scholarly journals Safety and efficacy of intermittent presumptive treatment with sulfadoxine-pyrimethamine using rapid diagnostic test screening and treatment with dihydroartemisinin-piperaquine at the first antenatal care visit (IPTp-SP+): study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jean-Bertin Bukasa Kabuya ◽  
Matthew M. Ippolito ◽  
Jay Sikalima ◽  
Clifford Tende ◽  
Davies Champo ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Hybrid Approach ◽  
World Health ◽  
Suitable Alternative ◽  
Care Clinic ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
In Pregnancy

Abstract Background Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended by the World Health Organization for the prevention of malaria in pregnancy (MIP)-associated adverse outcomes in high burden areas. However, the efficacy of IPTp-SP has decreased in step with increasing parasite drug resistance. Suitable alternative strategies are needed. Methods This is a protocol for a phase IIIb open-label, two-armed randomized controlled superiority trial to assess the safety and efficacy of a hybrid approach to IPTp combining screening and treatment with dihydroartemisinin-piperaquine (DP) to the current IPTp-SP regimen at the first antenatal care clinic visit. Pregnant women without HIV infection and without signs or symptoms of malaria will be randomized to either standard IPTp-SP or hybrid IPTp-SP plus screening and treatment (IPTp-SP+). In the IPTp-SP+ arm, participants who screen positive by rapid diagnostic test for P. falciparum will be treated with DP at the first antenatal visit while those who screen negative will receive SP per current guidelines. All participants will be administered SP on days 35 and 63 and will be actively followed biweekly up to day 63 and then monthly until delivery. Infants will be followed until 1 year after delivery. The primary endpoint is incident PCR-confirmed MIP at day 42. Secondary endpoints include incident MIP at other time points, placental malaria, congenital malaria, hemoglobin trends, birth outcomes, and incidence of adverse events in infants up to the first birthday. Discussion A hybrid approach to IPTp that combines screening and treatment with an artemisinin-based combination therapy at the first visit with standard IPTp-SP is hypothesized to confer added benefit over IPTp-SP alone in a high malaria transmission area with prevalent SP resistant parasites. Trial registration Pan African Clinical Trials Registry 201905721140808. Registered retrospectively on 11 May 2019

Safety and Efficacy of Intermittent Presumptive Treatment with Sulfadoxine-Pyrimethamine Using Rapid Diagnostic Test Screening and Treatment with Dihydroartemisinin-Piperaquine at the First Antenatal Care Visit (IPTp-SP+): Study Protocol for a Randomized Controlled Trial

2021 ◽  
Author(s):  
Jean-Bertin Bukasa Kabuya ◽  
Matthew M. Ippolito ◽  
Jay Sikalima ◽  
Clifford Tende ◽  
Davies Champo ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Hybrid Approach ◽  
World Health ◽  
Suitable Alternative ◽  
Care Clinic ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
In Pregnancy

Abstract Background: Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended by the World Health Organization for the prevention of malaria in pregnancy (MIP)-associated adverse outcomes in high burden areas. However, the efficacy of IPTp-SP has decreased in step with increasing parasite drug resistance. Suitable alternative strategies are needed. Methods: This is a protocol for a phase IIIb open-label, two-armed randomized controlled superiority trial to assess the safety and efficacy of a hybrid approach to IPTp combining screening and treatment with dihydroartemisinin-piperaquine (DP) to the current IPTp-SP regimen at the first antenatal care clinic visit. Pregnant women without HIV infection and without signs or symptoms of malaria will be randomized to either standard IPTp-SP or hybrid IPTp-SP plus screening and treatment (IPTp-SP+). In the IPTp-SP+ arm, participants who screen positive by rapid diagnostic test for P. falciparum will be treated with DP at the first antenatal visit while those who screen negative will receive SP per current guidelines. All participants will be administered SP on days 35 and 63 and will be actively followed biweekly up to day 63 and then monthly until delivery. Infants will be followed until 1 year after delivery. The primary endpoint is incident PCR-confirmed MIP at day 42. Secondary endpoints include incident MIP at other time points, placental malaria, congenital malaria, hemoglobin trends, birth outcomes, and incidence of adverse events in infants up to the first birthday.Discussion: A hybrid approach to IPTp that combines screening and treatment with an artemisinin-based combination therapy at the first visit with standard IPTp-SP is hypothesized to confer added benefit over IPTp-SP alone in a high malaria transmission area with prevalent SP resistant parasites. Trial Registration {2a and 2b}.Pan African Clinical Trials Registry, ID: PACTR201905721140808. Registered on May 20, 2019 – Retrospectively, http://www.pactr.org

Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Danger Signs ◽  
In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

Prevalence and factors associated with anemia in pregnancy among women receiving antenatal care at the West Gonja District Hospital of Northern Ghana.

