Bottlenecks for High Coverage of Intermittent Preventive Treatment in Pregnancy The Case of Adolescent Pregnancies in Rural Burkina Faso 英文参考文献.docVIP

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Bottlenecks for High Coverage of Intermittent Preventive Treatment in Pregnancy The Case of Adolescent Pregnancies in Rural Burkina Faso 英文参考文献.doc

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Bottlenecks for High Coverage of Intermittent Preventive Treatment in Pregnancy The Case of Adolescent Pregnancies in Rural Burkina Faso 英文参考文献

BottlenecksforHighCoverageofIntermittentPreventive TreatmentinPregnancy:TheCaseofAdolescent PregnanciesinRuralBurkinaFaso KoenPeetersGrietens1,2*.,SabineGies1.,SheickOumarCoulibaly3,4,ClotildeKy4,JudithSomda4, ElizabethToomer2,JoanMuelaRibera2,UmbertoD’Alessandro1 1PrinceLeopoldInstituteforTropicalMedicine,Antwerp,Belgium,2PASSInternational,Tessenderlo,Belgium,3UFRSciencesdelaSante′,Universite′ deOuagadougou, Ouagadougou,BurkinaFaso,4LaboratoireNationaldeSante′ Publique,Ouagadougou,BurkinaFaso Abstract Background: While IPTp-SP is currently being scaled up in sub-Saharan Africa (SSA), the coverage with the required $2 dosesofSPremainsconsiderablyshortoftheRollBackMalaria(RBM)goalof80%,nottomentionoftherecentlyadvocated universalcoverage. Methods: The study triangulates quantitative data from a health center randomized community-based trial on IPTp-SP effectivenessandtheadditionalbenefitofapromotionalcampaignwithqualitativedatafromfocusedethnography. Findings:InruralBurkinaFaso,despitethesignificantlyhigher riskofmalariainfectionamongadolescent primigravidae (PG)(OR2.4495%CI1.81–3.28,p,0.001),makingthemprimarytargetbeneficiariesofIPTp-SP,adolescentsadheredtothe requiredthreeormoreANCvisitssignificantlyless(PG:46.6%;SG43.7%)thanadults(PG:61.9%;SG54.9%)andhadlower SPuptakeduringthemalariatransmissionseason,furthershowingthedifficultyofreachingthisagegroup.Adolescents’ structuralconstraints(suchastheirsocialpositionandhouseholdlaborrequirements)andneeds(suchasanonymityinthe health encounter) leave them highly vulnerable during their pregnancies and, especially, during the high malaria transmissionseason. Conclusion: Our study shows that adolescents need to be targeted specifically, prior to their first pregnancy and with measures adapted to their social context, addressing their structural constraints and needs and going beyond standard healthpromotioncampaigns.Unlesssuchspecificmeasuresaretaken,adolescents’socialvulnerabilitywillpresentaserious bot