title: Acceptability of coupling intermittent preventive treatment in infants with the expanded programme on immunization in three francophone countries in Africa.
abstract: OBJECTIVE
  Intermittent preventive treatment in infants (IPTi) is a malaria control strategy currently recommended by WHO for implementation at scale in Africa, consisting of administration of sulphadoxine-pyrimethamine (SP) coupled with routine immunizations offered to children under 1 year. In this study, we analysed IPTi acceptability by communities and health staff.
  
  
  METHODS
  Direct observation, in-depth interviews (IDIs) and focus group discussions (FGDs) were conducted in Benin, Madagascar and Senegal during IPTi pilot implementation. Villages were stratified by immunization coverage. Data were transcribed and analysed using NVivo7 software.
  
  
  RESULTS
  Communities' knowledge of malaria aetiology and diagnosis was good, although generally villagers did not seek treatment at health centres as their first choice. Perceptions and attitudes towards IPTi were very positive among communities and health workers. A misconception that SP was an antipyretic that prevents post-vaccinal fever contributed to IPTi's acceptability. No refusals or negative rumours related to IPTi coupling with immunizations were identified, and IPTi did not negatively influence attitudes towards other malaria control strategies. Healthcare decisions about children, normatively made by the father, are starting to shift to educated and financially independent mothers.
  
  
  CONCLUSIONS
  Intermittent preventive treatment in infants is well accepted by providers and communities, showing a synergic acceptability when coupled with routine immunizations. However, a misconception that SP alleviates fever should be addressed when scaling up implementation.
authors: World Health Organization, Geneva, Switzerland. desousaa@who.int
authors: Alexandra
authors: A
authors: de Sousa
authors: Leon P
authors: LP
authors: Rabarijaona
authors: Jean L
authors: JL
authors: Ndiaye
authors: Doudou
authors: D
authors: Sow
authors: Mouhamed
authors: M
authors: Ndyiae
authors: Jacques
authors: J
authors: Hassan
authors: Nilda
authors: N
authors: Lambo
authors: Paul
authors: P
authors: Adovohekpe
authors: Flavia
authors: F
authors: Guidetti
authors: Judith
authors: J
authors: Recht
authors: Alphonse
authors: A
authors: Affo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D058633:Antipyretics; D001291:Attitude of Health Personnel; D001428:Bacterial Vaccines; D001541:Benin; D003153:Community Health Services / Q000706:statistics & numerical data; D003657:Decision Making; D004338:Drug Combinations; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D008270:Madagascar; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008458:Measles Vaccine; D008875:Middle Aged; D010290:Parents; D010342:Patient Acceptance of Health Care; D010465:Perception; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use*; D012111:Residence Characteristics; D012675:Senegal; D013413:Sulfadoxine / Q000008:administration & dosage / Q000627:therapeutic use*; D014611:Vaccination; D014944:World Health Organization; D055815:Young Adult
chemical_list: D000962:Antimalarials; D058633:Antipyretics; D001428:Bacterial Vaccines; D004338:Drug Combinations; D008458:Measles Vaccine; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine