scholarly journals The protective effectiveness of control interventions for malaria prevention: a systematic review of the literature

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1932 ◽  
Author(s):  
Thomas Kesteman ◽  
Milijaona Randrianarivelojosia ◽  
Christophe Rogier
Keyword(s):  
Intermittent Preventive Treatment ◽  
Indoor Residual Spraying ◽  
Preventive Treatment ◽  
Malaria Prevention ◽  
Cross Sectional Study ◽  
Bed Nets ◽  
Cross Sectional ◽  
Only Children ◽  
Pubmed Database ◽  
Protective Effectiveness

Background: Thanks to a considerable increase in funding, malaria control interventions (MCI) whose efficacy had been demonstrated by controlled trials have been largely scaled up during the last decade. Nevertheless, it was not systematically investigated whether this efficacy had been preserved once deployed on the field. Therefore, we sought the literature to assess the disparities between efficacy and effectiveness and the effort to measure the protective effectiveness (PE) of MCI. Methods: The PubMed database was searched for references with keywords related to malaria, to control interventions for prevention and to study designs that allow for the measure of the PE against parasitemia or against clinical outcomes. Results: Our search retrieved 1423 references, and 162 articles were included in the review. Publications were scarce before the year 2000 but dramatically increased afterwards. Bed nets was the MCI most studied (82.1%). The study design most used was a cross-sectional study (65.4%). Two thirds (67.3%) were conducted at the district level or below, and the majority (56.8%) included only children even if the MCI didn’t target only children. Not all studies demonstrated a significant PE from exposure to MCI: 60.6% of studies evaluating bed nets, 50.0% of those evaluating indoor residual spraying, and 4/8 showed an added PE of using both interventions as compared with one only; this proportion was 62.5% for intermittent preventive treatment of pregnant women, and 20.0% for domestic use of insecticides. Conclusions: This review identified numerous local findings of low, non-significant PE –or even the absence of a protective effect provided by these MCIs. The identification of such failures in the effectiveness of MCIs advocates for the investigation of the causes of the problem found. Ideal evaluations of the PE of MCIs should incorporate both a large representativeness and an evaluation of the PE stratified by subpopulations.

The Economics of Malaria Prevention

2018 ◽  
Author(s):  
Bénédicte Apouey ◽  
Gabriel Picone ◽  
Joshua Wilde
Keyword(s):  
Financial Constraints ◽  
Intermittent Preventive Treatment ◽  
Indoor Residual Spraying ◽  
Preventive Treatment ◽  
Malaria Prevention ◽  
Sub Saharan Africa ◽  
Bed Nets ◽  
Preventive Behaviors ◽  
Mosquito Net ◽  
Positive Externalities

Malaria is a potentially life-threatening disease transmitted through the bites of female anopheline mosquitos infected with protozoan parasites. Malaria remains one of the major causes of mortality by infectious disease: in 2015, there were an estimated 212 million cases and 429,000 deaths globally, according to the 2016 World Malaria Report. Children under 5 years in sub-Saharan Africa bear the greatest burden of the disease worldwide. However, most of these cases could be prevented or treated. Several methods are highly effective in preventing malaria: in particular, sleeping under an insecticide-treated mosquito net (ITN), indoor residual spraying (IRS), and taking intermittent preventive treatment for pregnant women (IPTp). Regarding treatment, artesiminin-based combination therapy (ACT) is recommended as first-line treatment in many countries. Compared with other actions, malaria prevention behaviors have some specific features. In particular, they produce public health externalities. For example, bed net usage creates positive externalities since bed nets not only directly protect the user, but also reduce transmission probabilities through reduction in the number of disease hosts, and in the case of ITNs, reduction of the vector itself. In contrast, ACT uptake creates both positive externalities when individuals with malaria are treated, and negative externalities in the case of overtreatment that speeds up the spread of long-run parasite resistance. Moreover, ITNs, IPTp, and ACTs are experience goods (meaning individuals only ascertain their benefits upon usage), which implies that current preventive actions are linked to past preventive behaviors. Malaria prevention and eradication produce unambiguous benefits across various domains: economic conditions, educational outcomes, survival, fertility, and health. However, despite the high private returns to prevention, the adoption of antimalarial products and behaviors remains relatively low in malaria-affected areas. A variety of explanations have been proposed for low adoption rates, including financial constraints, high prices, and absence of information. While recent studies highlight that all of these factors play a role, the main barrier to adoption is probably financial constraints. This finding has implications regarding the appropriate pricing policy for these health products. In addition, there is a shortage of causally identified research on the effect of cultural and psychological barriers to the adoption of preventive behaviors. The literature which does exist is from a few randomized control trials of few individuals in very specific geographic and cultural contexts, and may not be generalizable. As a result, there are still ample opportunities for research on applying the insights of behavioral economics to malaria-preventive behavior in particular. Moreover, little research has been done on the supply side, such as whether free or heavily subsidized distribution of prevention technologies is fiscally sustainable; finding effective methods to solve logistical problems which lead to shortages and ineffective alternative treatments to fill the gap; or training sufficient healthcare workers to ensure smooth and effective delivery. Given these gaps in the literature, there are still multiple fruitful avenues for research which may have a first-order effect on reducing the prevalence of malaria in the developing world.

