| Bottlenecks for high coverage of intermittent preventive treatment in pregnancy: the case of adolescent pregnancies in rural Burkina Faso. | |
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MedLine Citation:
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PMID: 20700460 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: While IPTp-SP is currently being scaled up in sub-Saharan Africa (SSA), the coverage with the required>or=2 doses of SP remains considerably short of the Roll Back Malaria (RBM) goal of 80%, not to mention of the recently advocated universal coverage. METHODS: The study triangulates quantitative data from a health center randomized community-based trial on IPTp-SP effectiveness and the additional benefit of a promotional campaign with qualitative data from focused ethnography. FINDINGS: In rural Burkina Faso, despite the significantly higher risk of malaria infection among adolescent primigravidae (PG) (OR 2.44 95%CI 1.81-3.28, p<0.001), making them primary target beneficiaries of IPTp-SP, adolescents adhered to the required three or more ANC visits significantly less (PG: 46.6%; SG 43.7%) than adults (PG: 61.9%; SG 54.9%) and had lower SP uptake during the malaria transmission season, further showing the difficulty of reaching this age group. Adolescents' structural constraints (such as their social position and household labor requirements) and needs (such as anonymity in the health encounter) leave them highly vulnerable during their pregnancies and, especially, during the high malaria transmission season. CONCLUSION: Our study shows that adolescents need to be targeted specifically, prior to their first pregnancy and with measures adapted to their social context, addressing their structural constraints and needs and going beyond standard health promotion campaigns. Unless such specific measures are taken, adolescents' social vulnerability will present a serious bottleneck for the effectiveness of IPTi-SP. |
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Authors:
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Koen Peeters Grietens; Sabine Gies; Sheick Oumar Coulibaly; Clotilde Ky; Judith Somda; Elizabeth Toomer; Joan Muela Ribera; Umberto D'Alessandro |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-08-06 |
Journal Detail:
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Title: PloS one Volume: 5 ISSN: 1932-6203 ISO Abbreviation: PLoS ONE Publication Date: 2010 |
Date Detail:
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Created Date: 2010-08-11 Completed Date: 2010-11-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101285081 Medline TA: PLoS One Country: United States |
Other Details:
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Languages: eng Pagination: e12013 Citation Subset: IM |
Affiliation:
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Prince Leopold Institute for Tropical Medicine, Antwerp, Belgium. kpeeters@itg.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Age Distribution Attitude to Health / ethnology Burkina Faso / ethnology Drug Combinations Female Health Promotion / statistics & numerical data Humans Malaria / prevention & control* Patient Compliance / ethnology, statistics & numerical data Pregnancy Pregnancy Complications / prevention & control* Prenatal Care / statistics & numerical data Pyrimethamine / pharmacology Rural Health Services / statistics & numerical data Rural Population / statistics & numerical data* Shame Sulfadoxine / pharmacology Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Drug Combinations; 2447-57-6/Sulfadoxine; 37338-39-9/sulfadoxine-pyrimethamine; 58-14-0/Pyrimethamine |
| Comments/Corrections | |
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