Brabin Loretta, Stokes Elizabeth, Dumbaya Isatou, Owens Stephen
Academic Unit of Obstetrics & Gynaecology, University of Manchester, Manchester M13 OJH, UK.
Malar J. 2009 Feb 12;8:25. doi: 10.1186/1475-2875-8-25.
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.
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.
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.
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.
大多数抗疟药物在孕期的使用受到限制，但推荐在孕中期之后服用两剂磺胺多辛-乙胺嘧啶作为孕期间歇性预防治疗（IPTp）。在冈比亚，只有32%的女性接受了两剂治疗，而且针对女性对孕期药物安全性的认知开展的研究极少。本文的目的是评估冈比亚农村女性是否了解两剂IPTp给药方案的时间安排的重要性及其与药物安全性的相关性。
这是一项定性研究，对女性、青少年、男性和传统助产士进行了41次访谈和16次焦点小组讨论。采用通用的定性方法来生成关于女性可能未按推荐参与IPTp的原因的理论。
尽管大多数女性用月份来计算孕期阶段，但这些月份与她们对胎儿发育的概念并不相关。胎儿生长按照伊斯兰教传统被描述为水、凝块、肉块和人，不过对于这些阶段出现的顺序或时间几乎没有共识。疟疾的常见症状和情况是已知的。女性担心流产，并且认识到有些药物在孕早期不应服用，但男性和传统助产士敦促她们在孕早期去进行产前检查以“开始治疗”。男性和女性对孕期用药的目的以及何时应该服药的常识都很匮乏。一个重要的结果是女性完全依赖医护人员在正确的时间提供安全的药物。
女性没有相关信息来判断孕期用药的安全性和合适的时间，这使她们过度依赖医护人员。应该鼓励她们用与文化相关的方式来确定自己的孕周，并预期何时以及应该服用哪种药物。
