***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Malaria in pregnancy is associated with increased risks of maternal and foetal complications . Currently , intermittent preventive treatment ( IPT ) of malaria during pregnancy with sulphadoxine-pyrimethamine ( SP ) is recommended by the WHO as part of a package of interventions also including insecticide-treated nets and effective case management . However , with increasing resistance to SP , the effectiveness of SP-IPT has been question ed . A r and omized controlled trial ( RCT ) to investigate the relative efficacy of an alternative strategy of intermittent screening and treatment ( IST ) , which involves a rapid diagnostic test for malaria at scheduled ANC visits and treatment of women only if positive , versus SP-IPT has been conducted in Ashanti region , Ghana . This paper reports on a complementary study investigating the acceptability of the different strategies to women enrolled in the trial . Methods Data were collected through twelve focus group discussion s with women selected at r and om from the different arms of the RCT , exploring their experiences and perceptions about antenatal care and their involvement in the trial . Content analysis was used to identify relevant themes to structure the results . Results Five main themes emerged from participants ' experiences of ANC and the RCT that would influence their acceptability of malaria prevention strategies during pregnancy : health benefits ; drugs received ; tests received ; other services received ; and health worker attitude . Their own health and that of their baby were strong motivations for attending ANC , and reported favourably as an outcome of being in the RCT . Women were not always clear on the biomedical function of drugs or blood tests but generally accepted them due to strong trust in the health staff . Home visits by staff and free ITNs as part of the trial were appreciated . Politeness and patience of health staff was a very strong positive factor . Conclusions Overall , both intermittent screening and treatment and intermittent preventive treatment appeared equally acceptable to pregnant women as strategies for the control of malaria in pregnancy . The women were more concerned about quality of services received , in particular the polite and patient attitude of health staff , and positive health implication s for themselves and their babies than about the nature of the intervention Background Tanzania has a well-developed network of commercial ITN retailers . In 2004 , the government introduced a voucher subsidy for pregnant women and , in mid 2005 , helped distribute free nets to under-fives in small number of districts , including Rufiji on the southern coast , during a child health campaign . Contributions of these multiple insecticide-treated net delivery strategies existing at the same time and place to coverage in a poor rural community were assessed . Methods Cross-sectional household survey in 6,331 members of r and omly selected 1,752 households of 31 rural villages of Demographic Surveillance System in Rufiji district , Southern Tanzania was conducted in 2006 . A question naire was administered to every consenting respondent about net use , treatment status and delivery mechanism . Findings Net use was 62.7 % overall , 87.2 % amongst infants ( 0 to1 year ) , 81.8 % amongst young children ( > 1 to 5 years ) , 54.5 % amongst older children ( 6 to 15 years ) and 59.6 % amongst adults ( > 15 years ) . 30.2 % of all nets had been treated six months prior to interview . The biggest source of nets used by infants was purchase from the private sector with a voucher subsidy ( 41.8 % ) . Half of nets used by young children ( 50.0 % ) and over a third of those used by older children ( 37.2 % ) were obtained free of charge through the vaccination campaign . The largest source of nets amongst the population overall was commercial purchase ( 45.1 % use ) and was the primary means for protecting adults ( 60.2 % use ) . All delivery mechanisms , especially sale of nets at full market price , under-served the poorest but no difference in equity was observed between voucher-subsidized and freely distributed nets . Conclusion All three delivery strategies enabled a poor rural community to achieve net coverage high enough to yield both personal and community level protection for the entire population . Each of them reached their relevant target group and free nets only temporarily suppressed the net market , illustrating that in this setting that these are complementary rather than mutually exclusive approaches Background Intermittent preventive treatment for prevention of malaria in pregnancy ( IPTp ) is a key component