scholarly journals Uptake of intermittent preventive treatment for malaria during pregnancy with Sulphadoxine-Pyrimethamine in Malawi after adoption of updated World Health Organization policy: an analysis of demographic and health survey 2015–2016

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Steven Chifundo Azizi
Keyword(s):  
World Health Organization ◽  
Health Survey ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Demographic And Health Survey ◽  
World Health ◽  
Malaria During Pregnancy ◽  
Organization Policy ◽  
Health Organization ◽  
Sulphadoxine Pyrimethamine

scholarly journals Uptake of Intermittent Preventive Treatment for Malaria during Pregnancy with Sulphadoxine-Pyrimethamine in Malawi after adoption of updated World Health Organization policy: An Analysis of Demographic and Health Survey 2015-2016

2020 ◽  
Author(s):  
Steven Chifundo Azizi
Keyword(s):  
Health Survey ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria Prevention ◽  
Demographic And Health Survey ◽  
World Health ◽  
Limited Effectiveness ◽  
Malaria During Pregnancy ◽  
Health Organization ◽  
Sulphadoxine Pyrimethamine

Abstract Background: Malawi adopted the 2012 updated Word Health Organization (WHO) Intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) policy in 2013. This study aimed to estimate the proportion of and identify factors associated with the uptake of at least three doses of IPTp with SP among pregnant women in Malawi after the adoption and operationalisation of updated WHO IPTp-SP policy. Methods: The 2015-16 Malawi Demographic and Health Survey dataset was analysed. Of 1,219 women aged 15-49 years who had live births and the children were born after the date of July 2015, 1,069 women were included in the analysis. Bivariate and multiple logistic regression were used in data analysis. The statistical analysis took into account a complex survey sample design. Results: Of the 1,069 women, 447 (42%, 95% CI: 38.1-45.6) received three (optimal) or more doses of IPTp-SP. Less than half (47%) managed to attend at least four antenatal care (ANC) clinics. Only 52% received optimal SP doses among those who made at least four ANC visits. Only the number of ANC visits was associated with the optimal uptake of SP. Women who attended ANC three times only and those who visited ANC once or twice only were less likely to receive at least three doses of SP than those who managed to attend ANC at least four times during pregnancy (AOR=0.71, 95% CI 0.49-1.02) and (AOR=0.12, 95% CI 0.06-0.21) respectively. Conclusions: To achieve effective malaria prevention in pregnancy, IPTP-SP is used alongside other interventions. However, there is low uptake of optimal SP doses in Malawi, and this seems to be associated with the number of ANC visits. Moreover, there is limited effectiveness of an increased number of ANC visits on the uptake of optimal SP doses. Further research should be done to explore health systems factors affecting uptake of optimal IPTp with SP doses during pregnancy.

scholarly journals Uptake of Intermittent Preventive Treatment for Malaria during Pregnancy with Sulphadoxine-Pyrimethamine (IPTp-SP) in Malawi after adoption of updated World Health Organization policy: An Analysis of Demographic and Health Survey 2015-2016

2020 ◽  
Author(s):  
Steven Chifundo Azizi
Keyword(s):  
Health Survey ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria Prevention ◽  
Demographic And Health Survey ◽  
World Health ◽  
Limited Effectiveness ◽  
Malaria During Pregnancy ◽  
Health Organization ◽  
Sulphadoxine Pyrimethamine

Abstract Background Malawi adopted the 2012 updated Word Health Organization (WHO) Intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) policy in 2013. This study aimed to estimate the proportion of and identify factors associated with the uptake of at least three doses of IPTp-SP among pregnant women in Malawi after the adoption of updated WHO IPTp-SP policy.Methods The 2015-16 Malawi Demographic and Health Survey dataset was used. Of 1,219 women aged 15-49 years who had live births and the children were born after date of July 2015, 1,069 women were included in the analysis. Bivariate and multiple logistic regression were used in data analysis. The statistical analysis took into account complex survey sample design.Results Of the 1,069 women, 447 (42%, 95% CI: 38.1-45.6) received three (optimal) or more doses of IPTp-SP. Less than half (47%) managed to attend at least four antenatal care (ANC) clinics. Only 52% received optimal SP doses among those who made at least four ANC visits. Only the number of ANC visits was associated with the optimal uptake of SP. Women who attended ANC three times only and those who visited ANC once or twice only were less likely to receive at least three doses of SP than those who managed to attend ANC at least four times during pregnancy (AOR=0.71, 95% CI 0.49-1.02) and (AOR=0.12, 95% CI 0.06-0.21) respectively.Conclusions To achieve effective malaria prevention in pregnancy, IPTP-SP is used alongside other interventions. However, there is low uptake of optimal SP doses in Malawi, and this seems to be associated with the number of ANC visits. There is limited effectiveness of increased number of ANC visits on the uptake of optimal SP doses. Further research should be done to explore health systems factors affecting uptake of optimal IPTp-SP doses during pregnancy.

scholarly journals Uptake of Intermittent Preventive Treatment for Malaria during Pregnancy with Sulphadoxine-Pyrimethamine in Malawi after adoption of updated World Health Organization policy: An Analysis of Demographic and Health Survey 2015-2016

2020 ◽  
Author(s):  
Steven Chifundo Azizi
Keyword(s):  
Health Survey ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria Prevention ◽  
Demographic And Health Survey ◽  
World Health ◽  
Limited Effectiveness ◽  
Malaria During Pregnancy ◽  
Health Organization ◽  
Sulphadoxine Pyrimethamine

