Jhpiego, 1615 Thames Street, Baltimore, MD, 21231, USA.
Jhpiego Nigeria, Plot 971 Reuben Okoya Crescent, Utako, Abuja, Nigeria.
Malar J. 2020 Jan 29;19(1):51. doi: 10.1186/s12936-020-3099-x.
Every year, malaria in pregnancy contributes to approximately 20% of stillbirths in sub-Saharan Africa and 10,000 maternal deaths globally. Most eligible pregnant women do not receive the minimum three recommended doses of intermittent preventive treatment with Sulfadoxine-pyrimethamine (IPTp-SP). The objective of this analysis was to determine whether women randomized to group antenatal care (G-ANC) versus standard antenatal care (ANC) differed in IPTp uptake and insecticide-treated nets (ITN) use.
Prospective data were analysed from the G-ANC study, a pragmatic, cluster randomized, controlled trial that investigated the impact of G-ANC on various maternal newborn health-related outcomes. Data on IPTp were collected via record abstraction and difference between study arms in mean number of doses was calculated by t test for each country. Data on ITN use were collected via postpartum interview, and difference between arms calculated using two-sample test for proportions.
Data from 1075 women and 419 women from Nigeria and Kenya, respectively, were analysed: 535 (49.8%) received G-ANC and 540 (50.2%) received individual ANC in Nigeria; 211 (50.4%) received G-ANC and 208 (49.6%) received individual ANC in Kenya. Mean number of IPTp doses received was higher for intervention versus control arm in Nigeria (3.45 versus 2.14, p < 0.001) and Kenya (3.81 versus 2.72, p < 0.001). Reported use of ITN the previous night was similarly high in both arms for mothers in Nigeria and Kenya (over 92%). Reported ITN use for infants was higher in the intervention versus control arm in Nigeria (82.7% versus 75.8%, p = 0.020).
G-ANC may support better IPTp-SP uptake, possibly related to better ANC retention. However, further research is needed to understand impact on ITN use. Trial registration Pan African Clinical Trials Registry, May 2, 2017 (PACTR201706002254227).
每年，妊娠疟疾导致撒哈拉以南非洲地区约 20%的死产和全球 1 万例孕产妇死亡。大多数符合条件的孕妇没有接受磺胺多辛-乙胺嘧啶（IPTp-SP）最低推荐的三次间歇性预防治疗。本分析的目的是确定随机分配到组产前保健（G-ANC）与标准产前保健（ANC）的妇女在 IPTp 摄入和驱虫蚊帐（ITN）使用方面是否存在差异。
对 G-ANC 研究进行了前瞻性数据分析，该研究是一项实用的、集群随机对照试验，研究了 G-ANC 对各种母婴健康相关结局的影响。通过记录提取收集关于 IPTp 的数据，并且通过 t 检验计算每个国家组间剂量的平均差异。通过产后访谈收集 ITN 使用数据，并使用两样本检验计算组间差异。
分析了来自尼日利亚和肯尼亚的 1075 名和 419 名妇女的数据：535 名（49.8%）接受 G-ANC，540 名（50.2%）接受尼日利亚的个体 ANC；211 名（50.4%）接受 G-ANC，208 名（49.6%）接受肯尼亚的个体 ANC。干预组与对照组相比，尼日利亚（3.45 比 2.14，p<0.001）和肯尼亚（3.81 比 2.72，p<0.001）接受的 IPTp 剂量更高。尼日利亚和肯尼亚的母亲在前一晚报告的 ITN 使用率相似（超过 92%）。尼日利亚干预组与对照组相比，婴儿报告的 ITN 使用率更高（82.7%比 75.8%，p=0.020）。
G-ANC 可能支持更好的 IPTp-SP 摄入，这可能与更好的 ANC 保留有关。然而，需要进一步研究以了解其对 ITN 使用的影响。试验注册 泛非临床试验注册中心，2017 年 5 月 2 日（PACTR201706002254227）。