scholarly journals Regular Antenatal Attendance and Education Influence the Uptake of Intermittent Preventive Treatment of Malaria in Pregnancy: A Cross-Sectional Study at the University Hospital, Kumasi, Ghana

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Otchere Addai-Mensah ◽  
Max Efui Annani-Akollor ◽  
Linda Ahenkorah Fondjo ◽  
Kwadwo Sarbeng ◽  
Enoch Odame Anto ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Tertiary Education ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Cross Sectional Study ◽  
World Health ◽  
Bed Nets ◽  
Sectional Study ◽  
Formal Sector ◽  
Cross Sectional

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.

scholarly journals Coverage of intermittent preventive treatment of malaria in pregnancy in four sub-Saharan countries: findings from household surveys

2020 ◽  
Author(s):  
Clara Pons-Duran ◽  
Mireia Llach ◽  
Charfudin Sacoor ◽  
Sergi Sanz ◽  
Eusebio Macete ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria Prevention ◽  
Reproductive Age ◽  
Cluster Sampling ◽  
Household Surveys ◽  
Cross Sectional ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) is a key malaria prevention strategy in areas with moderate to high transmission. As part of the TIPTOP (Transforming IPT for Optimal Pregnancy) project, baseline information about IPTp coverage was collected in eight districts from four sub-Saharan countries: Democratic Republic of Congo (DRC), Madagascar, Mozambique and Nigeria. Methods Cross-sectional household surveys were conducted using a multistage cluster sampling design to estimate the coverage of IPTp and antenatal care attendance. Eligible participants were women of reproductive age who had ended a pregnancy in the 12 months preceding the interview and who had resided in the selected household during at least the past 4 months of pregnancy. Coverage was calculated using percentages and 95% confidence intervals. Results A total of 3911 women were interviewed from March to October 2018. Coverage of at least three doses of IPTp (IPTp3+) was 22% and 24% in DRC project districts; 23% and 12% in Madagascar districts; 11% and 16% in Nigeria local government areas; and 63% and 34% in Mozambique districts. In DRC, Madagascar and Nigeria, more than two-thirds of women attending at least four antenatal care visits during pregnancy received less than three doses of IPTp. Conclusions The IPTp3+ uptake in the survey districts was far from the universal coverage. However, one of the study districts in Mozambique showed a much higher coverage of IPTp3+ than the other areas, which was also higher than the 2018 average national coverage of 41%. The reasons for the high IPTp3+ coverage in this Mozambican district are unclear and require further study.

scholarly journals Cross-Study of Malaria Prevalence in History, Bed Net Utilization, and Knowledge about the Disease among Tanzanian College Students

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Yakobo Nyahoga ◽  
Zanda Bochkaeva
Keyword(s):  
Malaria Prevention ◽  
Cross Sectional Study ◽  
Malaria Prevalence ◽  
Bed Nets ◽  
Bed Net ◽  
Prevention Measures ◽  
Cross Sectional ◽  
University Campuses ◽  
High Prevalence ◽  
Two Factors

University campuses are potential reservoirs of infectious diseases, but they are not in the research focus. It is obvious that the use of malaria preventive tools is extremely necessary in campus conditions in endemic countries. This study is the first malaria survey, conducted in a student campus in Tanzania. This cross-sectional study uncovered a surprisingly high prevalence of malaria history among students: 89,4% of 246 random respondents assume that they had malaria in history, among whom 145 (58,9%) suffered from the disease during the last year. And although students are relatively confident about the vector, parasite, and prevention measures of the disease, only 44,7% of the students use bed nets and 4,5% use a body spray or ointment daily. The others seldom use spray or ointment or do not care about the problem at all. This situation was found to be associated with two factors, financial and educational. Current results show that students are relatively educated on malaria, but they do not follow the malaria prevention guidance. It has become clear that at least proper informational propaganda of bed net use is required in Tanzanian university campuses.

scholarly journals Malaria Preventive Practices among Pregnant Women in Akwa Ibom State, Southern Nigeria

2020 ◽  
pp. 1-8
Author(s):  
T. Kasso ◽  
I. L. Oboro ◽  
O. Maduka ◽  
A. T. O. Awopeju ◽  
N. I. Paul ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Open Data ◽  
Public Health Problem ◽  
Preventive Treatment ◽  
Health Facilities ◽  
Bed Nets ◽  
P Value ◽  
Cross Sectional ◽  
Preventive Practices

