Is there a distinction between malaria treatment and intermittent preventive treatment? Insights from a cross-sectional study of anti-malarial drug use among Ugandan pregnant women

Malaria Journal

Research

Josaphat Byamugisha¹  Kuteesa R Bisaso²  Charles O Odongo³  Freddy Kitutu⁴  Celestino Obua⁵ 

[1] Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda;Department of Pharmacology and Therapeutics, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda;Department of Pharmacology and Therapeutics, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda;Department of Pharmacology and Therapeutics, Faculty of Medicine, Gulu University, Gulu, Uganda;Department of Pharmacy, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda;Mbarara University of Science and Technology, Mbarara, Uganda;

关键词: Malaria treatment;    Intermittent preventive treatment;    Sulphadoxine-pyrimethamine;    Pregnant women;    Uganda;   

DOI  :  10.1186/s12936-015-0702-7

 received in 2014-10-20, accepted in 2015-04-20,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIn Uganda, treatment of clinical malaria and intermittent preventive treatment with sulphadoxine-pyrimethamine (SP) are common during pregnancy. As a result, both formal and informal reports from antenatal sources suggest possible misuse of SP for malaria treatment among pregnant women. The objective of this study was to investigate anti-malarial drug use patterns among women who had recently suffered malaria illness before and during pregnancy.MethodsA cross-sectional study in which a structured questionnaire (interviewer-administered) was used to collect data from pregnant women attending an urban antenatal clinic. Details of medicines used to treat malaria episodes suffered before and during pregnancy were captured. A first order Markov probability model was used to estimate probabilities of transitioning between treatment choices made before and during pregnancy. Logistic regression was used to explore whether demographic and obstetric characteristics were associated with transition patterns.ResultsSeven hundred women were interviewed among whom 428 had suffered malaria in both instances. Three hundred thirty of these could recall the medicines used in both instances. Women who used ACT/QNN (correct choice) before pregnancy had higher probabilities of transitioning to SP than staying on ACT/QNN during pregnancy (0.463 versus 0.451). Access of medicines from private outlets (clinics and pharmacies) were more than nine times predictive of receiving correct medicines (p=0.035 and p=0.039 respectively). Access of medicines from clinics was 5.9 times protective against receiving SP for malaria treatment (p=0.033). Among those who used SP before pregnancy, there was a 0.75 probability of staying on it during pregnancy. None of the factors explored could explain this observation.ConclusionUse of SP for malaria treatment is common during pregnancy. This may be contributing to adverse pregnancy outcomes. Antenatal care providers should endeavour to emphasize the distinction between treatment and prevention of malaria during pregnancy.

【 授权许可】

CC BY   
© Odongo et al.; licensee BioMed Central. 2015