TY - JOUR

T1 - Symptom-based diagnosis of malaria and its implication on antimalarial drug use in pregnancy in Central Uganda

T2 - Results from a community trial

AU - Mbonye, Anthony K.

AU - Magnussen, Pascal

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Diagnosis of malaria based on the symptomatic approach has been associated with overtreatment. We sought to assess the magnitude of antimalarial drug use in pregnancy in order to contribute to the debate of introducing effective diagnostic tools for malaria. Methods: Data on malaria morbidity and treatment seeking practices were collected from pregnant women as part of a community intervention study testing new approaches to deliver intermittent preventive treatment of malaria in pregnancy in Mukono district, central Uganda. Results: A high proportion of pregnant women, 261/667 (39.1%) at the health units reported having fever; and of these 124/559 (22.2%) had positive smears for Plasmodium faciliparum. The symptom-based approach had a low sensitivity of 26.4%, leading to many pregnant women with malaria undiagnosed. Similarly, a high proportion of pregnant women, 145/383 (37.9%) with negative blood smears for P. falciparum received antimalarial drugs in addition to intermittent preventive treatment (IPTp) with sulfadoxine-pyrimethamine (SP). Conclusion: The results call for urgent strategies to identify effective diagnostic tools for malaria in pregnancy and to assess the negative effects of the over-use of antimalarial drugs in pregnancy.

AB - Diagnosis of malaria based on the symptomatic approach has been associated with overtreatment. We sought to assess the magnitude of antimalarial drug use in pregnancy in order to contribute to the debate of introducing effective diagnostic tools for malaria. Methods: Data on malaria morbidity and treatment seeking practices were collected from pregnant women as part of a community intervention study testing new approaches to deliver intermittent preventive treatment of malaria in pregnancy in Mukono district, central Uganda. Results: A high proportion of pregnant women, 261/667 (39.1%) at the health units reported having fever; and of these 124/559 (22.2%) had positive smears for Plasmodium faciliparum. The symptom-based approach had a low sensitivity of 26.4%, leading to many pregnant women with malaria undiagnosed. Similarly, a high proportion of pregnant women, 145/383 (37.9%) with negative blood smears for P. falciparum received antimalarial drugs in addition to intermittent preventive treatment (IPTp) with sulfadoxine-pyrimethamine (SP). Conclusion: The results call for urgent strategies to identify effective diagnostic tools for malaria in pregnancy and to assess the negative effects of the over-use of antimalarial drugs in pregnancy.

KW - Antimalarial drugs

KW - Malaria

KW - Pregnancy

KW - Symptom-based diagnosis

KW - Uganda

UR - http://www.scopus.com/inward/record.url?scp=77958177459&partnerID=8YFLogxK

U2 - 10.1515/IJAMH.2010.22.2.257

DO - 10.1515/IJAMH.2010.22.2.257

M3 - Journal article

AN - SCOPUS:77958177459

VL - 22

SP - 257

EP - 262

JO - International Journal of Adolescent Medicine and Health

JF - International Journal of Adolescent Medicine and Health

SN - 0334-0139

IS - 2

ER -