Intermittent preventive treatment of malaria in pregnancy: a new delivery system and its effect on maternal health and pregnancy outcomes in Uganda.

OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non-randomized communi...

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Publicado en:Bulletin of the World Health Organization Vol. 86; no. 2; pp. 93 - 101
Autores principales: Mbonye AK, Bygbjerg IC, Magnussen P
Formato: clinical trial research Journal Article
Publicado: World Health Organization Feb2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2008
      vid: 86
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      pub: World Health Organization
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        10.2471/blt.07-041822
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        atl: Intermittent preventive treatment of malaria in pregnancy: a new delivery system and its effect on maternal health and pregnancy outcomes in Uganda.
      aug:
        au:
          Mbonye AK
          Bygbjerg IC
          Magnussen P
        affil: Department of Community Health, Ministry of Health, Kampala, Uganda. vpadmn@infocom.co.ug
      sug:
        subj:
          Antimalarials Therapeutic Use
          Malaria Prevention and Control
          Maternal Welfare
          Pregnancy Outcomes
          Pyrimethamine Therapeutic Use
          Sulfadoxine Therapeutic Use
          Adolescence
          Adult
          Child
          Clinical Trials
          Drug Combinations
          Female
          Infant, Low Birth Weight
          Infant, Newborn
          Malaria Drug Therapy
          Malaria Epidemiology
          Middle Age
          Pregnancy
          Prevalence
          Program Development
          Risk Factors
          Time Factors
          Uganda
          Human
          Adolescent: 13-18 years
          Adult: 19-44 years
          Child: 6-12 years
          Infant, Newborn: birth-1 month
          Middle Aged: 45-64 years
          Female
      ab: OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non-randomized community trial was implemented in 21 community clusters (intervention) and four clusters where health units provided routine IPTp (control). The primary outcome measures were access and adherence to IPTp, number of malaria episodes, prevalence of anaemia, and birth weight. Numbers of live births, abortions, still births, and maternal and child deaths were secondary endpoints. FINDINGS: 1404 (67.5%) of 2081 with the new delivery system received two doses of sulfadoxine-pyrimethamine versus 281 (39.9%) of 704 with health units (P < 0.0001). The prevalence of malaria episodes decreased from 906 (49.5%) of 1830 to 160 (17.6%) of 909 (P < 0.001) with the new delivery system and from 161 (39.1%) of 412 to 13 (13.1%) of 99 (P < 0.001) with health units. Anaemia was significantly less prevalent in both arms. There was a lower proportion of low birth weight 6.0% with the new delivery system versus 8.3% with health units (P < 0.03). Few abortions and stillbirths were recorded in either arm. Fewer children and women who accessed IPTp with health units died than in the intervention group. CONCLUSION: The new approaches were associated with early access and increased adherence to IPTp. Health units were, however, more effective in reducing parasitaemia and malaria episodes. We recommend further studies to assess programming modalities linking the new approaches and health units. Copyright © 2008 World Health Organization
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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