{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T07:04:01Z","timestamp":1775027041234,"version":"3.50.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP46099"],"award-info":[{"award-number":["OPP46099"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In malaria endemic regions in Kenya, pregnant women are offered long-lasting insecticidal nets and intermittent preventive treatment (IPTp) with sulfadoxine\u2013pyrimethamine (SP) at antenatal care (ANC) to prevent the adverse effects of malaria. Fears of growing SP resistance have heightened the search for alternative strategies. The implementation feasibility of intermittent screening and treatment (ISTp) with dihydroartemisinin\u2013piperaquine (DP) in routine ANC settings was evaluated using qualitative and quantitative methods, including the exploration of healthcare provider and pregnant women\u2019s perceptions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Qualitative methods included data from 13 focus group discussions (FGDs) with pregnant women and 43 in-depth interviews with healthcare providers delivering ANC services. FGDs were conducted with women who had received either ISTp-DP or current policy (IPTp-SP). Thematic analysis was used to explore experiences among women and providers and findings\u00a0were used to provide insights into results of the parallel quantitative study.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Women were accepting of testing with rapid diagnostic tests (RDTs) and receiving treatment if malaria positive. Providers perceived DP to be an effective drug and well tolerated by women. Some providers indicated a preference for test and treat strategies to reduce unnecessary exposure to medication in pregnancy, others preferred a hybrid strategy combining screening at every ANC visit followed by IPTp-SP for women who tested negative, due to the perception that RDTs missed some infections and concerns about the growing resistance to SP. Testing with RDTs during ANC was appreciated as it was perceived to reduce wait times. The positive attitude of healthcare providers towards ISTp supports findings from the quantitative study that showed a high proportion (90%) of women were tested at ANC. There were concerns about affordability of DP and the availability of sufficient RDT stocks.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In ANC settings, healthcare providers and pregnant women found ISTp-DP to be an acceptable strategy for preventing malaria in pregnancy when compared with IPTp-SP. DP was considered an effective anti-malarial and a suitable alternative to IPTp-SP in the context of SP resistance. Despite providers\u2019 lack of confidence in RDT results at current levels of sensitivity and specificity, the quantitative findings show their willingness to test women routinely at ANC.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12936-021-03826-8","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T20:02:32Z","timestamp":1624996952000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Healthcare provider and pregnant women\u2019s perspectives on the implementation of intermittent screening and treatment with dihydroartemisinin\u2013piperaquine for malaria in pregnancy in western Kenya: a qualitative study"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8002-3282","authenticated-orcid":false,"given":"Jenna","family":"Hoyt","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Hill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence","family":"Achieng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Ouma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Kariuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghna","family":"Desai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayne","family":"Webster","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"key":"3826_CR1","doi-asserted-by":"publisher","first-page":"e107","DOI":"10.1016\/S1473-3099(18)30066-5","volume":"18","author":"SJ Rogerson","year":"2018","unstructured":"Rogerson SJ, Desai M, Mayor A, Sicuri E, Taylor SM, van Eijk AM. Burden, pathology, and costs of malaria in pregnancy: new developments for an old problem. Lancet Infect Dis. 2018;18:e107\u201318.","journal-title":"Lancet Infect Dis"},{"key":"3826_CR2","unstructured":"Ministry of Health Kenya, Ministry of Public Health and Sanitation. The Kenya malaria strategy 2009\u20132018 (Revised 2014). Nairobi; 2014."},{"key":"3826_CR3","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1093\/cid\/cir376","volume":"53","author":"WE Harrington","year":"2011","unstructured":"Harrington WE, Mutabingwa TK, Kabyemela E, Fried M, Duffy PE. Intermittent treatment to prevent pregnancy malaria does not confer benefit in an area of widespread drug resistance. Clin Infect Dis. 2011;53:224\u201330.","journal-title":"Clin Infect Dis"},{"key":"3826_CR4","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1093\/infdis\/jiv421","volume":"213","author":"J Gutman","year":"2016","unstructured":"Gutman J, Taylor S, Meshnick S, Ter Kuile F. 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Intermittent screening and treatment or intermittent preventive treatment with dihydroartemisinin\u2013piperaquine versus intermittent preventive treatment with sulfadoxine\u2013pyrimethamine for the control of malaria during pregnancy in western Kenya: an open-lab. Lancet. 2015;386:2507\u201319.","journal-title":"Lancet"},{"key":"3826_CR7","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1016\/S1473-3099(19)30156-2","volume":"19","author":"R Ahmed","year":"2019","unstructured":"Ahmed R, Poespoprodjo JR, Syafruddin D, Khairallah C, Pace C, Lukito T, et al. Efficacy and safety of intermittent preventive treatment and intermittent screening and treatment versus single screening and treatment with dihydroartemisinin\u2013piperaquine for the control of malaria in pregnancy in Indonesia: a cluster-randomised, open-la. 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The clusters (health facilities) were consented prior to implementing the feasibility study. The study was approved by the ethical committees of the Kenya Medical Research Institute\u2019s (KEMRI) National Ethics Review Committee, Kenya; the Liverpool School of Tropical Medicine, UK; the London School of Hygiene and Tropical Medicine, UK; and the Centers for Disease Control and Prevention, Atlanta, Georgia, USA. All participants were consented prior to the interviews; participants in the IDIs provided written informed consent and FGD participants provided verbal informed consent. In Kenya pregnant women aged 15\u201317\u00a0years are considered emancipated minors and were consented directly.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"291"}}