scholarly journals Is there a distinction between malaria treatment and intermittent preventive treatment? Insights from a cross-sectional study of anti-malarial drug use among Ugandan pregnant women

2015 ◽  
Vol 14 (1) ◽  
Author(s):  
Charles O Odongo ◽  
Kuteesa R Bisaso ◽  
Freddy Kitutu ◽  
Celestino Obua ◽  
Josaphat Byamugisha
2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Otchere Addai-Mensah ◽  
Max Efui Annani-Akollor ◽  
Linda Ahenkorah Fondjo ◽  
Kwadwo Sarbeng ◽  
Enoch Odame Anto ◽  
...  

Background. The World Health Organization (WHO) recommends the use of Insecticide Treated Bed-Nets and Intermittent Preventive Treatment (IPT) with Sulphadoxine-Pyrimethamine (SP) as interventions in curbing malaria during pregnancy. However, increasing evidence shows a gap in coverage where not all pregnant women receive the recommended SP dose. This study evaluated the factors influencing uptake of IPTp-SP among pregnant women in Kumasi, Ghana. Methodology. This cross-sectional study was conducted among 280 pregnant women attending the Kwame Nkrumah University of Science and Technology Hospital in Kumasi, Ghana. Validated structured questionnaires were administered to obtain sociodemographic, medical/reproductive information, and IPTp-SP uptake among participants. Statistical analyses were performed using IBM SPSS 25.0 statistics. Results. The mean age of respondents was 29.7±4.9 years. Of the 280 women interviewed, 74.6% attended the antenatal care (ANC) clinic at least four times with only 31.8% completing the recommended doses. Tertiary education [aOR=3.15, 95% CI (0.94 -10.97), and p=0.042] and ≥ 4 ANC visits [aOR=24.6, 95% CI (5.87-103.07), p<0.0001] had statistically significant higher odds of completing the recommended IPTp-SP dose. However, participants employed by the formal sector [aOR=0.28, 95% CI (0.09 - 0.79), p=0.016] and participants with more than four children [aOR=0.14, 95% CI (0.03 - 0.63), and p=0.011] had statistically significant lower odds of completing the recommended IPT dose. Conclusion. ANC attendance is critical in IPTp uptake. The results emphasize the need for the Health Policy Makers in Kumasi to encourage pregnant women, especially women working in the formal sector and women having more than four children to patronize ANC attendance to ensure high coverage of the recommended IPTp dose.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250350
Author(s):  
Yaa Nyarko Agyeman ◽  
Sam Newton ◽  
Raymond Boadu Annor ◽  
Ellis Owusu-Dabo

In 2012 the World Health Organisation (WHO) revised the policy on Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) to at least three doses for improved protection against malaria parasitaemia and its associated effects such as anaemia during pregnancy. We assessed the different SP dosage regimen available under the new policy to determine the dose at which women obtained optimal protection against anaemia during pregnancy. A cross-sectional study was conducted among pregnant women who attended antenatal clinic at four different health facilities in Ghana. The register at the facilities served as a sampling frame and simple random sampling was used to select all the study respondents; they were enrolled consecutively as they kept reporting to the facility to receive antenatal care to obtain the required sample size. The haemoglobin level was checked using the Cyanmethemoglobin method. Multivariable logistic regression was performed to generate odds ratios, confidence intervals and p-values. The overall prevalence of anaemia among the pregnant women was 62.6%. Pregnant women who had taken 3 or more doses of IPTp-SP had anaemia prevalence of 54.1% compared to 66.6% of those who had taken one or two doses IPTp-SP. In the multivariable logistic model, primary (aOR 0.61; p = 0.03) and tertiary education (aOR 0.40; p = <0.001) decreased the odds of anaemia in pregnancy. Further, pregnant women who were anaemic at the time of enrollment (aOR 3.32; p = <0.001) to the Antenatal Care clinic and had malaria infection at late gestation (aOR 2.36; p = <0.001) had higher odds of anaemia in pregnancy. Anaemia in pregnancy remains high in the Northern region of Ghana. More than half of the pregnant women were anaemic despite the use of IPTp-SP. Maternal formal education reduced the burden of anaemia in pregnancy. The high prevalence of anaemia in pregnancy amid IPTp-SP use in Northern Ghana needs urgent attention to avert negative maternal and neonatal health outcomes.


Author(s):  
Ilboudo Bernard ◽  
Savadogo G. Léon Blaise ◽  
Kinda Maurice ◽  
Guiguemde T. Robert ◽  
Dramaix-wilmet Michèle ◽  
...  

