Access and barriers to measures targeted to prevent malaria in pregnancy in rural Kenya
Access and barriers to measures targeted to prevent malaria in pregnancy in rural Kenya
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DOI：
10.1111/j.1365-3156.2007.01992.x
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发表时间：
2008-02-01
影响因子：
3.3
通讯作者：
Snow, Robert W.
中科院分区：
文献类型：
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作者：
Gikandi, Priscilla W.;Noor, Abdisalan M.;Snow, Robert W.
为了评估障碍，防止孕妇使用驱虫蚊帐（ITN）和间歇性推定治疗（IPT）与磺胺嘧啶乙胺嘧啶（SP）5年后推出的国家疟疾战略，促进这些措施在Keny.METHODS所有妇女年龄在15-49岁进行了采访，在2006年12月和2007年1月之间的四个地区的社区调查。对过去12个月内怀孕的妇女进行了调查，询问她们的年龄、产次、教育程度、蚊帐使用情况、驱虫蚊帐、产前保健服务和磺胺乙胺嘧啶（总体和用于IPT）。记录了宅基地资产，并用于制定财富指数。使用地理信息系统算法计算前往ANC诊所的旅行时间。净和IPT使用的预测因素进行了定义，使用多变量logistic regression.RESULTS总体68%的孕妇使用净; 52%使用ITN; 84%参加ANC诊所至少一次，74%至少两次。53%的女性至少服用了一剂IPT-SP，但只有22%的女性服用了两剂或两剂以上。来自最不贫困家庭的妇女（OR = 2.53，1.36-4.68）和使用IPT服务的妇女（OR = 1.73，1.24-2.42）更有可能睡在任何蚊帐下。使用IPT的妇女更有可能使用ITN（OR 1.35，1.03-1.77），而那些住在ANC诊所一个小时以上的人不太可能使用ITN（OR 0.61，0.46-0.81）。妇女与正规教育（1.47，1.01-2.17）和那些谁使用ITN（OR：1.68，1.20-2.36）更有可能已经收到至少一个剂量的IPT-SP.CONCLUSION虽然使用ITN增加了10倍，使用IPT四倍，因为最后一次测量在2001年，覆盖率仍然很低。提供者在提供疟疾预防措施方面的做法必须改变，并辅之以关于母亲使用因特网预防疗法重要性的社区宣传运动。
OBJECTIVES To evaluate barriers preventing pregnant women from using insecticide-treated nets (ITN) and intermittent presumptive treatment (IPT) with sulphadoxine-pyrimethamine (SP) 5 years after the launch of the national malaria strategy promoting these measures in Kenya.METHODS All women aged 15-49 years were interviewed during a community survey in four districts between December 2006 and January 2007. Women pregnant in the last 12 months were asked about their age, parity, education, use of nets, ITN, antenatal care (ANC) services and sulphadoxine-pyrimethamine (SP) (overall and for IPT) during pregnancy. Homestead assets were recorded and used to develop a wealth index. Travel time to ANC clinics was computed using a geographic information system algorithm. Predictors of net and IPT use were defined using multivariate logistic regression.RESULTS Overall 68% of pregnant women used a net; 52% used an ITN; 84% attended an ANC clinic at least once and 74% at least twice. Fifty-three percent of women took at least one dose of IPT-SP, however only 22% took two or more doses. Women from the least poor homesteads (OR = 2.53, 1.36-4.68) and those who used IPT services (OR = 1.73, 1.24-2.42) were more likely to sleep under any net. Women who used IPT were more likely to use ITNs (OR 1.35, 1.03-1.77), while those who lived more than an hour from an ANC clinic were less likely (OR 0.61, 0.46-0.81) to use ITN. Women with formal education (1.47, 1.01-2.17) and those who used ITN (OR: 1.68, 1.20-2.36) were more likely to have received at least one dose of IPT-SP.CONCLUSION Although the use of ITN had increased 10-fold and the use of IPT fourfold since last measured in 2001, coverage remains low. Provider practices in the delivery of protective measures against malaria must change, supported by community awareness campaigns on the importance of mothers' use of IPT.