Doku David Teye, Zankawah Mumuni Mukaila, Adu-Gyamfi Addae Boateng
Department of Population and Health, Private Mail Bag, University of Cape Coast, Cape Coast, Ghana.
School of Health Sciences, University of Tampere, Tampere, Finland.
BMC Res Notes. 2016 Oct 10;9(1):460. doi: 10.1186/s13104-016-2265-2.
The burden of malaria in terms of morbidity and mortality is huge is Sub-Saharan Africa, particularly among pregnant women. Among the measures to curb down this burden include intermittent preventive treatment (IPT) and effective case management. These strategies were adopted by Ghana and implemented since 2003; however, there is still high dropout rate in IPT coverage. This study sought to investigate factors contributing to high dropout rate between IPT1 and IPT3 in the Tamale Metropolis, one of the health facilities with the highest IPT dropout rates in Ghana.
Survey, in-depth interviews and short ethnographic techniques were conducted among pregnant women, antenatal care (ANC) health workers and heads of health facilities to investigate factors which account for dropout rate of intermittent treatment of malaria.
Shortage of sulphadoxine pyrimethamine (SP), inadequate supply of portable water for administration of SP, unavailability of IPT during outreach services, lack of knowledge by ANC staff about the dropout rate in their area of jurisdiction and poor attitude of some health workers were identified as barriers to achieving high IPT3 coverage.
Late ANC visit, provider and logistical barriers account for the women's missed opportunities to prevent malaria in pregnancy through IPT. Addressing the above barriers will contribute to saving lives and ensuring progress towards the goal of combating malaria as well as reducing maternal, neonatal and child mortalities.
在撒哈拉以南非洲，疟疾在发病率和死亡率方面造成的负担巨大，尤其是在孕妇中。遏制这一负担的措施包括间歇性预防治疗（IPT）和有效的病例管理。加纳自2003年起采用并实施了这些策略；然而，IPT的覆盖率仍然存在很高的辍学率。本研究旨在调查导致塔马利市IPT1和IPT3之间辍学率高的因素，该市是加纳IPT辍学率最高的医疗机构之一。
对孕妇、产前保健（ANC）卫生工作者和医疗机构负责人进行了调查、深入访谈和简短的人种学研究，以调查导致疟疾间歇性治疗辍学率的因素。
发现周效磺胺-乙胺嘧啶（SP）短缺、用于服用SP的便携式水供应不足、外展服务期间无法提供IPT、ANC工作人员对其管辖地区的辍学率缺乏了解以及一些卫生工作者态度不佳是实现高IPT3覆盖率的障碍。
ANC就诊延迟、提供者和后勤障碍导致妇女错过通过IPT预防妊娠疟疾的机会。解决上述障碍将有助于拯救生命，并确保在抗击疟疾以及降低孕产妇、新生儿和儿童死亡率方面取得进展。
