Résumé
Background: Effective prevention and control of malaria during pregnancy include prompt and effective case management of malaria combined with prevention of infection by the use of insecticide-treated nets and intermittent preventive treatment in pregnancy (IPTp). Care givers knowledge and practice of malaria control is pivotal to effective implementation of these guidelines. The objective of this study was to determine the awareness of care providers in facilities offering maternity services in Ibadan of the National Malaria Treatment Guideline and Policy in Nigeria. The study also aimed to describe the prescription practice, for malaria chemoprophylaxis and case management in pregnancy, by these care providers.
Materials and method: The study was a cross-sectional survey of the lead care givers in all registered hospitals and maternity centres in Ibadan over one year (April 2008 to April 2009), using structured questionnaires. The list of the one hundred and thirty-two (132) registered centres was obtained from the State Ministry of Health. The lead care givers provided information on their awareness of the new government policy and antimalarials believed to be effective and prescribed for malaria prevention and case management in pregnancy.
Results: Over two thirds (84.2%) of the facilities were operated by either Medical Officers with only basic medical training or by Nurses/ Midwives. The modes of prevention most commonly reported as being effective were the use of insecticide spray, window nets and ITN. The drugs most commonly prescribed for chemoprophylaxis were sulphadoxine- pyrimethamine (SP) (65.2%),
Proguanil (45.5%) and pyrimethamine (42.4%). The drugs most commonly prescribed for case management were ACTs (66.7%), amodiaquine (59.8%) and artemether (47.7%). Quite a number of respondents were unsure of the frequency (81.8%) and timing (56.5%) of administration of sulphadoxine-pyrimethamine for prophylaxis.
Conclusion: This study demonstrates awareness but lack of in-depth knowledge of control measures. Also, there is poor use of the recommended agent for IPT. The factors militating against the use of these preventive measures need to be urgently explored and addressed.
Keywords:-Malaria in pregnancy, chemoprophylaxis, intermittent preventive therapy
Résumé
Le contrôle et la prévention effective du paludisme pendant la grossesse inclus les soins précis et efficaces combiné avec la prévention de l’infection par l’usage des moustiquaires imprégnés et le traitement préventif intermittent en grossesse (TPI). La connaissance et la pratique des personnels de santé est important dans l’implémentation effective des instructions. L’objectif de cette étude était de déterminer le sensibilisation des personnels de santé enregistrés dans les centres de santé offrant les soins de maternité à Ibadan du Programme de traitement, guide et politique nationale sur le paludisme d’Avril 2008 à Avril 2009 en utilisant un questionnaire structuré. L’étude aussi avait pour but de décrire les pratiques de chimioprophaxie et des soins en grossesse by les personnels de santé. Au total cent trente deux (132) centres enregistrés par le ministère de santé de cet état. Les personnels de santé apportaient des informations de senbilisation sur la nouvelle politique gouvernementale et les médicaments antipalustres pourraient être effectifs et prescrit dans la prévention et les soins du paludisme. Plus de deux tiers (84.2%) des facilités étaient opérés par les médecins avec juste une formation médicale généraliste ou par une infirmière ou sage femme. Les modes de prévention les plus communément rapportées étant efficace étaient l’usage des insecticides, moustiquaires de fenêtres et moustiquaires impregnés, Les médicaments les plus communément prescrit pour chimioprophylaxie étaient la sulfadoxine- pyrimethamine (SP) (65.2%), Proguanil (45.5%) et pyrimethamine (42.4%). Les médicaments couramment prescrit dans les soins étaient les CTAs (66.7%), amodiaquine (59.8%) et Artemether (47.7%). Quelques participants n’étaient pas sûr de la fréquence (81.8%) et de planification (56.5%) d’administration de la sulfadoxine- pyrimethamine pour prophylaxie. Cette étude démontre une sensibilisation mais un manque de connaissances approfondies sur les mesures de contrôle. Aussi, Il y avait un faible usage des mesures préventives recommandées. Les facteurs influençant l’usage de ces mesures nécessitent d’être des recherches.
Correspondence: Dr. A. Oladokun, Department of Obstetrics and Gynaecology, C ollege of Medicine, University of Ibadan, Ibadan, Nigeria. E-mail: sinaoladokun@yahoo.com; oladokun@comui.edu.ng
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