">Brian Greenwood</name><name sortKey="Jones, Caroline" sort="Jones, Caroline" uniqKey="Jones C" first="Caroline" last="Jones">Caroline Jones</name><name sortKey="Tagbor, Harry" sort="Tagbor, Harry" uniqKey="Tagbor H" first="Harry" last="Tagbor">Harry Tagbor</name><name sortKey="Webster, Jayne" sort="Webster, Jayne" uniqKey="Webster J" first="Jayne" last="Webster">Jayne Webster</name></country><country name="Ghana"><noRegion><name sortKey="Antwi, Gifty D" sort="Antwi, Gifty D" uniqKey="Antwi G" first="Gifty D." last="Antwi">Gifty D. Antwi</name></noRegion><name sortKey="Adjei, Rose O" sort="Adjei, Rose O" uniqKey="Adjei R" first="Rose O." last="Adjei">Rose O. Adjei</name><name sortKey="Afrah, Nana A" sort="Afrah, Nana A" uniqKey="Afrah N" first="Nana A." last="Afrah">Nana A. Afrah</name><name sortKey="Amoako, Esther" sort="Amoako, Esther" uniqKey="Amoako E" first="Esther" last="Amoako">Esther Amoako</name><name sortKey="Tagbor, Harry" sort="Tagbor, Harry" uniqKey="Tagbor H" first="Harry" last="Tagbor">Harry Tagbor</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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