title: Patterns of case management and chemoprevention for malaria-in-pregnancy by public and private sector health providers in Enugu state, Nigeria.
abstract: BACKGROUND
  Malaria in pregnancy (MIP) is a major disease burden in Nigeria and has adverse consequences on the health of the mother, the foetus and the newborn. Information is required on how to improve its prevention and treatment from both the providers' and consumers' perspectives.
  
  
  METHODS
  The study sites were two public and two private hospitals in Enugu, southeast Nigeria. Data was collected using a pre-tested structured questionnaire. The respondents were healthcare providers (doctors, pharmacists and nurses) providing ante-natal care (ANC) services. They consisted of 32 respondents from the public facilities and 20 from the private facilities. The questionnaire elicited information on their: knowledge about malaria, attitude, chemotherapy and chemoprophylaxis using pyrimethamine, chloroquine proguanil as well as IPTp with sulphadoxine-pyrimethamine (SP). The data was collected from May to June 2010.
  
  
  RESULTS
  Not many providers recognized maternal and neonatal deaths as potential consequences of MIP. The public sector providers provided more appropriate treatment for the pregnant women, but the private sector providers found IPTp more acceptable and provided it more rationally than public sector providers (p < 0.05). It was found that 50 % of private sector providers and 25 % of public sector providers prescribed chemoprophylaxis using pyrimethamine, chloroquine and proguanil to pregnant women.
  
  
  CONCLUSIONS
  There is sub-optimal level of knowledge about current best practices for treatment and chemoprophylaxis for MIP especially in the private sector. Also, IPTp was hardly used in the public sector. Interventions are required to improve providers' knowledge and practices with regards to management of MIP.
authors.affiliation: Department of Pharmacy, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria.
authors.forename: Ogochukwu C
authors.initials: OC
authors.lastname: Onwujekwe
authors.forename: Rebecca O
authors.initials: RO
authors.lastname: Soremekun
authors.forename: Benjamin
authors.initials: B
authors.lastname: Uzochukwu
authors.forename: Elvis
authors.initials: E
authors.lastname: Shu
authors.forename: Obinna
authors.initials: O
authors.lastname: Onwujekwe
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D019090:Case Management / Q000706:statistics & numerical data / Q000639:trends; D018890:Chemoprevention / Q000706:statistics & numerical data / Q000639:trends; D002738:Chloroquine / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D008288:Malaria / Q000188:drug therapy* / Q000517:prevention & control; D009549:Nigeria; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy* / Q000517:prevention & control; D017149:Private Sector / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D011739:Pyrimethamine / Q000627:therapeutic use; D013413:Sulfadoxine / Q000627:therapeutic use; D011795:Surveys and Questionnaires
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D011739:Pyrimethamine