ACCEPTABILITY OF COUPLING INTERMITTENT PREVENTIVE TREATMENT IN INFANTS WITH THE EXPANDED PROGRAMME ON IMMUNIZATION IN THREE FRANCOPHONE COUNTRIES IN AFRICA.

Tuesday, 25th of June 2013

[source]Tropical Medicine and International Health[|source]

This paper presents multi-country data on community perceptions and acceptability of integrating intermittent preventive treatment for malaria during infancy (IPTi) into routine immunizations. Notwithstanding the misconceptions that SP alleviates fevers that follows immunization, all programs in malaria endemic countries would strive to leverage the synergies the intervention brings to the program. More details are available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02915.x/full

Abstract

OBJECTIVE: Intermittent preventive treatment in infants (IPTi) is a malaria control strategy currently recommended by WHO for implementation at scale in Africa, consisting of administration of sulphadoxine-pyrimethamine (SP) coupled with routine immunizations offered to children under 1 year. In this study, we analysed IPTi acceptability by communities and health staff.

METHODS: Direct observation, in-depth interviews (IDIs) and focus group discussions (FGDs) were conducted in Benin, Madagascar and Senegal during IPTi pilot implementation. Villages were stratified by immunization coverage. Data were transcribed and analysed using NVivo7 software.

RESULTS: Communities knowledge of malaria aetiology and diagnosis was good, although generally villagers did not seek treatment at health centres as their first choice. Perceptions and attitudes towards IPTi were very positive among communities and health workers. A misconception that SP was an antipyretic that prevents post-vaccination fever contributed to IPTi acceptability. No refusals or negative rumours related to IPTi coupling with immunizations were identified, and IPTi did not negatively influence attitudes towards other malaria control strategies. Healthcare decisions about children, normatively made by the father, are starting to shift to educated and financially independent mothers.

DISCUSSION: Intermittent preventive treatment in infants is well accepted by providers and communities, showing a synergic acceptability when coupled with routine immunizations. However, a misconception that SP alleviates fever should be addressed when scaling up implementation.