PMID- 17054746
OWN - NLM
STAT- MEDLINE
DCOM- 20070103
LR  - 20061023
IS  - 1360-2276 (Print)
IS  - 1360-2276 (Linking)
VI  - 11
IP  - 11
DP  - 2006 Nov
TI  - Community response to intermittent preventive treatment delivered to infants 
      (IPTi) through the EPI system in Manhica, Mozambique.
PG  - 1670-8
AB  - OBJECTIVE: To describe attitudes to the expanded programme on immunization (EPI) 
      and intermittent preventive treatment in infants (IPTi), and perceptions of the 
      relationship between them. In particular, whether the introduction of IPTi 
      negatively affects community attitudes to, or use of, EPI; or, conversely, 
      whether and if so how, the concurrent delivery of IPTi and immunization 
      influences perceptions of IPTi. METHODS: Anthropological study carried out in the 
      context of a trial of IPTi with sulphadoxine-pyrimethamine delivered alongside 
      routine EPI vaccinations. We used open in-depth interviews, semi-structured 
      interviews and participant observation, conducted in both community and clinic 
      settings. RESULTS: IPTi was generally acceptable, in spite of initial resistance. 
      Perceived negative aspects of IPTi did not affect perceptions of EPI, and IPTi 
      was not misinterpreted as immunization against malaria, leading to a reduction of 
      other preventive measures or delay in treatment seeking. Initial resistance was 
      related more to the trial than to IPTi per se, but both rejection and acceptance 
      were embedded in a complex constellation of local and wider contextual factors. 
      CONCLUSIONS: IPTi delivered together with EPI was generally accepted after 
      initial rejection. The factors that led to this rejection were largely local and 
      trial related, but they did resonate with much wider cultural themes (rumours 
      about research and health interventions, gender inequality and health-related 
      decision making). The prior acceptance and routine administration of EPI played a 
      key role in the acceptance of IPTi in this community. However, more studies, in 
      different social and cultural settings and using different drugs and regimens, 
      are needed before generalizations can be made. Although trial settings are 
      different from actual implementation, it is necessary to study acceptability 
      before implementation in order to anticipate problems and design information 
      campaigns to ensure maximum community acceptance.
FAU - Pool, Robert
AU  - Pool R
AD  - London School of Hygiene and Tropical Medicine, London, UK, and Center for 
      International Health, Hospital Clinic, IDIBAPS, Barcelona, Spain. 
      robert.pool@lshtm.ac.uk
FAU - Munguambe, Khatia
AU  - Munguambe K
FAU - Macete, Eusebio
AU  - Macete E
FAU - Aide, Pedro
AU  - Aide P
FAU - Juma, Geraldina
AU  - Juma G
FAU - Alonso, Pedro
AU  - Alonso P
FAU - Menendez, Clara
AU  - Menendez C
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Trop Med Int Health
JT  - Tropical medicine & international health : TM & IH
JID - 9610576
RN  - 0 (Malaria Vaccines)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Attitude to Health
MH  - Caregivers/psychology
MH  - Child
MH  - Delivery of Health Care/methods/organization & administration
MH  - Female
MH  - Health Knowledge, Attitudes, Practice
MH  - Hematologic Tests/psychology
MH  - Humans
MH  - Immunization/psychology
MH  - Immunization Programs/*organization & administration
MH  - Malaria Vaccines/therapeutic use
MH  - Malaria, Falciparum/epidemiology/*prevention & control/psychology
MH  - Mozambique/epidemiology
MH  - Patient Acceptance of Health Care/psychology
EDAT- 2006/10/24 09:00
MHDA- 2007/01/04 09:00
CRDT- 2006/10/24 09:00
PHST- 2006/10/24 09:00 [pubmed]
PHST- 2007/01/04 09:00 [medline]
PHST- 2006/10/24 09:00 [entrez]
AID - TMI1725 [pii]
AID - 10.1111/j.1365-3156.2006.01725.x [doi]
PST - ppublish
SO  - Trop Med Int Health. 2006 Nov;11(11):1670-8. doi: 
      10.1111/j.1365-3156.2006.01725.x.