2020 ◽  
Vol 4 (3) ◽  
pp. 01-12
Author(s):  
Martin Malick
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Hemoglobin Concentration ◽  
World Health ◽  
Multiple Gestation ◽  
The West ◽  
Factors Associated ◽  
Folate Supplement ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Background: Anemia in pregnancy is a major public health problem especially in Low and Middle-income countries (LMIC) including Ghana and is defined by the World Health Organization (WHO) as being present when the hemoglobin concentration in the peripheral blood is 11g/dl or less. In most African countries anemia in pregnancy occurs if the hemoglobin concentration falls below 10g/dl. Pregnant women are at a higher risk of developing anemia due to several factors such as hemodilution, nutritional factors, multiple gestation, socio-economic status and malaria infestation. Anemia in pregnancy is an important cause of maternal mortality and affects half of pregnant women worldwide; with 56% of West African pregnant women being anemic. The objective of this study is to assess the prevalence and identify the risk factors associated with anemia among pregnant women receiving antenatal care at the West Gonja Hospital (WGH) Methods: A cross-sectional was conducted with 136 pregnant women receiving antenatal care at the WGH between January 2017 to February 2018. Random sampling was used to select participants and data was collected using a structured questionnaire. Data was analyzed using the SPSS Version 24.0. Results: A total 71(52.2%) of the study population were anemic, while 65 (47.8%) were not anemic. 20(74.1%) of the 27 pregnant housewives were anemic, while 11(64.7%) of the pregnant farmers were anemic. 27 (96.4%) of the 28 pregnant women who took their iron/folate supplement only some few days were anemic. 12 (100%) of the 12 participants who took their iron/folate supplement a few times a week were anemic. 4 (80%) of the 5 participants who never took their iron/folate supplement were anemic. 21 (70%) of those who did not sleep under ITN were anemic. 33 (84.6%) of the 39 patients who were diagnosed with malaria were also anemic. 28 (87.5%) of the 32 participants who took only 2 meals a day were anemic. 27 (79.4%) of the 34 patients who took liver, beef, chicken and fish only twice weekly were anemic. 15 (88.2%) of the 17 patients who drank tea some days in a week were anemic. Conclusion: Although most of the pregnant women were adequately educated on the most relevant aspects of anemia in pregnancy, more than half of them were still anemic. Anemia was more prevalent among pregnant uneducated housewives with poor nutritional habits. All the pregnant sickle cell disease patients as well as those diagnosed with malaria were also anemic.

scholarly journals Partisipasi Dalam Pencegahan Dan Penanggulangan Covid-19

2021 ◽  
Vol 4 (4) ◽  
pp. 941-953
Author(s):  
Dyan Kunthi Nugrahaeni ◽  
Novie Elvinawaty Mauliku ◽  
Budiman Budiman ◽  
Gunawan Irianto ◽  
Arina Novilla
Keyword(s):  
World Health Organization ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Community Service ◽  
Prevention And Control ◽  
Community Services ◽  
World Health ◽  
The World ◽  
Health Organization ◽  
And Control

