Intermittent screening and treatment or intermittent preventive treatment compared to current policy of single screening and treatment for the prevention of malaria in pregnancy in Eastern Indonesia: acceptability among health providers and pregnant women
Abstract Background The control of malaria in pregnancy in much of Asia relies on screening asymptomatic women for malaria infection, followed by passive case detection and prevention with insecticide-treated nets. In 2012, Indonesia introduced screening for malaria by microscopy or rapid diagnostic...
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| Format: | Article |
| Language: | English |
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BMC
2018-09-01
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| Series: | Malaria Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12936-018-2490-3 |
| _version_ | 1811268495182135296 |
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| author | Jenna Hoyt Chandra U R Landuwulang Ansariadi Rukhsana Ahmed Faustina H Burdam Irene Bonsapia Jeanne R Poespoprodjo Din Syafruddin Feiko O ter Kuile Jayne Webster Jenny Hill |
| author_facet | Jenna Hoyt Chandra U R Landuwulang Ansariadi Rukhsana Ahmed Faustina H Burdam Irene Bonsapia Jeanne R Poespoprodjo Din Syafruddin Feiko O ter Kuile Jayne Webster Jenny Hill |
| author_sort | Jenna Hoyt |
| collection | DOAJ |
| description | Abstract Background The control of malaria in pregnancy in much of Asia relies on screening asymptomatic women for malaria infection, followed by passive case detection and prevention with insecticide-treated nets. In 2012, Indonesia introduced screening for malaria by microscopy or rapid diagnostic tests (RDTs) at pregnant women’s first antenatal care (ANC) visit to detect and treat malaria infections regardless of the presence of symptoms. Acceptability among health providers and pregnant women of the current ‘single screen and treat’ (SSTp) strategy compared to two alternative strategies that were intermittent preventive treatment (IPTp) and intermittent screening and treatment (ISTp) was assessed in the context of a clinical trial in two malaria endemic provinces of Eastern Indonesia. Methods Qualitative data were collected through in-depth interviews with 121 health providers working in provision of antenatal care, heads of health facilities and District Health Office staff. Trial staff were also interviewed. Focus group discussions were conducted with 16 groups of pregnant women (N = 106) to discuss their experiences of each intervention in the trial. Results Health providers and pregnant women were receptive to screening for malaria at every ANC visit due to the increased opportunity to detect and treat asymptomatic infections. A primary concern for providers was the accuracy and availability of RDTs used for screening in the SSTp and ISTp arms, which they considered less accurate than microscopy. Providers had reservations about giving anti-malarials presumptively as IPTp, due to concerns of causing potential harm to mother and baby and as a possible driver of drug resistance. Pregnant women were accepting of all three interventions. Women in the IPTp arm were happy to take anti-malarials presumptively to protect themselves and their babies against malaria. Conclusions The findings indicate that, within a trial context, malaria screening of pregnant women at every ANC visit ISTp was an acceptable strategy among both health providers and pregnant women owing to an existing culture of screening and treatment. The adoption of IPTp however would require a considerable shift in health provider attitudes and a clear communication strategy. By contrast, pregnant women welcomed the opportunity to prevent malaria infections during pregnancy. |
| first_indexed | 2024-04-12T21:23:48Z |
| format | Article |
| id | doaj.art-941488a3bf024badae15c6eaf157df64 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-12T21:23:48Z |
| publishDate | 2018-09-01 |
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| series | Malaria Journal |
| spelling | doaj.art-941488a3bf024badae15c6eaf157df642022-12-22T03:16:14ZengBMCMalaria Journal1475-28752018-09-0117111110.1186/s12936-018-2490-3Intermittent screening and treatment or intermittent preventive treatment compared to current policy of single screening and treatment for the prevention of malaria in pregnancy in Eastern Indonesia: acceptability among health providers and pregnant womenJenna Hoyt0Chandra U R Landuwulang1Ansariadi2Rukhsana Ahmed3Faustina H Burdam4Irene Bonsapia5Jeanne R Poespoprodjo6Din Syafruddin7Feiko O ter Kuile8Jayne Webster9Jenny Hill10Department of Clinical Sciences, Liverpool School of Tropical MedicineEijkman Institute for Molecular BiologyEijkman Institute for Molecular BiologyDepartment of Clinical Sciences, Liverpool School of Tropical MedicineMimika District Health AuthorityTimika Malaria Research Program, Papuan Health and Community Development FoundationMimika District Health AuthorityDepartment of Epidemiology, School of Public Health, Hasanuddin UniversityDepartment of Clinical Sciences, Liverpool School of Tropical MedicineDisease Control Department, London School