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Uptake of intermittent preventive treatment and pregnancy outcomes: health facilities and community surveys in Chokwe district, southern Mozambique

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dc.contributor.author Arnaldo, P. en_US
dc.contributor.author Rovira-Vallbona, E. en_US
dc.contributor.author Langa, J. S. en_US
dc.contributor.author Salvador, C. en_US
dc.contributor.author Guetens, P. en_US
dc.contributor.author Chiheb, D. en_US
dc.contributor.author Xavier, B. en_US
dc.contributor.author Kestens, L. en_US
dc.contributor.author Enosse, S. M. en_US
dc.contributor.author Rosanas-Urgell, A. en_US
dc.date.accessioned 2019-06-04T12:20:57Z
dc.date.available 2019-06-04T12:20:57Z
dc.date.issued 2018 en_US
dc.identifier.issn 1475-2875 en_US
dc.identifier.doi http://dx.doi.org/10.1186/s12936-018-2255-z en_US
dc.identifier.other http://lib.itg.be/pdf/itg/2018/2018mjou0109.pdf en_US
dc.identifier.other 13 pp. en_US
dc.identifier.other 60 en_US
dc.identifier.other ITG-B1B; ITG-B2B; ITG-B5A; ITG-B6A; ITG-B8A; ITG-BLA; DBM; U-MALAR; U-IMMUN; JIF; DOI; PDF; PMC; OAJ; E-only; Abstract; ITMPUB; DSPACE65 en_US
dc.identifier.uri http://hdl.handle.net/10390/10657
dc.description.abstract BACKGROUND: Malaria in pregnancy leads to serious adverse effects on the mother and the child and accounts for 75,000-200,000 infant deaths every year. Currently, the World Health Organization recommends intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) at each scheduled antenatal care (ANC) visit. This study aimed to assess IPTp-SP coverage in mothers delivering in health facilities and at the community. In addition, factors associated with low IPTp-SP uptake and malaria adverse outcomes in pregnancy were investigated. METHODS: A community and a health facility-based surveys were conducted in mothers delivering in Chokwe district, southern Mozambique. Social-demographic data, malaria prevention practices and obstetric history were recorded through self-report and antenatal records. For women delivering at health facilities, a clinical examination of mother and child was performed, and malaria infection at delivery was determined by rapid diagnostic test, microscopy, quantitative PCR and placental histology. RESULTS: Of 1141 participants, 46.6, 30.2, 13.5 and 9.6% reported taking >/= 3, two, one and none SP doses, respectively. Low IPTp uptake (< 3 doses) was associated with non-institutional deliveries (AOR = 2.9, P < 0.001), first ANC visit after week 28 (AOR = 5.4, P < 0.001), low awareness of IPTp-SP (AOR = 1.6, P < 0.002) and having no or only primary education (AOR = 1.3, P = 0.041). The overall prevalence of maternal malaria (peripheral and/or placental) was 16.8% and was higher among women from rural areas compared to those from urban areas (AOR = 1.9, P < 0.001). Younger age (< 20 years; AOR = 1.6, P = 0.042) and living in rural areas (AOR = 1.9, P < 0.001) were predictors of maternal malaria at delivery. Being primigravidae (AOR = 2.2, P = 0.023) and preterm delivery (AOR = 2.6, P < 0.001) predicted low birth weight while younger age was also associated with premature delivery (AOR = 1.4, P = 0.031). CONCLUSION: The coverage for two and >/= 3 doses of IPTp-SP is moderately higher than estimates from routine health facility records in Gaza province in 2015. However, this is still far below the national target of 80% for >/= 3 doses. Ongoing campaigns aiming to increase the use of malaria prevention strategies during pregnancy should particularly target rural populations, increasing IPTp-SP knowledge, stimulate early visits to ANC, improve access to health services and the quality of the service provided. en_US
dc.language English en_US
dc.relation.uri http://www.ncbi.nlm.nih.gov/pubmed/29530044 en_US
dc.subject Malaria en_US
dc.subject Protozoal diseases en_US
dc.subject Treatment en_US
dc.subject Prevention en_US
dc.subject Pregnancy en_US
dc.subject Outcomes en_US
dc.subject Mozambique en_US
dc.subject Africa-Southern en_US
dc.title Uptake of intermittent preventive treatment and pregnancy outcomes: health facilities and community surveys in Chokwe district, southern Mozambique en_US
dc.type Article-E en_US
dc.citation.issue 1 en_US
dc.citation.jtitle Malaria Journal en_US
dc.citation.volume 17 en_US
dc.citation.pages 109 en_US
dc.citation.abbreviation Malar J en_US


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