Use of intermittent presumptive treatment and insecticide treated bed nets by pregnant women in four Kenyan districts
Use of intermittent presumptive treatment and insecticide treated bed nets by pregnant women in four Kenyan districts
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DOI：
10.1046/j.1365-3156.2003.01193.x
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发表时间：
2004-02-01
影响因子：
3.3
通讯作者：
Snow, RW
中科院分区：
文献类型：
--
作者：
Guyatt, HL;Noor, AM;Snow, RW
减少疟疾运动提倡使用经杀虫剂处理的蚊帐和疟疾感染的间歇假定治疗，作为预防疟疾对非洲孕妇不利影响的措施。为了确定这些预防措施的使用情况，我们于2001年12月对从肯尼亚四个区的社区中随机选出的最近怀孕的妇女进行了一次以社区为基础的调查。在接受调查的1814名女性中，只有5%的人睡在驱虫蚊帐下。在使用蚊帐（经处理或未经处理）的13%妇女中，一半以上是从商店或市场购买蚊帐。农村地区妇女使用蚊帐的比例低于城市妇女（11%对27%; P < 0.001），农村妇女使用的蚊帐中有41%是从邦多的一个研究项目或全国范围的儿童基金会通过产前诊所捐赠的。尽管96%的ANC供应商知道IPT与磺胺嘧啶乙胺嘧啶（SP），只有5%的受访妇女接受了两个或两个以上剂量的SP作为假定治疗。至少接受过一剂IPT和SP的孕妇覆盖率为14%，但也有类似比例的孕妇至少接受过一剂IPT作为治愈性治疗。2001年，在肯尼亚多样化的疟疾生态中，国家推荐的怀孕期间预防疟疾战略的覆盖率很低。必须迅速扩大获得这些服务的机会，以便在2005年之前实现国际和国家目标。通过产前护理服务扩大疟疾预防方案的规模是可能的，在所有四个区，74%的妇女至少两次到产前护理中心就诊。商品供应和客户服务成本问题将是实现成果管理制目标的最大障碍。
The roll back malaria (RBM) movement promotes the use of insecticide-treated bednets (ITNs) and intermittent presumptive treatment (IPT) of malaria infection as preventive measures against the adverse effects of malaria among pregnant women in Africa. To determine the use of these preventive measures we undertook a community-based survey of recently pregnant women randomly selected from communities in four districts of Kenya in December 2001. Of the 1814 women surveyed, only 5% had slept under an ITN. More than half of the 13% of women using a bednet (treated or untreated) had bought their nets from shops or markets. Women from rural areas used bednets less than urban women (11%vs. 27%; P < 0.001), and 41% of the bednets used by rural women had been obtained free of charge from a research project in Bondo or a nationwide UNICEF donation through antenatal clinics (ANCs). Despite 96% of ANC providers being aware of IPT with sulphadoxine-pyrimethamine (SP), only 5% of women interviewed had received two or more doses of SP as a presumptive treatment. The coverage of pregnant women with at least one dose of IPT with SP was 14%, though a similar percentage also had received at least a single dose as a curative treatment. The coverage of nationally recommended strategies to prevent malaria during pregnancy during 2001 was low across the diverse malaria ecology of Kenya. Rapid expansion of access to these services is required to meet international and national targets by the year 2005. The scaling up of malaria prevention programmes through ANC services should be possible with 74% of women visiting ANCs at least twice in all four districts. Issues of commodity supply and service costs to clients will be the greatest impediments to reaching RBM targets.