ABSTRAK The World Health Organization menetapkan outbreak SARS-CoV-2 sebagai Kedaruratan Kesehatan Masyarakat yang Meresahkan Dunia dan dinyatakan sebagai pandemik. Penyebaran dan penularan penyakit Coronavirus Disease-19 (COVID-19) sangat tinggi, dengan jumlah penderita lebih dari 117 juta di seluruh dunia. Diperlukan berbagai strategi dan tindakan yang dapat dilakukan untuk pencegahan, penanggulangan dalam rangka mengatasi COVID-19. Tujuan Pengabdian masyarakat yang dilakukan oleh Stikes Achmad Yani adalah ikut berperan serta dalam pencegahan dan penanggulangan COVID-19 di wilayah Kota Cimahi dan Kota Bandung. Metode yang digunakan adalah partisipatori dalam berbagai aktifias pencegahan dan penanggulangan COVID-19. Kegiatan Pengabdian Masyarakat yang dilakukan selama pandemic COVID-19 diantaranya adalah demontrasi pembuatan handsanitizer, penyemprotan disinfektan, mengirimkan tim relawan pemeriksaan Rapid Diagnostic Test (RDT) antibodi Cluster Lembang dan relawan Check Point pada kegiatan Pembatasan Sosial Berskala Besar di Kota Bandung. Pemberian donasi kepada masyarakat terdampak pandemik COVID-19 dan donasi Alat Pelindung Diri (APD) ke fasilitas pelayanan kesehatan seperti Rumah Sakit dan Puskesmas. Pelaksanaan Rapid Test Diagnostic (RTD) antibodi dan RTD antigen bagi mahasiswa, dosen dan Karyawan. Stikes Achmad Yani juga berperan serta dalam gebyar Vaksin COVID-19 bagi tenaga kesehatan dan mengirimkan relawan sebagai vaksinator yang diselenggarakan oleh Rumah Sakit Hasan Sadikin berkerjasama dengan PPNI. Partisipasi Stikes Achmad Yani Cimahi dalam berbagai kegiatan yang terkait dengan COVID-19 diharapkan dapat memberikan kontribusi dalam rangka pencegahan penularan, pengendalian dan penanggulangan COVID-19. Kata Kunci: COVID-19, disinfeksi, relawan, Rapid Diagnostic Test  ABSTRACT The World Health Organization recognize the SARS-CoV-2 outbreak as a public health emergency of Internasional Concerns and declared it as a pandemic. The spread and transmission of Coronavirus Disease-19 (COVID-19) are very high and reported that over 117 million people have been sufferers worldwide. Several strategies and actions can be carried out to prevention, controlling and overcoming COVID-19. The purpose of community service carried out by Stikes Achmad Yani is to participate in the prevention and control of COVID-19 in Cimahi and Bandung district. The methode used in community services are participatory methods in several activities for prevention and control of COVID-19. Community Service activities carried out during the COVID-19 pandemic included demonstrations of making hand sanitizers, spraying disinfectants, sending a team of volunteers to examine the Rapid Diagnostic Test (RDT) antibody for the Lembang Cluster, and volunteer Check Points at Large-Scale Social Restrictions activities in Bandung. Providing donations to people affected by the COVID-19 pandemic and donations of Personal Protective Equipment (PPE) to health service facilities such as hospitals and health centers. Implementation of Rapid Diagnostic Test (RTD) antibody and RDT antigen for students, lecturers, and staff. Stikes Achmad Yani also participated in the COVID-19 Vaccine for health workers and sent volunteers as vaccinators organized by Hasan Sadikin Hospital in collaboration with PPNI. The participation of Stikes Achmad Yani Cimahi in various activities to contribute prevention of disease transmission and controlling COVID-19. Kata Kunci: COVID-19, disinfection, volunteer, Rapid Diagnostic Test

scholarly journals Rapid Diagnostic Test Versus Microscopy for Diagnosing Malaria Among Pregnant Women in a Resource-Poor Setting; A Cross-Sectional Comparative Study

2020 ◽  
Vol 12 (8) ◽  
pp. 52
Author(s):  
Bartholomew N. Odio ◽  
Leonard O. Ajah ◽  
Perpetus C. Ibekwe ◽  
Monique I. Ajah ◽  
George O. Ugwu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Clinical Features ◽  
Scale Up ◽  
World Health ◽  
Resource Poor Setting ◽  
Cross Sectional ◽  
Significant Difference ◽  
Resource Poor

