Author

Grace Wanjiku

Date of Award

January 2011

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Elijah Paintsil

Subject Area(s)

Medicine

Abstract

Objectives: The clinical course and complications of malaria during pregnancy are exacerbated in HIV-positive women. Furthermore, malaria during pregnancy may increase the risk of mother to child transmission (MTCT) of HIV. We assessed the uptake of WHO recommended intermittent preventive treatment (IPT) for malaria and insecticide treated bed nets (ITN) during pregnancy among HIV-negative and HIV-positive pregnant women in a malaria endemic area.

Methods: A cross sectional study of 151 women (96 HIV-negative and 55 HIV-positive) receiving antenatal and HIV care at an urban district hospital in Accra, Ghana from July to August, 2008. The women were interviewed to obtain demographic data and information on the use of IPT and insecticide treated bed nets (ITN) during their current pregnancy. Antenatal care cards were used to verify obstetric history and a record of IPT use.

Results: HIV-positive pregnant women had significantly low uptake of all three doses of WHO recommended IPT compared to HIV-negative pregnant women. Dose 1: 70% and 47% p=0.019, Dose 2: 54.8% and 30.2%, p=0.018. Dose 3: 40% and 9.1% p=<0.002 for HIV negative and HIV positive pregnant women respectively. For ITN use, 43.8% of HIV negative and 36.4% of HIV positive women reported having ITNs at home, p=0.375. Of the women who had nets, 45.2% of HIV negative and 70% HIV positive women reported having slept under a net the previous night, P=0.068.

Conclusion: The low uptake of IPT among HIV-positive pregnant women is of concern in light of emerging evidence that malaria during pregnancy may increase the risk of MTCT of HIV. Comprehensive prevention of MTCT programs should include components aimed at increasing the uptake of IPT among HIV-positive pregnant women.

Comments

This is an Open Access Thesis.

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