Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: user acceptability.


Smith, LA; Jones, C; Adjei, RO; Antwi, GD; Afrah, NA; Greenwood, B; Chandramohan, D; Tagbor, H; Webster, J; (2010) Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: user acceptability. Malar J, 9 (1). p. 18. ISSN 1475-2875 DOI: https://doi.org/10.1186/1475-2875-9-18

[img]
Preview
Text - Published Version
License:

Download (338kB) | Preview

Abstract

ABSTRACT: BACKGROUND: Malaria in pregnancy is associated with increased risks of maternal and foetal complications. Currently, intermittent preventive treatment (IPT) of malaria during pregnancy with sulphadoxine-pyrimethamine (SP) is recommended by the WHO as part of a package of interventions also including insecticide-treated nets and effective case management. However, with increasing resistance to SP, the effectiveness of SP-IPT has been questioned. A randomized controlled trial (RCT) to investigate the relative efficacy of an alternative strategy of intermittent screening and treatment (IST), which involves a rapid diagnostic test for malaria at scheduled ANC visits and treatment of women only if positive, versus SP-IPT has been conducted in Ashanti region, Ghana. This paper reports on a complementary study investigating the acceptability of the different strategies to women enrolled in the trial. METHODS: Data were collected through twelve focus group discussions with women selected at random from the different arms of the RCT, exploring their experiences and perceptions about antenatal care and their involvement in the trial. Content analysis was used to identify relevant themes to structure the results. RESULTS: Five main themes emerged from participants' experiences of ANC and the RCT that would influence their acceptability of malaria prevention strategies during pregnancy: health benefits; drugs received; tests received; other services received; and health worker attitude. Their own health and that of their baby were strong motivations for attending ANC, and reported favourably as an outcome of being in the RCT. Women were not always clear on the biomedical function of drugs or blood tests but generally accepted them due to strong trust in the health staff. Home visits by staff and free ITNs as part of the trial were appreciated. Politeness and patience of health staff was a very strong positive factor. CONCLUSIONS: Overall, both intermittent screening and treatment and intermittent preventive treatment appeared equally acceptable to pregnant women as strategies for the control of malaria in pregnancy. The women were more concerned about quality of services received, in particular the polite and patient attitude of health staff, and positive health implications for themselves and their babies than about the nature of the intervention.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Centre for Evaluation
Malaria Centre
Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 20074372
Web of Science ID: 274379700002
URI: http://researchonline.lshtm.ac.uk/id/eprint/4104

Statistics


Download activity - last 12 months
Downloads since deposit
300Downloads
387Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item