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Increased uptake of intermittent preventive treatment for malaria in pregnant women in Zambia(2006–2012):Potential determinants and highlight of lessons learnt

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Asian Pacific Journal of Tropical Biomedicine 2016年第7期6卷 620-624页

作者： Freddie Masaninga Mary Katepa Bwalya Sarai Malumo Busiku Hamainza Peter Songolo mulakwa kamuliwo Martin Meremikwu Lawrence Kazembe Jacob Mufunda Olusegun Ayorinde Babaniyi World Health Organization Ministry of Health Department of Pediatrics University of Calabar Teaching Hospitals Biostatistics Department University of Namibia

Objective:To assess potential determinants of uptake and highlight lessons learnt from the implementation of intermittent preventive treatment(IPTp), given to pregnant women as early as possible during the second trimester in ***: Data from four national malaria surveys(2006, 2008, 2010, 2012) were reviewed, and proportions of pregnant women attending antenatal clinics(ANCs) who received two or more doses of sulfadoxine–pyrimethamine(IPTp2) were compared by place of residence, education level, and wealth status. Malaria cases and deaths in pregnant women, from Health Information Management System 2011–2013, were analyzed to determine malaria burden in pregnancy in Zambia. A multiple logistic regression model was applied to identify potential determinants of IPTp ***: The proportion of pregnant women who took IPTp at ANCs increased from near zero at inception in 2001 to 61.9% in 2006; and to 72% by 2012(P < 0.001), and overall the uptake was 1.41 times higher in 2012 compared to 2006. From 2006 to 2012,IPTp2 uptake among women with no formal education increased from 51% to 68%(P < 0.1). Likewise, uptake among pregnant women with the lowest wealth index increased from 58.2% to 61.2%. By 2012, IPTp uptake among pregnant women within the lowest wealth index increased to a similar level as the women with high wealth index(P = 0.05). Incidence of malaria cases, hospital admissions and mortality during pregnancy decreased between 2011 and 2013. Overall, increased IPTp uptake was associated with being in urban areas(OR = 1.56, 95% CI: 1.39–1.74), having college(OR = 1.83,95% CI: 1.25–2.75) or secondary education(OR = 1.68, 95% CI: 1.44–1.96) or of being of higher wealth status(OR = 1.86, 95% CI: 1.60–2.17).Conclusions: Zambia has increased IPTp uptake through ANC for all women. The malaria control program has contributed to increasing access to health services and reducing demographic and socioeconomic disparities.

关键词： Intermittent preventive treatment Malaria Pregnancy Zambia

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Review of the malaria epidemiology and trends in Zambia

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Asian Pacific Journal of Tropical Biomedicine 2013年第2期3卷 89-94页

作者： Freddie Masaninga Emmanuel Chanda Pascalina Chanda-Kapata Busiku Hamainza Hieronymo T Masendu mulakwa kamuliwo Wambinji Kapelwa John Chimumbwa John Govere Mac Otten Ibrahima Soce Fall Olusegun Babaniyi World Health Organization(WHO) Country Office National Mataria Control Centre(NMCC) Ministry of Health HQ Africa Indoor Residual Spraying Zimbabwe Abt Associates Inc. Management Science for Health Chemonics International Malawi Indoor Residual Spraying LLC Inc Public Health International WHO Regional Office for Africa

A comprehensive desk review of malaria trends was conducted between 2000-2010 in Zambia to study malaria epidemiology and trends to guide strategies and approaches for effective malaria *** review considered data from the National Health Information Management System,Malaria Surveys and Programme Review reports and analyzed malaria in-patient cases and deaths in relation to intervention coverage for all *** showed three distinct epidemiological strata after a notable malaria reduction(66%)in in-patient cases and deaths,particularly between *** changes occurred following the(re-)introduction and expansion of indoor residual spraying up to 90%coverage,scale-up of coverage of long-lasting insecticidetreated nets in household from 50%to 70%,and artemisin-based combination therapy ***,malaria cases and deaths re-surged,increasing in 2009-2010 in the northern-eastern parts of *** in the disbursement of funds affected the implementation of interventions,which resulted in resurgence of cases and *** spite of a decline in malaria disease burden over the past decade in Zambia,a reversal in impact is notable in the year 2009-2010,signifying that control gains are fragile and must be sustained toeliminate malaria.

关键词： Malaria Epidemiology Trends Zambia

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