Objectives: To analyze the factors associated with anemia in pregnancy in the Cascades region in Burkina Faso. Methods: A cross-sectional study was carried out in antenatal clinics of the Cascades region in Burkina Faso during one month from May to June 2012. We collected data on socio-demographics and health characteristics of pregnant women attending these clinics. Hemoglobin was measured to assess anemia. Factors associated with anemia were identified through a multivariate analysis. Results: A total of 1763 pregnant women, irrespectively of pregnancy stage, were enrolled. The mean (SD) hemoglobin level was 10.6 (1.4) g/dl. The prevalence of anemia in pregnancy was 58.9%, 3.2% of them being severe. Factors associated with anemia were the absence of intermittent preventive treatment of malaria with sulfadoxin-pyrimetamin (OR = 1.3, 95% CI: 1.0-1.7), number of pregnancies >6 (OR = 1.4, 95% CI: 1.1-1.9). Moderate consumption of local alcohol extracted from Palmyra was associated with a lower prevalence of anemia (OR = 0.7, 95% CI: 0.5-0.9). Surprisingly, anemia was not associated with supplementation with folic acid + iron (p = 0.60). Conclusions: Interventions which aim to reduce the prevalence of anemia in pregnancy in Burkina Faso should improve the coverage of the intermittent preventive treatment of malaria and support the limitation of births.


BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e020248 ◽  
Author(s):  
Victoria H Coleman-Cowger ◽  
Emmanuel A Oga ◽  
Erica N Peters ◽  
Kathleen Trocin ◽  
Bartosz Koszowski ◽  
...  

IntroductionPrescription-drug use in the USA has increased by more than 60% in the last three decades. Prevalence of prescription-drug use among pregnant women is currently estimated around 50%. Prevalence of illicit drug use in the USA is 14.6% among pregnant adolescents, 8.6% among pregnant young adults and 3.2% among pregnant adults. The first step in identifying problematic drug use during pregnancy is screening; however, no specific substance-use screener has been universally recommended for use with pregnant women to identify illicit or prescription-drug use. This study compares and validates three existing substance-use screeners for pregnancy—4 P’s Plus, National Institute on Drug Abuse (NIDA) Quick Screen/Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and the Substance Use Risk Profile-Pregnancy (SURP-P) scale.Methods and analysisThis is a cross-sectional study designed to evaluate the sensitivity, specificity and usability of existing substance-use screeners. Recruitment occurs at two obstetrics clinics in Baltimore, Maryland, USA. We are recruiting 500 participants to complete a demographic questionnaire, NIDA Quick Screen/ASSIST, 4 P’s Plus and SURP-P (ordered randomly) during their regularly scheduled prenatal appointment, then again 1 week later by telephone. Participants consent to multidrug urine testing, hair drug testing and allowing access to prescription drug and birth outcome data from electronic medical records. For each screener, reliability and validity will be assessed. Test–retest reliability analysis will be conducted by examining the results of repeated screener administrations within 1 week of original screener administrations for consistency via correlation analysis. Furthermore, we will assess if there are differences in the validity of each screener by age, race and trimester.Ethics and disseminationThis study is approved by the Institutional Review Board of the University of Maryland (HP-00072042), Baltimore, and Battelle Memorial Institute (0619–100106433). All participants are required to give their informed consent prior to any study procedure.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Niguse Meles Alema ◽  
Getachew Semagn ◽  
Shetey Melesse ◽  
Ephrem Mebrahtu Araya ◽  
Hagazi Gebremedhin ◽  
...  

Abstract Background A vigilant prescription of drugs during pregnancy can potentially safeguard the growing fetus from the deleterious effect of the drug while attempting to manage the mother’s health problems. There is a paucity of information about the drug utilization pattern in the area of investigation. Hence, this study was implemented to investigate the pattern of drug utilization and its associated factors among pregnant women in Adigrat general hospital, Northern Ethiopia. Methods An institution-based cross-sectional study was conducted among randomly selected 314 pregnant women who attended obstetrics-gynecology and antenatal care units of the hospital. Relevant data were retrieved from the pregnant women’s medical records and registration logbook. The drugs prescribed were categorized based on the United States Food and Drug Administration (US-FDA) fetal harm classification system. Data analysis was done using SPSS version 20 statistical software. Multivariate logistic regression was employed to analyze the association of the explanatory variables with the medication use, and p < 0.05 was declared statistically significant. Results The overall prescribed drug use in this study was found to be 87.7%. A considerable percentage of the study participants (41.4%) were prescribed with supplemental drugs (iron folate being the most prescribed drug) followed by antibiotics (23.4%) and analgesics (9.2%). According to the US-FDA drug’s risk classification, 42.5, 37, 13, and 7% of the drugs prescribed were from categories A, B, C, and D or X respectively. Prescribed drug use was more likely among pregnant women who completed primary [AOR = 5.34, 95% CI (1.53–18.6)] and secondary education [AOR = 4.1, 95% CI (1.16–14)], who had a history of chronic illness [AOR = 7.9, 95% CI (3.14–19.94)] and among multigravida women [AOR = 2.9, 95% CI (1.57 5.45)]. Conclusions The finding of this study revealed that a substantial proportion of pregnant women received drugs with potential harm to the mother and fetus. Reasonably, notifying health practitioners to rely on up-to-date treatment guidelines strictly is highly demanded. Moreover, counseling and educating pregnant women on the safe and appropriate use of medications during pregnancy are crucial to mitigate the burden that the mother and the growing fetus could face.


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