of malaria control strategy in Nigeria and sulfadoxine-pyrimethamine ( SP ) is the drug of choice . Despite the evidence of the effectiveness of IPTp strategy using SP in reducing the adverse effects of malaria during pregnancy the uptake and coverage in Nigeria is low . This study set out to assess the use of IPTp among pregnant women attending primary health centres in the rural area and determine factors that influence the uptake . Methods A cross-sectional study was carried out between July and August 2007 among 209 pregnant women selected by systematic r and om sampling from antenatal care attendees at primary health care in a rural Local Government Area of Ekiti State , Nigeria . Information on knowledge of IPT , delivery , adherence and acceptability was obtained using an interviewer administered question naire . Descriptive statistics such as means , range , proportions were used . Chi-square test was used to examine association between categorical variables . All analyses were performed at 5 % level of significance . Results One hundred and nine of 209 ( 52.2 % ) respondents have heard about IPTp but only 26 ( 23.9 % ) were able to define it . Fifty seven ( 27.3 % ) reported to have received at least one dose of IPTp during the index pregnancy and all were among those who have heard of IPTp ( 52.3 % ) . Twenty one of the 57 ( 36.8 % ) took the SP in the clinic . Only three of the twenty-one ( 14.3 % ) were supervised by a health worker . Twenty two of the 36 women ( 61.1 % ) who did not take their drugs in the clinic would have liked to do so if allowed to bring their own drinking cups . Almost half ( 43.9 % ) of those who had used IPTp during the index pregnancy expressed concern about possible adverse effect of SP on their pregnancies . Periodic shortages of SP in the clinics were also reported . Conclusion In this study , IPTp use among pregnant women was very low and there was poor adherence to the Directly Observed Therapy ( DOT ) scheme . Concerted effort should be made to increase awareness of IPTp among the public especially women of child bearing age . Health workers should also be trained and monitored to ensure adherence Background Delivery of two doses of intermittent preventive treatment of malaria during pregnancy ( IPTp ) is a key strategy to reduce the burden of malaria  in pregnancy in sub-Saharan Africa . However , different setting s have reported coverage levels well below the target 80 % . Antenatal implementation guidelines in Tanzania recommend IPTp first dose to be given at the second antenatal visit , and second dose at the third visit . This investigation measured coverage of IPTp at national level in Tanzania and examined the role of individual , facility , and policy level influences on achieved coverage . Methods Three national household and linked reproductive and child health ( RCH ) facility surveys were conducted July-August 2005 , 2006 , and 2007 in 210 clusters sample d using two-stage cluster sampling from 21 r and omly selected districts . Female residents who reported a livebirth in the previous year were asked questions about malaria prevention during that pregnancy and individual characteristics including education , pregnancy history , and marital status . The RCH facility serving each cluster was also surveyed , and information collected about drug stocks , health education delivery , and the timing of antenatal care delivery by clinic users . Results The national IPTp coverage had declined over the survey period being 71 % for first dose in 2005 falling to 65 % in 2007 ( χ2 2.9 , p = 0.05 ) , and 38 % for second dose in 2005 but 30 % in 2007 ( χ2 4.4 , p = 0.01 ) . There was no evidence of any individual factors being associated with second dose coverage beyond living in an urban area . Availability of sulphadoxine-pyrimethamine at RCH had decreased year on year from 85 % of clinics in stock in 2005 to 60 % in 2007 ( χ2 20.6 , p < 0.001 ) . This reduction was evident in rural but not urban clinics . If safety recommendations and national antenatal care guidelines for IPTp delivery were followed , in 2007 only 76 % of pregnant women could have received IPTp first dose and only 46 % could have received second dose . Conclusion There is scope to improve IPTp first and second dose coverage at national scale within existing systems by improving stock at RCH , and by revising the existing guidelines to recommend delivery of IPTp after quickening , rather than at a pre-defined antenatal visit Background In 2009 , the first national long-lasting insecticide-treated net ( LLIN ) distribution campaign in Senegal result ed in the distribution of 2.2 million LLINs in two phases to children aged 6 - 59 months . Door-to-door teams visited all households to administer vitamin A and mebendazole , and to give a coupon to redeem later for an LLIN . Methods A nationwide community-based two-stage cluster survey was conducted , with clusters selected within regions by probability proportional to size sampling , followed by GPS-assisted mapping , simple r and om selection of households in each cluster , and administration of a question naire using personal digital assistants ( PDAs ) . The question naire followed the Malaria Indicator Survey format , with rosters of household members and bed nets , and questions on campaign participation . Results There were 3,280 households in 112 clusters representing 33,993 people . Most ( 92.1 % ) guardians of eligible children had heard about the campaign , the primary sources being health workers ( 33.7 % ) , neighbours ( 26.2 % ) , and radio ( 22.0 % ) . Of eligible children , 82.4 % received mebendazole , 83.8 % received vitamin A , and 75.4 % received LLINs . Almost all ( 91.4 % ) LLINs received during the campaign remained in the household ; of those not remaining , 74.4 % had been given away and none were reported sold . At least one insecticide-treated net ( ITN ) was present in 82.3 % of all households , 89.2 % of households with a child < 5 years and 57.5 % of households without a child < 5 years . Just over half ( 52.4 % ) of ITNs had been received during the campaign . Considering possible indicators of universal coverage , 39.8 % of households owned at least one ITN per two people , 21.6 % owned at least one ITN per sleeping space and 34.7 % of the general population slept under an ITN the night before the survey . In addition , 45.6 % of children < 5 years , and 49.2 % of pregnant women had slept under an ITN . Conclusions The nationwide integrated LLIN distribution campaign allowed household ITN ownership of one or more ITNs to surpass the RBM target of 80 % set for 2010 , though additional distribution strategies are needed to reach population s missed by the targeted campaign and to reach the universal coverage targets of one ITN per sleeping space and 80 % of the population using an ITN OBJECTIVE To determine the knowledge and utilization of malaria preventive measures as well as barriers to the utilization of these measures by pregnant women . MATERIAL S AND METHODS The study was a prospect i ve cross-sectional survey involving pregnant women at the booking clinic of the University of Abuja Teaching Hospital between May and August 2010 . Close-ended pre-tested structured question naires were administered by interviewer method to 403 consecutive consenting women . RESULTS The knowledge of malaria and its preventive measures in pregnancy was 71.5 % . There was a statistically significant association between knowledge of malaria and educational status ( X2 = 16.053 , P = 0.035 ) .  Intermittent preventive treatment  was used by 15.9 % of the respondents .  Insecticide-treated net ownership was 42.6 % ; however , its use declined from 28.5 % before pregnancy to 24.6 % during pregnancy . CONCLUSION There is adequate knowledge about malaria and its preventive measures in pregnancy , but the utilization of these measures is poor . There is need for concerted efforts at addressing the barriers to utilization of these effective interventions Background The effectiveness of intermittent preventive treatment of malaria in pregnancy ( IPTp ) may be compromised by the spread of resistance to sulphadoxine/pyrimethamine ( SP ) across Africa . But little informtion exists on alternative drugs for IPTp or alternative strategies for the prevention of malaria in pregnancy . Therefore , we have investigated whether screening with a rapid diagnostic test and treatment of those who are positive ( IST ) at routine antenatal clinic attendances is as effective and as safe as SP-IPTp in pregnant women . Methods and Findings During antenatal clinic sessions in six health facilities in Ghana held between March 2007 and September 2007 , 3333 pregnant women who satisfied inclusion criteria were r and omised into three intervention arms ( 1 ) st and ard SP-IPTp , ( 2 ) IST and treatment with SP or ( 3 ) IST and treatment with amodiaquine+artesunate ( AQ+AS ) . All women received a long-lasting insecticide treated net . Study women had a maximum of three scheduled follow-up visits following enrolment . Haemoglobin concentration and peripheral parasitaemia were assessed between 36 and 40 weeks of gestation . Birth weight was 
    Output:
    
Delivery of ITNs through antenatal clinics presents fewer problems than delivery of IPTp .
Many obstacles to IPTp delivery are relatively simple barriers that could be resolved in the short term .