Malaria that IPTp.3 A review of 2011 Roll Back Malaria Road
Maps wherein countries identify and plan to meet gaps in funding and commodities has shown many instances of shortages in RDTs and ACTs. IST will require addi- tional RDTs and may pose a procurement challenge.12 Ghanaian ANC staff appear favorably disposed to IST
One additional quality issue that needs attention is the acceptability of getting IST when women have positive parasitaemia but no symptoms or con- versely when they have symptoms but no parasitaemia as found through RDTs. Clearly client and community health education need to be tailored to local percep- tions to make IST truly acceptable. In conclusion, IST offers a promising intervention in
as a way of protecting their clients, though they naturally would prefer prevention over treatment. Therefore, training of ANC workers on the procedures as well as planning on how to ensure IST fits seamlessly into ANC procedures are a few of the operational challenges.13 From the consumer point of view both IST and IPTp seemed acceptable to pregnant women The Ghana researchers reported that pregnant women were more concerned about quality of services received including politeness.14
low transmission countries as well as high burden coun- tries as they move closer to elimination. As with most malaria interventions, the science will be easier to solve than the logistics and staff attitudes. Therefore, opera- tional research will be needed to test the best combina- tion of MIP interventions and the role IST will play.3
References 1 World Health Organization. Technical Expert Group meeting on intermittent preventive treatment in pregnancy (IPTp). Geneva: World Health Organization, 2007.
2 World Health Organization Regional Office for Africa. A Strategic Framework for Malaria Prevention and Control During Pregnancy in the African Region. Brazzaville: World Health Organization, 2004, AFR/MAL/04/01.
3 4 5 6 7
Chico RM, Chandramohan D. Intermittent preventive treatment of malaria in pregnancy: at the crossroads of public health policy. Trop Med Int Health 2011; 16: 774–85.
National Malaria Control Program, Ministry of Health and Social Welfare, Liberia Institute of Statistics and Geo-Information Services and ICF Macro. Malaria Indicator Survey. Liberia: MHSW, 2009.
Batwala V, Magnussen P, Nuwaha F. Are rapid diagnostic tests more accurate in diagnosis of Plasmodium falciparum malaria compared to microscopy at rural health centres? Malaria J 2010, 9:349
Tagbor H, Bruce J, Browne E, Greenwood B, Chandramohan D. Performance of the OptiMAL® dipstick in the diagnosis of malaria infection in pregnancy. Therapeutics Clin Risk Manage 2008; 4: 631–6.
Chandramohan D. Intermittent preventive treatment (IPT) or intermittent screening and treatment (IDT) for control of malaria in pregnancy in Asia Pacific region. 11th Meeting of The RBM Malaria In Pregnancy Working Group (MIP), 21–23 October 2008. WHO Regional Office for the Western Pacific, Manila Philippines.
http://www.rbm.who.int/partnership/wg/wg_pregnancy/docs/ MPWG_11Meeting_Minutes-e.pdf.
8 9
Tagbor H, Bruce J, Agbo M, Greenwood B, Chandramohan D. Intermittent Screen- ing and Treatment versus Intermittent Preventive Treatment of Malaria in Preg- nancy: A Randomised Controlled Non-Inferiority Trial. PLoS One 2010; 5: e14425.
USAID. Malaria in Pregnancy. USAID/Indonesia, Jakarta, Indonesia. http://
indonesia.usaid.gov/en/USAID/Activity/312/Malaria_in_Pregnancy.
10 Drake TL, Okello G, Njagi K, et al. Cost analysis of school-based intermittent screening and treatment of malaria in Kenya. Malaria J 2011; 10: 273.
11 Okello G, Ndegwa SN, Halliday KE, et al. Local perceptions of intermittent screening and treatment for malaria in school children on the south coast of Kenya. Malaria J 2012; 11: 185.
12 Roll Back Malaria, 2011 Country Road Maps.
http://www.rbm.who.int/rbm- roadmaps2011.html.
13 Paintain LS, Antwi GD, Jones C, et al. Intermittent Screening and Treatment versus Intermittent Preventive Treatment of Malaria in Pregnancy: Provider Knowledge and Acceptability. PLoS ONE 2011; 6: e24035.
14 Smith LA, Jones C, Adjei RO, et al. Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: user acceptability. Malaria J 2012; 9:18.
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