加纳上西部地区两个区季节性疟疾化学预防措施在照护者中的可接受性：一项横断面研究

Caregiver acceptability of seasonal malaria chemoprevention in two districts in the Upper West region, Ghana: a cross-sectional study.

作者信息

Diarra Youssouf, Opoku Michael M, Amankwa Charles E, Annor Raymond B, Nonvignon Justice, Bonful Harriet A

机构信息

Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.

Department of Pharmacology and Neuroscience, North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA.

出版信息

Malar J. 2025 Jan 14;24(1):14. doi: 10.1186/s12936-024-05169-6.

DOI:10.1186/s12936-024-05169-6

PMID:39810150

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11734325/

Abstract

BACKGROUND

Acceptability of malaria chemoprevention interventions by caregivers is crucial for overall programme success. This study assessed coverage and acceptability of Seasonal Malaria Chemoprevention (SMC) in selected communities in the Northern part of Ghana.

METHODS

An analytical cross-sectional design was conducted from "July 23rd to August 4th, 2020-a 12-day period that covered 5 days of the first SMC implementation cycle and 7 days post-implementation. Using a stratified multi-stage sampling technique, a total of 495 caregivers providing care for 569 eligible children aged 3-59 months from randomly selected households in the study communities were enrolled into the study. Acceptability of SMC was assessed on a set of 19 questionnaire items-8 of the items measured caregivers' perceptions and 11 items measured children's reaction to administered medicines. Univariable and stepwise multivariable logistic regression analyses were performed to assess the predictors of acceptability of SMC at a 95% confidence interval and a p-value of 0.05.

RESULTS

SMC coverage was 95.1% (541/569). Caregivers had a good level of knowledge of SMC (n = 475; 96.0%; 95% CI 94.2-97.7%) and a good perception of SMC (n = 471; 95.2%; 95% CI 93.3-97.0). Seven out of ten caregivers (70.9%; 95% CI 66.9-74.9%) had good acceptability of SMC. For 7 out of 28 children who did not receive the SMC intervention, their caregivers intentionally refused them the intervention. Of those that received the treatment, 17.2% (n = 85; 95%CI 13.8-20.5%) of caregivers had at least one leftover amodiaquine tablet after the third day of treatment. Caregivers who practice Christianity or Islam had better acceptability than caregivers who practice African traditional religion (p < 0.001).

CONCLUSION

Health authorities and stakeholders can work towards bridging the gap between knowledge and SMC treatment practices of caregivers through continuous education, adherence counseling, and effective monitoring of SMC practices in malaria-endemic countries.

摘要

背景

照顾者对疟疾化学预防干预措施的接受程度对于整个项目的成功至关重要。本研究评估了加纳北部部分社区季节性疟疾化学预防（SMC）的覆盖范围和接受程度。

方法

于2020年7月23日至8月4日进行了一项分析性横断面设计，为期12天，涵盖第一个SMC实施周期的5天和实施后7天。采用分层多阶段抽样技术，从研究社区中随机选取的家庭中，共纳入495名照顾者，他们为569名年龄在3至59个月的符合条件的儿童提供照料。通过一组19个问卷项目评估SMC的接受程度，其中8个项目测量照顾者的认知，11个项目测量儿童对所服用药物的反应。进行单变量和逐步多变量逻辑回归分析，以评估在95%置信区间和p值为0.05的情况下SMC接受程度的预测因素。

结果

SMC覆盖率为95.1%（541/569）。照顾者对SMC有较好的了解程度（n = 475；96.0%；95%CI 94.2 - 97.7%），对SMC有较好的认知（n = 471；95.2%；95%CI 93.3 - 97.0）。十分之七的照顾者（70.9%；95%CI 66.9 - 74.9%）对SMC有较好的接受程度。在28名未接受SMC干预的儿童中，有7名儿童的照顾者故意拒绝让他们接受干预。在接受治疗的儿童中，17.2%（n = 85；95%CI 13.8 - 20.5%）的照顾者在治疗第三天后至少有一片剩余的阿莫地喹片。信奉基督教或伊斯兰教的照顾者比信奉非洲传统宗教的照顾者有更好的接受程度（p < 0.001）。