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Evaluation of intermittent preventive treatment during pregnancy (IPTp) in Chókwè district, Southern Mozambique: coverage and effect on pregnancy and parasitological outcomes
Boek - Dissertatie
Malaria in pregnancy (MiP) is an important public health problem in Sub-Saharan Africa. It is known to be the most common and preventable cause of harmful outcomes to both mothers and developing foetuses in malaria-endemic areas. In stable transmission areas, MiP typically does not cause clinical symptoms and is usually not detected.
This thesis aimed to evaluate the community coverage of IPTp-SP and factors potentially related to low IPTp-SP among women with non-institutional and institutional deliveries; investigate the factors associated with malaria infection and adverse pregnancy outcomes among pregnant women at delivery; explore the perceptions, views, experiences and behaviors of pregnant women and health workers on accessing IPTp-SP for malaria prevention in pregnancy and assess the frequency of dhfr/dhps mutations in P. falciparum isolates collected from pregnant women, analyze the association between mutant haplotypes with parasitological and pregnancy outcomes and, investigate the effect of IPTp-SP on the carriage of asexual and sexual stages.
We found that less than a half of the women reported taking the recommended ≥ 3 doses of SP during their last pregnancy. This coverage remained well below the national’s target of 80% of pregnant women receiving ≥ 3 doses of IPTp-SP. This low IPTp-SP coverage was associated with non-institutional births, late first ANC visit, lower awareness about IPTp and the level of education attained by pregnant women.
Pregnant women were not aware of the risks of MiP or the benefits of its prevention. Delays in accessing antenatal care, irregular attendance of visits, and insufficient time for proper antenatal care counselling by health workers may explain inadequate IPTp delivery.
This thesis aimed to evaluate the community coverage of IPTp-SP and factors potentially related to low IPTp-SP among women with non-institutional and institutional deliveries; investigate the factors associated with malaria infection and adverse pregnancy outcomes among pregnant women at delivery; explore the perceptions, views, experiences and behaviors of pregnant women and health workers on accessing IPTp-SP for malaria prevention in pregnancy and assess the frequency of dhfr/dhps mutations in P. falciparum isolates collected from pregnant women, analyze the association between mutant haplotypes with parasitological and pregnancy outcomes and, investigate the effect of IPTp-SP on the carriage of asexual and sexual stages.
We found that less than a half of the women reported taking the recommended ≥ 3 doses of SP during their last pregnancy. This coverage remained well below the national’s target of 80% of pregnant women receiving ≥ 3 doses of IPTp-SP. This low IPTp-SP coverage was associated with non-institutional births, late first ANC visit, lower awareness about IPTp and the level of education attained by pregnant women.
Pregnant women were not aware of the risks of MiP or the benefits of its prevention. Delays in accessing antenatal care, irregular attendance of visits, and insufficient time for proper antenatal care counselling by health workers may explain inadequate IPTp delivery.
Aantal pagina's: 200
Jaar van publicatie:2019
Toegankelijkheid:Open