Changing the policy for intermittent preventive treatment with sulfadoxine–pyrimethamine during pregnancy in Malawi

Malaria Journal

Case Study

Herbert Longwe¹  Christiaan de Jager²  Chikondi A. Mwendera²  Clifford M. Mutero³  Charles Hongoro⁴  Kamija Phiri⁵ 

[1] Mailman School of Public Health, ICAP at Columbia University, Pretoria, South Africa;School of Health Systems and Public Health, Institute for Sustainable Malaria Control (UP ISMC), University of Pretoria, Private Bag X363, 0001, Pretoria, South Africa;School of Health Systems and Public Health, Institute for Sustainable Malaria Control (UP ISMC), University of Pretoria, Private Bag X363, 0001, Pretoria, South Africa;International Centre of Insect Physiology and Ecology (ICIPE), P.O. Box 30772, Nairobi, Kenya;School of Health Systems and Public Health, Institute for Sustainable Malaria Control (UP ISMC), University of Pretoria, Private Bag X363, 0001, Pretoria, South Africa;Population Health, Health Systems and Innovation, Human Sciences Research Council (HSRC), Pretoria, South Africa;School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi;

关键词: Malaria;    Pregnancy;    Sulfadoxine–pyrimethamine;    Policy change;    Malawi;   

DOI  :  10.1186/s12936-017-1736-9

 received in 2017-01-07, accepted in 2017-02-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe growing resistance of Plasmodium falciparum to sulfadoxine–pyrimethamine (SP) treatment for uncomplicated malaria led to a recommendation by the World Health Organization for the use of artemisinin-based combination therapy. Inevitably, concerns were also raised surrounding the use of SP for intermittent prevention treatment of malaria during pregnancy (IPTp) amidst the lack of alternative drugs. Malawi was the first country to adopt intermittent prevention treatment with SP in 1993, and updated in 2013. This case study examines the policy updating process and the contribution of research and key stakeholders to this process. The findings support the development of a malaria research-to-policy framework in Malawi.MethodsDocuments and evidence published from 1993 to 2012 were systematically reviewed in addition to key informant interviews.ResultsThe online search identified 170 potential publications, of which eight from Malawi met the inclusion criteria. Two published studies from Malawi were instrumental in the WHO policy recommendation which in turn led to the updating of national policies. The updated policy indicates that more than two SP doses, as informed by research, overcome the challenges of the first policy of two SP doses only because of ineffectiveness by P. falciparum resistance and the global lack of replacement drugs to SP for IPTp.ConclusionInternational WHO recommendations facilitated a smooth policy change driven by motivated local leadership with technical and financial support from development partners. Policy development and implementation should include key stakeholders and use local malaria research in a research-to-policy framework.

【 授权许可】

CC BY   
© The Author(s) 2017