Prevention and treatment of malaria in pregnancy: what do pregnant women and health care workers in East India know and do about it?
Prevention and treatment of malaria in pregnancy: what do pregnant women and health care workers in East India know and do about it?
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DOI：
10.1186/s12936-018-2339-9
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发表时间：
2018-05-18
期刊：
影响因子：
3
通讯作者：
Hamer, Davidson H.
中科院分区：
文献类型：
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作者：
Sabin, Lora;Hecht, Evan M. S.;Hamer, Davidson H.
背景：印度开展了有限的定性研究，以调查孕妇对疟疾的看法和行为，尽管存在与疟疾有关的不良孕产妇和新生儿结局的威胁。为了弥补这一差距，对印度孕妇的疟疾防治态度、知识和行为进行了一项全面的研究。方法：对印度恰尔肯德邦和恰蒂斯加尔邦的7个医院地点和附近社区的孕妇和医护人员(包括以诊所为基础的提供者、传统助产士和辅助护士-助产士)进行了深入访谈。问题涉及有关疟疾预防和治疗的健康关切和态度、知识和做法；调查涉及现代和传统方法。结果：共有83名孕妇和119名医务工作者参与了202个注射吸毒者，其中90人在恰尔肯德邦，112人在恰蒂斯加尔邦。大多数恰尔肯德邦的受访者，但只有四分之一的恰蒂斯加尔邦，将疟疾列为孕妇的首要健康问题。刚刚超过一半的孕妇愿意尝试新的预防方法(特别是经杀虫剂处理的蚊帐)，尽管强调了此类方法的成本障碍。大多数受访者表达了对怀孕期间疟疾治疗的担忧，主要是提到对婴儿的潜在伤害。大多数人知道蚊子传播疟疾，但包括卫生工作者在内的相当少数人描述了不正确的传播方式。大多数人知道一种经过验证的预防方法(通常是蚊帐或蚊帐)；少数人知道其他方法。少数孕妇，但大多数卫生工作者知道疟疾治疗，尽管一些卫生工作者描述了未经证实的治疗方法。大多数受访者描述了在他们的社区使用现代预防方法，通常是蚊帐，尽管调查显示使用不规律。一半的人(尤其是在恰尔肯德邦，尤其是卫生工作者)描述了使用传统的预防方法，如焚烧树叶和在身体上擦油；传统的疟疾治疗方法很常见，而且因地点和人口而异。结论：对疟疾的理解不同，孕妇对疟疾的关注，在印度这一人群中继续使用未经证实的疟疾预防和治疗策略是显而易见的。这些结果突出表明，需要对孕妇和卫生工作者进行有关有效的疟疾方法的教育，以保护孕妇及其婴儿免受疟疾的侵袭。
Background: Limited qualitative research has been performed in India to investigate views and behaviours of pregnant women regarding malaria despite the threat of malaria-related adverse maternal and neonatal outcomes. To address this gap, a comprehensive study on malaria prevention and treatment attitudes, knowledge and behaviour among pregnant women in India was conducted.Methods: Pregnant women and healthcare workers (HCWs), encompassing clinic-based providers, traditional birth attendants, and auxiliary nurse-midwives were enrolled for in-depth interviews (IDIs) at 7 hospital sites and nearby communities in Jharkhand and Chhattisgarh States. Questions addressed health concerns and attitudes, knowledge and practices regarding malaria prevention and treatment; probing covered modern and traditional approaches. Data were analyzed using a thematic approach.Results: A total of 83 pregnant women and 119 HCWs participated in 202 IDIs, 90 in Jharkhand and 112 in Chhattisgarh. A majority of Jharkhand respondents, but only one-fourth in Chhattisgarh, named malaria among top health issues for pregnant women. Just over half of pregnant women were willing to try new prevention methods (especially insecticide-treated bed nets), although cost-related barriers to such methods were stressed. Most respondents voiced concerns about malaria treatment during pregnancy, mainly citing potential harm to the baby. Most knew that mosquitoes transmitted malaria, but a substantial minority, including among HCWs, described incorrect transmission modes. Most knew a proven prevention method (usually bed nets or coils); a few knew other methods. A minority of pregnant women, but most HCWs, knew about malaria treatment, although some HCWs described unproven treatments. Most respondents described use of modern prevention methods in their communities, typically bed nets, although probing revealed irregular use. Half (especially in Jharkhand and particularly HCWs) described use of traditional prevention approaches such as burning leaves and rubbing oils on the body; traditional remedies for malaria treatment were common, and varied by site and population.Conclusions: Understanding of malaria varied as a concern for pregnant women, continued use of unproven malaria prevention and treatment strategies was evident in this population in India. These results highlight the need to educate both pregnant women and HCWs about effective malaria methods to protect pregnant women and their babies from malaria.