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
Loading...
Date
2015
Authors
Odongo, Charles O.
Bisaso, Kuteesa R.
Kitutu, Freddy
Obua, Celestino
Byamugisha, Josaphat
Journal Title
Journal ISSN
Volume Title
Publisher
Malaria journal
Abstract
In Uganda, treatment of clinical malaria and intermittent preventive treatment with sulphadoxinepyrimethamine (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.
Methods: A 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.
Results: Seven 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.
Conclusion: Use 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.
Description
Keywords
Malaria treatment, Intermittent preventive treatment, Sulphadoxine-pyrimethamine, Pregnant women, Uganda
Citation
Odongo, C. O., Bisaso, K. R., Kitutu, F., Obua, C., & Byamugisha, J. (2015). 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, 14(1), 1-8. DOI 10.1186/s12936-015-0702-7