BACKGROUND: Diagnostic challenge of malaria in Nigeria remarkably impedes the World Health Organization (WHO) recommendation of laboratory diagnosis before treatment. Rapid Diagnostic Test (RDT) is easier and cheaper to perform when compared with microscopy especially in resource-poor settings. However there are conflicting results on the accuracy of RDT versus microscopy from previous studies. AIM: To compare the overall accuracy of   microscopy and RDT in detecting peripheral malaria among   pregnant women with clinical features of malaria. MATERIALS & METHODS: This was a cross-sectional comparative studyin whichRDT, microscopy and polymerase chain reaction (PCR) were performed using the peripheral bloodof the eligible study participants at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki between September 1, 2016 and March 31, 2017.The PCR was used as the gold standard in this study. Data was analyzed with the Statistical Package for Social Sciences version 18 (IBM SPSS, Chicago, USA). P value ≤ 0.05 was considered statistically significant. RESULTS: The actual prevalent rates of malaria based on RDT, microscopy and PCR results among the participants were 58.2%, 59.9% and 61.1% respectively. There was no statistical significant difference among RDT, microscopy and combined RDT and microscopy on overall accuracy. Malaria infestation was associated with self-employed and unemployed women, primigravidity, second trimester, rural residence, non-use of long lasting insecticide treated nets and intermittent preventive therapy for malaria. CONCLUSION: There was no difference in overall accuracy among RDT, microscopy and combined RDT and microscopy. This underscores the need to scale up RDT for every patient with clinical features of malaria before treatment in this environment.

scholarly journals PERAN PEREMPUAN DALAM PENCEGAHAN STUNTING DI KECAMATAN BUNAKEN KOTA MANADO PROVINSI SULAWESI UTARA

2019 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Jean Fanny Junita Timban ◽  
Ellen Grace Tangkere ◽  
Jelly Ribka Danaly Lumingkewas
Keyword(s):  
Antenatal Care ◽  
Health Professionals ◽  
Care Delivery ◽  
Child Growth ◽  
World Health ◽  
Educational Activities ◽  
Growth Standards ◽  
Under Five ◽  
The World ◽  
In Pregnancy

Stunting in under-five children is a reduced growth rate primarily caused by chronic undernutrition that leads to a child having height much less than is normal for age. This condition manifests mostly after two years old. The definition of stunting according to the World Health Organization (WHO) is for the "height for age" value to be less than two standard deviations of the WHO Child Growth Standards median. Indonesia has been plagued recently with stunting. In 2015, the World Bank indicates that stunting has cost 3 to 11 percent of the gross domestic product. Previous research works have documented that mothers play an important role in preventing stunting through antenatal care and child nursing. The objective of this study is to explore the role played by the mothers in Bunaken, Manado, in antenatal care and child nursing that prevent stunting. Samples are drawn using purposive sampling and data are analysis descriptively. The results show that the mothers’ roles include taking antenatal check up to four times during pregnancy, daily use of FE 90 pill, participating in pregnancy counseling and care, delivery by health professionals, attending integrated service post (posyandu), visiting health professionals for postnatal care, completing universal immunization on child over 12 months old, and participating in educational activities for under-five nursing and nutritional fulfillment at least once a month. Of these eight recorded roles, however, there are merely 20% mothers indicate they regularly taking part in pregnancy counseling and care. Furthermore, only one percent (n = 3) respondents that report they attending educational activities for under-five nursing and nutritional fulfillment.

scholarly journals Prioritizing Pregnant Women for COVID-19 Vaccination

2021 ◽  
Author(s):  
Yamini Sarwal ◽  
Tanvi Sarwal ◽  
Rakesh Sarwal
Keyword(s):  
High Risk ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Web Search ◽  
Safety And Efficacy ◽  
High Burden ◽  
Under Five ◽  
Mortality Burden ◽  
Dual Burden ◽  
In Pregnancy

Even though evidence for the safety and efficacy of COVID-19 vaccination in pregnancy is emerging, most countries currently do not offer COVID-19 vaccination to pregnant women, while a few leave the decision to the woman. Pregnant women are known to be at high risk of complications from COVID-19. We did a web search on policies for COVID-19 vaccination of pregnant women in two sets of countries – those bearing a high burden of COVID-19 cases globally, and a second set with a high burden of maternal and under five mortality. India and Indonesia fall in both the groups. Of the top 20 COVID-19 affected countries, six countries allow and two have in place guidelines for preferential vaccination of pregnant women. In contrast, none of the high maternal and under-five mortality burden countries have such preferential vaccination guidelines in place. For COVID-19 not to further aggravate already heavy existing burden of maternal and under five mortality, there is a strong case for inclusion of pregnant women as a high priority group for COVID-19 vaccination. We recommend including COVID-19 vaccination in the routine protocol for antenatal care in all countries, particularly India and Indonesia in view of their dual burden.

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