Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability.
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, w...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2011-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3161113?pdf=render |
| _version_ | 1818279642828636160 |
|---|---|
| author | Lucy Smith Paintain Gifty D Antwi Caroline Jones Esther Amoako Rose O Adjei Nana A Afrah Brian Greenwood Daniel Chandramohan Harry Tagbor Jayne Webster |
| author_facet | Lucy Smith Paintain Gifty D Antwi Caroline Jones Esther Amoako Rose O Adjei Nana A Afrah Brian Greenwood Daniel Chandramohan Harry Tagbor Jayne Webster |
| author_sort | Lucy Smith Paintain |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-12T23:36:35Z |
| format | Article |
| id | doaj.art-d2aa4e3812194fe1a54ec94852ecd37c |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T23:36:35Z |
| publishDate | 2011-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-d2aa4e3812194fe1a54ec94852ecd37c2022-12-22T00:07:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-01-0168e2403510.1371/journal.pone.0024035Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability.Lucy Smith PaintainGifty D AntwiCaroline JonesEsther AmoakoRose O AdjeiNana A AfrahBrian GreenwoodDaniel ChandramohanHarry TagborJayne WebsterMalaria 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.http://europepmc.org/articles/PMC3161113?pdf=render |
| spellingShingle | Lucy Smith Paintain Gifty D Antwi Caroline Jones Esther Amoako Rose O Adjei Nana A Afrah Brian Greenwood Daniel Chandramohan Harry Tagbor Jayne Webster Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability. PLoS ONE |
| title | Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability. |
| title_full | Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability. |
| title_fullStr | Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability. |
| title_full_unstemmed | Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability. |
| title_short | Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability. |
| title_sort | intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy provider knowledge and acceptability |
| url | http://europepmc.org/articles/PMC3161113?pdf=render |
| work_keys_str_mv | AT lucysmithpaintain intermittentscreeningandtreatmentversusintermittentpreventivetreatmentofmalariainpregnancyproviderknowledgeandacceptability AT giftydantwi intermittentscreeningandtreatmentversusintermittentpreventivetreatmentofmalariainpregnancyproviderknowledgeandacceptability AT carolinejones intermittentscreeningandtreatmentversusintermittentpreventivetreatmentofmalariainpregnancyproviderknowledgeandacceptability AT estheramoako intermittentscreeningandtreatmentversusintermittentpreventivetreatmentofmalariainpregnancyproviderknowledgeandacceptability AT roseoadjei intermittentscreeningandtreatmentversusintermittentpreventivetreatmentofmalariainpregnancyproviderknowledgeandacceptability AT nanaaafrah intermittentscreeningandtreatmentversusintermittentpreventivetreatmentofmalariainpregnancyproviderknowledgeandacceptability AT briangreenwood intermittentscreeningandtreatmentversusintermittentpreventivetreatmentofmalariainpregnancyproviderknowledgeandacceptability AT danielchandramohan intermittentscreeningandtreatmentversusintermittentpreventivetreatmentofmalariainpregnancyproviderknowledgeandacceptability AT harrytagbor intermittentscreeningandtreatmentversusintermittentpreventivetreatmentofmalariainpregnancyproviderknowledgeandacceptability AT jaynewebster intermittentscreeningandtreatmentversusintermittentpreventivetreatmentofmalariainpregnancyproviderknowledgeandacceptability |