Abstract Background Malawi adopted the 2012 updated Word Health Organization (WHO) Intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) policy in 2013. This study aimed to estimate the proportion of and identify factors associated with the uptake of at least three doses of IPTp-SP among pregnant women in Malawi after the adoption and operationalisation of updated WHO IPTp-SP policy. Methods The 2015-16 Malawi Demographic and Health Survey dataset was used. Of 1,219 women aged 15-49 years who had live births and the children were born after date of July 2015, 1,069 women were included in the analysis. Bivariate and multiple logistic regression were used in data analysis. The statistical analysis took into account complex survey sample design. Results Of the 1,069 women, 447 (42%, 95% CI: 38.1-45.6) received three (optimal) or more doses of IPTp-SP. Less than half (47%) managed to attend at least four antenatal care (ANC) clinics. Only 52% received optimal SP doses among those who made at least four ANC visits. Only the number of ANC visits was associated with the optimal uptake of SP. Women who attended ANC three times only and those who visited ANC once or twice only were less likely to receive at least three doses of SP than those who managed to attend ANC at least four times during pregnancy (AOR=0.71, 95% CI 0.49-1.02) and (AOR=0.12, 95% CI 0.06-0.21) respectively. Conclusions To achieve effective malaria prevention in pregnancy, IPTP-SP is used alongside other interventions. However, there is low uptake of optimal SP doses in Malawi, and this seems to be associated with the number of ANC visits. There is limited effectiveness of increased number of ANC visits on the uptake of optimal SP doses. Further research should be done to explore health systems factors affecting uptake of optimal IPTp-SP doses during pregnancy.

scholarly journals Treatment of COVID-19 with Chloroquine: Implication for Malaria Chemotherapy Using ACTs in Disease Endemic Countries

2020 ◽  
Author(s):  
Neils Ben Quashie ◽  
Nancy Odurowah Duah-Quashie
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
World Health ◽  
Cross Resistance ◽  
Drug Resistant ◽  
Combination Therapies ◽  
Parasite Resistance ◽  
Demand And Supply ◽  
First Choice ◽  
Health Organization

Abstract Based on reports of parasite resistance and on World Health Organization recommendation, chloroquine was replaced with the artemisinin-based combination therapies (ACTs) as the first choice of drugs for the treatment of uncomplicated malaria. Disuse of chloroquine led to restoration of drug-sensitive parasite to some extent in certain countries. Ever since chloroquine and hydroxychloroquine were touted as potential treatment for coronavirus disease 2019 (COVID-19), there has been a dramatic surge in demand for the drugs. Even in areas where chloroquine is proscribed, there has been an unexpected increase in demand and supply of the drug. This situation is quite worrying as the indiscriminate use of chloroquine may produce drug-resistant parasites which may impact negatively on the efficacy of amodiaquine due to cross-resistance. Amodiaquine is a partner drug in one of the ACTs and in some of the drugs used for intermittent preventive treatment. We herein discuss the consequences of the escalated use of chloroquine in the management of COVID-19 on chemotherapy or chemoprevention of malaria and offer an advice. We speculate that parasite strains resistant to chloroquine will escalate due to the increased and indiscriminate use of the drug and consequently lead to cross-resistance with amodiaquine which is present in some drug schemes aforementioned. Under the circumstance, the anticipated hope of reverting to the use of the ‘resurrected chloroquine’ to manage malaria in future is likely to diminish. The use of chloroquine and its derivatives for the management of COVID-19 should be controlled.

scholarly journals Adherence to Isoniazid Preventive Therapy among Under-Five Children in Contact with Adult Bacteriologically Confirmed Pulmonary Tuberculosis Patients: A Mixed-Method Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Getachew Seid ◽  
Tsegaye Tsedalu ◽  
Marta Ayele ◽  
Faham Khamesipour
Keyword(s):  
Pulmonary Tuberculosis ◽  
World Health Organization ◽  
Study Design ◽  
Addis Ababa ◽  
Preventive Treatment ◽  
Preventive Therapy ◽  
World Health ◽  
Tuberculosis Patients ◽  
The World ◽  
Health Organization

Background. The World Health Organization recommends that all children below the age of five who have household contact with an infectious tuberculosis case should receive isoniazid preventive treatment for at least six months after the active tuberculosis disease has been ruled out. This research aims to determine the adherence of children, eligible for isoniazid preventive treatment, to the treatment who had contact with pulmonary tuberculosis patients. Methods. A mixed study design was used to prospectively assess the adherence to IPT among children under the age of 5 in contact with pulmonary TB patients through the quantitative study design and barriers of adherence in view of health care professionals and the family of children through a descriptive qualitative study. The study was conducted from July 2019 to December 2019 in Addis Ababa. Data were collected by a structured datasheet from the selected health center registration book. Data were entered into Epi Data software and analyzed by using SPSS version 20. Descriptive statistical methods were used to summarize the sociodemographic characteristics of the study participants. Result. The ratio of the total number of pulmonary tuberculosis index cases recruited into the study to the number of child contacts aged less than 5 years was 1 : 1.32. The total isoniazid preventive treatment uptake in this study was 75.2%; one-fifth (21.3%) of the children who started IPT did not complete the full course of six-month isoniazid preventive treatment. Except for HIV not to be tested ( P < 0.001 ), there was no significant association of the listed risk factors in default to complete the full six months of preventive treatment. Conclusion. Enrolment of eligible children for isoniazid preventive treatment in the urban city Addis Ababa was still below the target of the World Health Organization End tuberculosis strategy by 2030. The treatment adherence rate also needs a great deal of effort to achieve the strategy. Child default after the first visit indicates a lack of understanding about the benefit and safety of preventive therapy in young children among families of TB patients, and awareness-creating efforts by health extension workers will help to improve the outcomes.

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