title: Use of antenatal care services and intermittent preventive treatment for malaria among pregnant women in Blantyre District, Malawi.
abstract: Malaria in pregnancy contributes to low birth weight and increased infant mortality. As part of WHO's Roll Back Malaria initiative, African heads of state pledged that by 2005, 60% of pregnant women will receive malaria chemoprophylaxis or intermittent preventive treatment (IPT). We performed a cluster sample survey to study the use of sulfadoxine-pyrimethamine (SP) for IPT among recently pregnant women in February 2000 in Blantyre District, Malawi. Among 391 women in the sample, 98.6% had attended antenatal clinic at least once and 90.2% knew that SP/IPT was recommended during pregnancy. Overall, only 36.8% received the full recommended two-dose regimen of SP/IPT. Using data from 187 women with antenatal clinic cards, we found that residence location, housing type and gender/age/education of the head of household were not associated with failure to receive SP/IPT. Adjusting for education, multigravid women were more likely not to receive the recommended SP/IPT regimen (RR 1.2, 95% CI 1.02-1.5, P=0.03). A substantial effort to improve the delivery and use of SP/IPT in Malawi will be necessary, but the Roll Back Malaria 2005 goal appears achievable.
authors.affiliation: Malaria Epidemiology Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. tkh@cdc.gov
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Holtz
authors.forename: S Patrick
authors.initials: SP
authors.lastname: Kachur
authors.forename: Jacquelin M
authors.initials: JM
authors.lastname: Roberts
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Marum
authors.forename: Christopher
authors.initials: C
authors.lastname: Mkandala
authors.forename: Nyson
authors.initials: N
authors.lastname: Chizani
authors.forename: Allan
authors.initials: A
authors.lastname: Macheso
authors.forename: Monica E
authors.initials: ME
authors.lastname: Parise
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000962:Antimalarials / Q000627:therapeutic use; D016000:Cluster Analysis; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control*; D008295:Malawi / Q000453:epidemiology; D008875:Middle Aged; D010298:Parity; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods / Q000706:statistics & numerical data*; D011739:Pyrimethamine / Q000627:therapeutic use; D013413:Sulfadoxine / Q000627:therapeutic use
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine