Title
Ruling out early trimester pregnancy when implementing community-based deworming programs
Date Issued
02 January 2020
Access level
open access
Resource Type
journal article
Author(s)
St-Denis K.
Blouin B.
Rahme E.
Montresor A.
Mupfasoni D.
Mbabazi P.S.
Gyorkos T.W.
Publisher(s)
Public Library of Science
Abstract
Background Large-scale deworming programs have, to date, mostly targeted preschool-and school-age children. As community-based deworming programs become more common, deworming will be offered to women of reproductive age. The World Health Organization recommends preventive chemotherapy be administered to pregnant women only after the first trimester. It is therefore important for deworming programs to be able to identify women in early preg-nancy. Our objective was to validate a short questionnaire which could be used by deworm-ing program managers to identify and screen out women in early pregnancy. Methodology/Principal findings In May and June 2018, interviewers administered a questionnaire, followed by a pregnancy test, to 1,203 adult women living in the Peruvian Amazon. Regression analyses were per-formed to identify questions with high predictive properties (using the pregnancy test as the gold standard). Test parameters were computed at different decision tree nodes (where nodes represented questions). With 106 women confirmed to be pregnant, the positive predictive value of asking the single question ‘Are you pregnant?’ was 100%, at a ‘cost’ of a false negative rate of 1.9% (i.e. 21 women were incorrectly identified as not pregnant when they were truly pregnant). Additional questions reduced the false negative rate, but increased the false positive rate. Rates were dependent on both the combination and the order of questions. Conclusions/Significance To identify women in early pregnancy when deworming programs are community-based, both the number and order of questions are important. The local context and cultural acceptability of different questions should inform this decision. When numbers are manage-able and resources are available, pregnancy tests can be considered at different decision tree nodes to confirm pregnancy status. Trade-offs in terms of efficiency and misclassifica-tion rates will need to be considered to optimize deworming coverage in women of reproductive age.
Start page
1
End page
17
Volume
14
Issue
1
Language
English
OCDE Knowledge area
Parasitología
Scopus EID
2-s2.0-85078711278
PubMed ID
Source
PLoS Neglected Tropical Diseases
ISSN of the container
19352727
Sponsor(s)
Funding was arranged by Children Without Worms from the Task Force for Global Health (https://www.taskforce.org). The McGill Global Health Programs (https://www.mcgill.ca/ global health/) provided a travel award to KS-D. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Dr. Rubina Imtiaz, Director of Children Without Worms, provided valuable comments at the initial stages of this research. Ms. Isabela Fabri Karam assisted in the training of the field team. Global Health Programs, McGill University provided awards to Kariane St-Denis (McGill Global Health Scholar (Graduate)) and Isabela Fabri Karam (McGill Global Health Scholar (Undergraduate)).
Sources of information:
Directorio de Producción Científica
Scopus