Document Detail


Rural Gambian women's reliance on health workers to deliver sulphadoxine-pyrimethamine as recommended intermittent preventive treatment for malaria in pregnancy.
MedLine Citation:
PMID:  19216759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The use of most anti-malarial medications is restricted during pregnancy, but two doses of sulphadoxine-pyrimethamine are recommended after the first trimester as intermittent preventive treatment in pregnancy (IPTp). In The Gambia, only 32% of women receive two doses and very little research has been conducted on women's awareness of drug safety during pregnancy. The objective of this paper was to assess whether rural Gambian women were aware of the importance of the timing of the two-dose IPT dose schedule and its relevance to drug safety.
METHODS: This was a qualitative study in which 41 interviews and 16 focus group discussions with women, adolescents, men and traditional birth attendants were conducted. A generic qualitative approach was used to generate a theory as to why women might not participate in IPTp as recommended.
RESULTS: Although most women used calendar months to count their stage of pregnancy, these months did not correlate with their concept of foetal development. Foetal growth was described following Islamic tradition as water, clot, piece of meat and human being, although there was little consensus about the order or timing in which these stages occurred. Common signs and conditions of malaria were known. Women were anxious about miscarriage and recognized that some medicines should not be taken in the first trimester, but were urged by men and traditional birth attendants to attend for antenatal care in the first trimester to "start treatment." General knowledge about the purpose of pregnancy medications and when they should be taken was poor among both men and women. One important result was that women relied entirely on health workers to provide safe drugs, at the correct time.
CONCLUSION: Women did not have relevant information to judge the safety and appropriate timing of pregnancy drugs, which made them over-reliant on health workers. They should be encouraged to date their own pregnancies in culturally relevant terms and to anticipate when and which medications they should receive.
Authors:
Loretta Brabin; Elizabeth Stokes; Isatou Dumbaya; Stephen Owens
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-02-12
Journal Detail:
Title:  Malaria journal     Volume:  8     ISSN:  1475-2875     ISO Abbreviation:  Malar. J.     Publication Date:  2009  
Date Detail:
Created Date:  2009-03-16     Completed Date:  2009-03-30     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  101139802     Medline TA:  Malar J     Country:  England    
Other Details:
Languages:  eng     Pagination:  25     Citation Subset:  IM    
Affiliation:
Academic Unit of Obstetrics & Gynaecology, University of Manchester, Manchester M13 OJH, UK. loretta.brabin@manchester.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antimalarials / administration & dosage*,  therapeutic use
Drug Administration Schedule
Drug Combinations
Female
Gambia / epidemiology
Guideline Adherence
Health Knowledge, Attitudes, Practice*
Health Personnel / organization & administration
Humans
Malaria / drug therapy,  prevention & control*
Middle Aged
Patient Acceptance of Health Care
Pregnancy
Pregnancy Complications, Parasitic / drug therapy,  prevention & control*
Prenatal Care / methods
Pyrimethamine / administration & dosage*,  therapeutic use
Qualitative Research
Rural Population
Sulfadoxine / administration & dosage*,  therapeutic use
Young Adult
Chemical
Reg. No./Substance:
0/Antimalarials; 0/Drug Combinations; 2447-57-6/Sulfadoxine; 37338-39-9/fanasil, pyrimethamine drug combination; 58-14-0/Pyrimethamine
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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