of Tropical Medicine and HygieneDepartment of Clinical Sciences, Liverpool School of Tropical MedicineAbstract Background The control of malaria in pregnancy in much of Asia relies on screening asymptomatic women for malaria infection, followed by passive case detection and prevention with insecticide-treated nets. In 2012, Indonesia introduced screening for malaria by microscopy or rapid diagnostic tests (RDTs) at pregnant women’s first antenatal care (ANC) visit to detect and treat malaria infections regardless of the presence of symptoms. Acceptability among health providers and pregnant women of the current ‘single screen and treat’ (SSTp) strategy compared to two alternative strategies that were intermittent preventive treatment (IPTp) and intermittent screening and treatment (ISTp) was assessed in the context of a clinical trial in two malaria endemic provinces of Eastern Indonesia. Methods Qualitative data were collected through in-depth interviews with 121 health providers working in provision of antenatal care, heads of health facilities and District Health Office staff. Trial staff were also interviewed. Focus group discussions were conducted with 16 groups of pregnant women (N = 106) to discuss their experiences of each intervention in the trial. Results Health providers and pregnant women were receptive to screening for malaria at every ANC visit due to the increased opportunity to detect and treat asymptomatic infections. A primary concern for providers was the accuracy and availability of RDTs used for screening in the SSTp and ISTp arms, which they considered less accurate than microscopy. Providers had reservations about giving anti-malarials presumptively as IPTp, due to concerns of causing potential harm to mother and baby and as a possible driver of drug resistance. Pregnant women were accepting of all three interventions. Women in the IPTp arm were happy to take anti-malarials presumptively to protect themselves and their babies against malaria. Conclusions The findings indicate that, within a trial context, malaria screening of pregnant women at every ANC visit ISTp was an acceptable strategy among both health providers and pregnant women owing to an existing culture of screening and treatment. The adoption of IPTp however would require a considerable shift in health provider attitudes and a clear communication strategy. By contrast, pregnant women welcomed the opportunity to prevent malaria infections during pregnancy.http://link.springer.com/article/10.1186/s12936-018-2490-3Malaria in pregnancyIntermittent screening and treatmentIntermittent preventive treatmentAcceptabilityPregnant womenHealth providers |
| spellingShingle | Jenna Hoyt Chandra U R Landuwulang Ansariadi Rukhsana Ahmed Faustina H Burdam Irene Bonsapia Jeanne R Poespoprodjo Din Syafruddin Feiko O ter Kuile Jayne Webster Jenny Hill Intermittent screening and treatment or intermittent preventive treatment compared to current policy of single screening and treatment for the prevention of malaria in pregnancy in Eastern Indonesia: acceptability among health providers and pregnant women Malaria Journal Malaria in pregnancy Intermittent screening and treatment Intermittent preventive treatment Acceptability Pregnant women Health providers |
| title | Intermittent screening and treatment or intermittent preventive treatment compared to current policy of single screening and treatment for the prevention of malaria in pregnancy in Eastern Indonesia: acceptability among health providers and pregnant women |
| title_full | Intermittent screening and treatment or intermittent preventive treatment compared to current policy of single screening and treatment for the prevention of malaria in pregnancy in Eastern Indonesia: acceptability among health providers and pregnant women |
| title_fullStr | Intermittent screening and treatment or intermittent preventive treatment compared to current policy of single screening and treatment for the prevention of malaria in pregnancy in Eastern Indonesia: acceptability among health providers and pregnant women |
| title_full_unstemmed | Intermittent screening and treatment or intermittent preventive treatment compared to current policy of single screening and treatment for the prevention of malaria in pregnancy in Eastern Indonesia: acceptability among health providers and pregnant women |
| title_short | Intermittent screening and treatment or intermittent preventive treatment compared to current policy of single screening and treatment for the prevention of malaria in pregnancy in Eastern Indonesia: acceptability among health providers and pregnant women |
| title_sort | intermittent screening and treatment or intermittent preventive treatment compared to current policy of single screening and treatment for the prevention of malaria in pregnancy in eastern indonesia acceptability among health providers and pregnant women |
| topic | Malaria in pregnancy Intermittent screening and treatment Intermittent preventive treatment Acceptability Pregnant women Health providers |
| url | http://link.springer.com/article/10.1186/s12936-018-2490-3 |
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