Availability and utilization of malaria prevention strategies in pregnancy in eastern India
<p>Abstract</p> <p>Background</p> <p>Malaria in pregnancy in India, as elsewhere, is responsible for maternal anemia and adverse pregnancy outcomes such as low birth weight and preterm birth.</p> <p>It is not known whether prevention and treatment strategies...
| Main Authors: | , , , , , , , , , , , , , , |
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BMC
2010-09-01
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| Series: | BMC Public Health |
| Online Access: | http://www.biomedcentral.com/1471-2458/10/557 |
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| author | Yeboah-Antwi Kojo Sabin Lora Hussain Mobassir Tuchman Jordan Singh Mrigendra P Singh Neeru Hashmi Ahmar H Wylie Blair J Banerjee Camellia Brooks Mohamad I Desai Meghna Udhayakumar Venkatachalam MacLeod William B Dash Aditya P Hamer Davidson H |
| author_facet | Yeboah-Antwi Kojo Sabin Lora Hussain Mobassir Tuchman Jordan Singh Mrigendra P Singh Neeru Hashmi Ahmar H Wylie Blair J Banerjee Camellia Brooks Mohamad I Desai Meghna Udhayakumar Venkatachalam MacLeod William B Dash Aditya P Hamer Davidson H |
| author_sort | Yeboah-Antwi Kojo |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Malaria in pregnancy in India, as elsewhere, is responsible for maternal anemia and adverse pregnancy outcomes such as low birth weight and preterm birth.</p> <p>It is not known whether prevention and treatment strategies for malaria in pregnancy (case management, insecticide-treated bednets, intermittent preventive therapy) are widely utilized in India.</p> <p>Methods</p> <p>This cross-sectional study was conducted during 2006-2008 in two states of India, Jharkhand and Chhattisgarh, at 7 facilities representing a range of rural and urban populations and areas of more versus less stable malaria transmission. 280 antenatal visits (40/site) were observed by study personnel coupled with exit interviews of pregnant women to assess emphasis upon, availability and utilization of malaria prevention practices by health workers and pregnant women. The facilities were assessed for the availability of antimalarials, lab supplies and bednets.</p> <p>Results</p> <p>All participating facilities were equipped to perform malaria blood smears; none used rapid diagnostic tests. Chloroquine, endorsed for chemoprophylaxis during pregnancy by the government at the time of the study, was stocked regularly at all facilities although the quantity stocked varied. Availability of alternative antimalarials for use in pregnancy was less consistent. In Jharkhand, no health worker recommended bednet use during the antenatal visit yet over 90% of pregnant women had bednets in their household. In Chhattisgarh, bednets were available at all facilities but only 14.4% of health workers recommended their use. 40% of the pregnant women interviewed had bednets in their household. Only 1.4% of all households owned an insecticide-treated bednet; yet 40% of all women reported their households had been sprayed with insecticide. Antimalarial chemoprophylaxis with chloroquine was prescribed in only 2 (0.7%) and intermittent preventive therapy prescribed in only one (0.4%) of the 280 observed visits.</p> <p>Conclusions</p> <p>A disconnect remains between routine antenatal practices in India and known strategies to prevent and treat malaria in pregnancy. Prevention strategies, in particular the use of insecticide-treated bednets, are underutilized. Gaps highlighted by this study combined with recent estimates of the prevalence of malaria during pregnancy in these areas should be used to revise governmental policy and target increased educational efforts among health care workers and pregnant women.</p> |
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| institution | Directory Open Access Journal |
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| spelling | doaj.art-e0d1360762f04cf392742a4a2594ab532022-12-21T18:10:48ZengBMCBMC Public Health1471-24582010-09-0110155710.1186/1471-2458-10-557Availability and utilization of malaria prevention strategies in pregnancy in eastern IndiaYeboah-Antwi KojoSabin LoraHussain MobassirTuchman JordanSingh Mrigendra PSingh NeeruHashmi Ahmar HWylie Blair JBanerjee CamelliaBrooks Mohamad IDesai MeghnaUdhayakumar VenkatachalamMacLeod William BDash Aditya PHamer Davidson H<p>Abstract</p> <p>Background</p> <p>Malaria in pregnancy in India, as elsewhere, is responsible for maternal anemia and adverse pregnancy outcomes such as low birth weight and preterm birth.</p> <p>It is not known whether prevention and treatment strategies for malaria in pregnancy (case management, insecticide-treated bednets, intermittent preventive therapy) are widely utilized in India.</p> <p>Methods</p> <p>This cross-sectional study was conducted during 2006-2008 in two states of India, Jharkhand and Chhattisgarh, at 7 facilities representing a range of rural and urban populations and areas of more versus less stable malaria transmission. 280 antenatal visits (40/site) were observed by study personnel coupled with exit interviews of pregnant women to assess emphasis upon, availability and utilization of malaria prevention practices by health workers and pregnant women. The facilities were assessed for the availability of antimalarials, lab supplies and bednets.</p> <p>Results</p> <p>All participating facilities were equipped to perform malaria blood smears; none used rapid diagnostic tests. Chloroquine, endorsed for chemoprophylaxis during pregnancy by the government at the time of the study, was stocked regularly at all facilities although the quantity stocked varied. Availability of alternative antimalarials for use in pregnancy was less consistent. In Jharkhand, no health worker recommended bednet use during the antenatal visit yet over 90% of pregnant women had bednets in their household. In Chhattisgarh, bednets were available at all facilities but only 14.4% of health workers recommended their use. 40% of the pregnant women interviewed had bednets in their household. Only 1.4% of all households owned an insecticide-treated bednet; yet 40% of all women reported their households had been sprayed with insecticide. Antimalarial chemoprophylaxis with chloroquine was prescribed in only 2 (0.7%) and intermittent preventive therapy prescribed in only one (0.4%) of the 280 observed visits.</p> <p>Conclusions</p> <p>A disconnect remains between routine antenatal practices in India and known strategies to prevent and treat malaria in pregnancy. Prevention strategies, in particular the use of insecticide-treated bednets, are underutilized. Gaps highlighted by this study combined with recent estimates of the prevalence of malaria during pregnancy in these areas should be used to revise governmental policy and target increased educational efforts among health care workers and pregnant women.</p>http://www.biomedcentral.com/1471-2458/10/557 |
| spellingShingle | Yeboah-Antwi Kojo Sabin Lora Hussain Mobassir Tuchman Jordan Singh Mrigendra P Singh Neeru Hashmi Ahmar H Wylie Blair J Banerjee Camellia Brooks Mohamad I Desai Meghna Udhayakumar Venkatachalam MacLeod William B Dash Aditya P Hamer Davidson H Availability and utilization of malaria prevention strategies in pregnancy in eastern India BMC Public Health |
| title | Availability and utilization of malaria prevention strategies in pregnancy in eastern India |
| title_full | Availability and utilization of malaria prevention strategies in pregnancy in eastern India |
| title_fullStr | Availability and utilization of malaria prevention strategies in pregnancy in eastern India |
| title_full_unstemmed | Availability and utilization of malaria prevention strategies in pregnancy in eastern India |
| title_short | Availability and utilization of malaria prevention strategies in pregnancy in eastern India |
| title_sort | availability and utilization of malaria prevention strategies in pregnancy in eastern india |
| url | http://www.biomedcentral.com/1471-2458/10/557 |
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