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...
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| 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. |
| doi_str_mv | 10.1371/journal.pone.0024035 |
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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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0024035</identifier><identifier>PMID: 21887367</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Anemia ; Birth weight ; Complications ; Disease control ; Disease prevention ; Drug dosages ; Ethics ; Female ; Fever ; Ghana ; Health care facilities ; Health facilities ; Health Policy ; Humans ; Hygiene ; Insecticide resistance ; Insecticides ; Malaria ; Malaria - diagnosis ; Malaria - drug therapy ; Malaria - prevention & control ; Medical personnel ; Medical screening ; Medicine ; Motivation ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy complications ; Pregnancy Complications, Parasitic ; Pregnant women ; Preventive medicine ; Public health ; Pyrimethamine ; Qualitative analysis ; Science ; Tropical diseases ; Vector-borne diseases ; Women's health ; Womens health</subject><ispartof>PloS one, 2011-08, Vol.6 (8), p.e24035-e24035</ispartof><rights>COPYRIGHT 2011 Public Library of Science</rights><rights>2011 Smith Paintain et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Smith Paintain et al. 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c691t-5d6898d42c2b91c490762c49d4605030655768c1eaee2408b82f26f66c5abce83</citedby><cites>FETCH-LOGICAL-c691t-5d6898d42c2b91c490762c49d4605030655768c1eaee2408b82f26f66c5abce83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3161113/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3161113/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21887367$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Ellis, Ruth D.</contributor><creatorcontrib>Smith Paintain, Lucy</creatorcontrib><creatorcontrib>Antwi, Gifty D</creatorcontrib><creatorcontrib>Jones, Caroline</creatorcontrib><creatorcontrib>Amoako, Esther</creatorcontrib><creatorcontrib>Adjei, Rose O</creatorcontrib><creatorcontrib>Afrah, Nana A</creatorcontrib><creatorcontrib>Greenwood, Brian</creatorcontrib><creatorcontrib>Chandramohan, Daniel</creatorcontrib><creatorcontrib>Tagbor, Harry</creatorcontrib><creatorcontrib>Webster, Jayne</creatorcontrib><title>Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability</title><title>PloS one</title><addtitle>PLoS One</addtitle><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.</description><subject>Adult</subject><subject>Anemia</subject><subject>Birth weight</subject><subject>Complications</subject><subject>Disease control</subject><subject>Disease prevention</subject><subject>Drug dosages</subject><subject>Ethics</subject><subject>Female</subject><subject>Fever</subject><subject>Ghana</subject><subject>Health care facilities</subject><subject>Health facilities</subject><subject>Health Policy</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Insecticide resistance</subject><subject>Insecticides</subject><subject>Malaria</subject><subject>Malaria - diagnosis</subject><subject>Malaria - drug therapy</subject><subject>Malaria - prevention & control</subject><subject>Medical personnel</subject><subject>Medical screening</subject><subject>Medicine</subject><subject>Motivation</subject><subject>Practice Guidelines as 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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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>21887367</pmid><doi>10.1371/journal.pone.0024035</doi><tpages>e24035</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2011-08, Vol.6 (8), p.e24035-e24035 |
| issn | 1932-6203 1932-6203 |
| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Anemia Birth weight Complications Disease control Disease prevention Drug dosages Ethics Female Fever Ghana Health care facilities Health facilities Health Policy Humans Hygiene Insecticide resistance Insecticides Malaria Malaria - diagnosis Malaria - drug therapy Malaria - prevention & control Medical personnel Medical screening Medicine Motivation Practice Guidelines as Topic Pregnancy Pregnancy complications Pregnancy Complications, Parasitic Pregnant women Preventive medicine Public health Pyrimethamine Qualitative analysis Science Tropical diseases Vector-borne diseases Women's health Womens health |
| title | Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-22T13%3A37%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Intermittent%20screening%20and%20treatment%20versus%20intermittent%20preventive%20treatment%20of%20malaria%20in%20pregnancy:%20provider%20knowledge%20and%20acceptability&rft.jtitle=PloS%20one&rft.au=Smith%20Paintain,%20Lucy&rft.date=2011-08-24&rft.volume=6&rft.issue=8&rft.spage=e24035&rft.epage=e24035&rft.pages=e24035-e24035&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0024035&rft_dat=%3Cgale_plos_%3EA476881738%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1308334886&rft_id=info:pmid/21887367&rft_galeid=A476881738&rft_doaj_id=oai_doaj_org_article_d2aa4e3812194fe1a54ec94852ecd37c&rfr_iscdi=true |