Evaluation of Implementation of Intermittent Screening and Treatment for Control of Malaria in Pregnancy in Jharkhand, India

This study evaluated intermittent screening and treatment during pregnancy (ISTp) for malaria using rapid diagnostic tests (RDTs) at antenatal care (ANC) compared with passive case detection within the routine health system. The mixed-method evaluation included two cross-sectional household surveys...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2020-06, Vol.102 (6), p.1343-1350
Main Authors: Webster, Jayne, Mishra, Vinit Kumar, Anvikar, Anupkumar R, Kuepfer, Irene, Hoyt, Jenna, Bruce, Jane, Greenwood, Brian, Chandramohan, Daniel, Valecha, Neena, Mishra, Neelima
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antimalarials - therapeutic use
Female
Humans
India - epidemiology
Malaria
Malaria - epidemiology
Malaria - prevention & control
Pregnancy
Pregnancy Complications, Parasitic - epidemiology
Pregnancy Complications, Parasitic - parasitology
Pregnancy Complications, Parasitic - prevention & control
Rural Population
Womens health
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:This study evaluated intermittent screening and treatment during pregnancy (ISTp) for malaria using rapid diagnostic tests (RDTs) at antenatal care (ANC) compared with passive case detection within the routine health system. The mixed-method evaluation included two cross-sectional household surveys (pre- and post-implementation of ISTp), in-depth interviews with health workers, and focus group discussions (FGDs) with pregnant women. Differences in proportions between surveys for a number of outcomes were tested; 553 and 534 current and recently pregnant women were surveyed (pre- and post-implementation, respectively). In-depth interviews were conducted with 29 health providers, and 13 FGDs were held with pregnant women. The proportion of pregnant women who received an RDT for malaria at ANC at least once during their pregnancy increased from pre- to post-implementation (19.2%; 95% CI: 14.9, 24.3 versus 42.5%; 95% CI: 36.6, 48.7; < 0.0001), and the proportion of women who had more than one RDT also increased (16.5%; 95% CI: 13.1, 20.5 versus 27.7%; 95% CI: 23.0, 33.0; = 0.0008). Post-implementation, however, only 8% of women who had completed their pregnancy received an RDT on three visits to ANC. Health workers were positive about ISTp mainly because of their perception that many pregnant women with malaria were asymptomatic. Health workers perceived pregnant women to have reservations about ISTp because of their dislike of frequent blood withdrawal, but pregnant women themselves were more positive. Intermittent screening and treatment during pregnancy was not sufficiently adopted by health workers to ensure the increased detection of malaria infections achievable with this strategy in this setting.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.19-0514