Acceptability of coupling Intermittent Preventive Treatment in infants with the Expanded Program on Immunization in three francophone countries in Africa; Acceptabilité du couplage du Traitement Préventif Intermittent chez le nourrisson avec le Programme Elargi de Vaccination dans trois pays francophones d'Afrique; Aceptación de la integración del Tratamiento Preventivo Intermitente de la malaria en lactantes con el Programa Ampliado de Inmunizaciones en tres países francófonos de África

• Published in: Tropical medicine & international health Vol. 17; no. 3; p. 308
• Main Authors: de Sousa, Alexandra, Rabarijaona, Leon P, Ndiaye, Jean L, Sow, Doudou, Ndyiae, Mouhamed, Hassan, Jacques, Lambo, Nilda, Adovohekpe, Paul, Guidetti, Flavia, Recht, Judith, Affo, Alphonse
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01.03.2012
• Subjects: Attitudes; Babies; Immunization; Malaria; Perceptions; Africa
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/j.1365-3156.2011.02915.x

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 1year. In this study, we analyzed 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 analyzed using NVivo7 software. Results: Communities' knowledge of malaria aetiology and diagnosis was good, although generally villagers did not seek treatment at health centers 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-vaccinal fever contributed to IPTi's acceptability. No refusals or negative rumors 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.[PUBLICATION ABSTRACT]