Women attending antenatal care as a sentinel surveillance population for malaria in Geita region, Tanzania: feasibility and acceptability to women and providers

• Published in: Malaria Journal
• Main Authors: Courtney Emerson, Stephen Ulimboka, Ruth Lemwayi, Alen Kinyina, Samwel L. Nhiga, Sijenunu Aaron, Japhet Simeo, Chonge Kitojo, Erik J. Reaves, Mary Drake, Yahaya Hussein, Leila Bungire, Julie R. Gutman, Peter J. Winch
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2023
• Subjects: Malaria; Pregnancy; Antenatal care; Surveillance; Tanzania; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic; Geita
• Online Access: https://doi.org/10.1186/s12936-023-04480-y; https://doaj.org/article/fed2610818834a5699c6259de9d2dda0

Abstract Background Measurement of malaria prevalence is conventionally estimated through infrequent cross-sectional household surveys that do not provide continuous information regarding malaria parasitaemia. Recent studies have suggested that malaria parasitaemia prevalence among women attending antenatal care (ANC) correlates with prevalence among children under 5 years old and that pregnant women could be a sentinel population for tracking malaria prevalence. In mainland Tanzania, 97% of women are tested for malaria parasitaemia during first ANC visits. However, acceptability among pregnant women and healthcare providers of collecting malaria risk factor data during ANC visits is limited. Methods A tablet-based questionnaire including 15 questions on insecticide-treated net ownership and use and care-seeking for febrile children was introduced at 40 healthcare facilities in Geita Region, Tanzania. Facilities were randomly selected from among those with 15–120 first ANC visits per month. To assess perspectives regarding introduction of the questionnaire, 21 semi-structured interviews were held with providers and facility in-charges at 12 facilities. Thirty pregnant and recently delivered women participated in focus group discussions at seven facilities to assess the acceptability of spending additional time answering questions about malaria risk. Results All pregnant women reported that introduction of ANC surveillance and spending 10 more minutes with providers answering questions about their health would be neutral or beneficial. They perceived being asked about their health as standard of care. Providers and in-charges reported that introduction of ANC surveillance was within their scope of practice. Nine of 21 indicated it could potentially benefit women’s health. Six providers expressed concern about staffing shortages and need for reimbursement for extra time and noted that data management occurs after hours. Conclusions Pregnant women and providers generally perceived ANC surveillance for malaria as ...