Background: Malaria is a serious public health problem in developing countries with Africa bearing most of its burden. Pregnant women are more susceptible to malaria and it is one of the leading causes of maternal and perinatal mortality/morbidity. Use of effective malaria preventive measures during pregnancy reduces its burden and complications. Aim: This was to determine malaria preventive practices used by pregnant women in Akwa Ibom state, Nigeria. Materials and Methods: It was a cross sectional study of pregnant women attending public and private health facilities in Akwa Ibom state. An informed written consent was obtained from the participants. Stratified sampling method was used in selecting the health facilities and the study participants. Information was obtained with pretested questionnaires by trained personnel with the aid of Open Data Kit (ODK) on android phones. Data was managed with SPSS 22.0 and P-value of <0.05 was considered statistically significant. Results: There were 935 participants in the study. Their mean age was 28.52 ± 5.09 years with 879 (94.0%) being married. Most had secondary and tertiary degrees: 451(48.2%) and 440(47.1%). Majority of them were traders/business women and self-employed (58.2%) while 7% were unemployed. Malaria preventive practices were use of window net, bed net and insecticides accounting for 659(71%), 447(48.2%) and 207(22.3%) respectively. There were 612 (65.5%) participants that received malaria drugs for prevention with 452(73.9%) receiving Intermittent Preventive Treatment in Pregnancy (IPTp) with Sulfadoxine-Pyrimethamine (SP). Only 296 (31.7%) of them slept under bed nets the night before the interview. Conclusion: Common preventive practices employed by pregnant women were IPTp with SP, window nets, ITNs and modified IRS. Majority of the women utilized widow nets, though not as effective as ITNs. Efforts should be intensified concerning awareness creation about the benefits of ITN use during pregnancy.

scholarly journals Community knowledge and perceptions about indoor residual spraying for malaria prevention in Soroti district, Uganda: a cross-sectional study

2013 ◽  
Vol 12 (1) ◽  
Author(s):  
Michael Ediau ◽  
Juliet N Babirye ◽  
Nazarius M Tumwesigye ◽  
Joseph KB Matovu ◽  
Simba Machingaidze ◽  
...  
Keyword(s):  
Indoor Residual Spraying ◽  
Malaria Prevention ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Community Knowledge

scholarly journals Factors Associated with Anemia in Pregnancy in Cascades Region in Burkina Faso

2015 ◽  
pp. 663-664
Author(s):  
Ilboudo Bernard ◽  
Savadogo G. Léon Blaise ◽  
Kinda Maurice ◽  
Guiguemde T. Robert ◽  
Dramaix-wilmet Michèle ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Anemia In Pregnancy ◽  
Prevalence Of Anemia ◽  
In Pregnancy

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.

scholarly journals Determinants of Uptake of Malaria Preventive Interventions among Pregnant Women in Eastern Uganda

2020 ◽  
Author(s):  
Solomon Tsebeni Wafula ◽  
Hilbert Mendoza ◽  
Aisha Nalugya ◽  
David Musoke ◽  
Peter Waiswa
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Cost Effective ◽  
Wealth Quintile ◽  
Malaria Prevention ◽  
Sub Saharan Africa ◽  
Insecticide Treated Nets ◽  
Cross Sectional ◽  
Itn Use ◽  
Eastern Uganda

Abstract Background Consistent use of insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp) have been recommended as cost-effective interventions for malaria prevention during pregnancy in endemic areas. However, the coverage of these interventions during pregnancy in sub-Saharan Africa is still suboptimal. In this study, we investigated the uptake of IPTp and ITNs, and associated factors among women during their recent pregnancy in Eastern Uganda. Methods This was a cross-sectional study conducted among 2,062 women who had delivered within the last 12 months in three districts in Eastern Uganda. The primary outcomes were consistent ITN use and optimal uptake (at least 3 doses) of IPTp. A modified Poisson regression was used to examine the association between consistent ITN use and the uptake of optimal doses of IPTp with independent variables. Data were analyzed using Stata 14 software. Results The level of uptake of IPTp3 (at least three doses) was 14.7 %, while IPTp2 (at least two doses) was 60.0%. The majority (86.4%) of mothers reported regularly sleeping under mosquito nets for the full duration of pregnancy. Uptake of IPTp3 was associated with engaging in farming (adjusted PR = 1.71, 95% CI [1.28 – 2.28]) or business (adjusted PR = 1.60, 95% CI [1.05 – 2.44]), and attending at least 4 antenatal care (ANC) visits (adjusted PR = 1.72, 95%CI [1.34 – 2.22]). On the other hand, consistent ITN use was associated with belonging to the fourth wealth quintile (adjusted PR = 1.08, 95% CI [1.02 – 1.14]) or fifth wealth quintile (adjusted PR = 1.08, 95% CI [1.02- 1.15]), and attending at least 4 ANC visits (adjusted PR = 1.07, 95% CI [1.03- 1.11]). Conclusion Uptake of IPTp3 and consistent ITN use during pregnancy were lower than recommended guidelines, thus threatening the progress so far made towards malaria elimination. Our findings highlight the need for more efforts to enhance utilisation of ANC services, which is likely to increase the uptake of these two key malaria preventive measures during pregnancy.

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