Systemic constraints continue to limit coverage of intermittent preventive treatment for malaria in pregnancy in southeast Tanzania
Systemic constraints continue to limit coverage of intermittent preventive treatment for malaria in pregnancy in southeast Tanzania
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DOI：
10.1093/inthealth/iht005
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发表时间：
2013-06-01
影响因子：
2.5
通讯作者：
Ba-Break, Maryam M.
中科院分区：
文献类型：
--
作者：
Graham, Kirstie J.;Ba-Break, Maryam M.
从卫生工作者的角度探讨了坦桑尼亚孕期疟疾间歇性预防治疗覆盖面的限制因素，以便提出改进服务提供的建议。最近的数据估计，推荐的两剂IPTp的覆盖率为26.3，远低于80的国家目标。2011年6月，在坦桑尼亚东南部伊奎里里对13名卫生工作者和2名卫生管理人员进行了半结构化采访。周效磺胺乙胺（SP）的交付受到药物短缺和广泛缺货的严重限制，这表明更广泛的卫生系统仍存在困难。虽然SP是众所周知的，对IPTp的态度是积极的，但卫生工作者往往不知道最新的给药时间表，限制了覆盖面。最近的文献表明，这可能是由于国家指导方针不一致和相互冲突造成的。此外，它被发现，两个药丸，而不是推荐的三个药丸，每剂量的IPTp经常给孕妇，一个发现以前unreported.To最大限度地提高IPTp的覆盖率，足够的和一致的供应SP的公共和私人卫生设施是必要的，结合有效的沟通修改剂量表。进一步的研究是必要的，以调查每剂量两片药丸的异常管理，因为它可能会加剧耐药性。
Factors limiting coverage of intermittent preventive treatment for malaria in pregnancy (IPTp) in Tanzania were explored from the perspective of health workers, in order to make recommendations to improve service delivery. Recent data estimates coverage of the recommended two doses of IPTp at 26.3, far short of the national target of 80.Semistructured interviews were conducted with 13 health workers and 2 health managers during June 2011 in Ikwiriri, southeast Tanzania.Delivery of sulfadoxinepyrimethamine (SP) was severely constrained by drug shortages and widespread stock-outs, indicative of ongoing difficulties in the wider health system. While SP was well known and attitudes towards IPTp were positive, health workers were often not informed of up-to-date dosing schedules, limiting coverage. Recent literature suggests this could be due to inconsistent and conflicting national guidelines. In addition, it was found that two pills, instead of the recommended three pills, per dose of IPTp were frequently given to pregnant women, a finding previously unreported.To maximize IPTp coverage, sufficient and consistent supplies of SP to both public and private health facilities are a necessity, combined with effective communication of revised dosing schedules. Further research is warranted to investigate the aberrant administration of two pills per dose, as it may exacerbate drug resistance.