A cross-sectional survey of perceptions related to symptoms of malaria, curable reproductive tract infections and associated treatments among pregnant women at health facilities in Tanzania

Malaria and curable sexually transmitted/reproductive tract infections (STIs/RTIs) in pregnancy are unacceptably high in sub-Saharan Africa due, in part, to poor coverage of antenatal interventions. Investigating the perceptions about these infections and related treatments among pregnant women may help to identify key barriers and facilitators to care-seeking and care provision. A cross-sectional survey of 397 pregnant women was conducted in rural Tanzania to examine perceptions of risk related to symptoms of malaria infection and curable STIs/RTIs, and associated treatments. Overall, 52% of pregnant women reported having a febrile episode in the last four weeks, of whom 79% received 459 astmh.org antimalarial treamtent, this despite only 46% of them being diagnosed with malaria. Fever during pregnancy was considered somewhat, very, or extremely harmful by 11%, 25%, and 34% of pregnant women, respectively, whereas 7%, 7%, and 10% believed fever to be not at all harmful, slightly harmful, or somewhat harmful, respectively. Over 20% of participants did not know if malaria treatment was harmful. In the previous four weeks, 53%; 41%; 13% and 9% of pregnant women reported experiencing symptoms of curable STIs/RTIs - lower abdominal pain, genital or vaginal itchiness, vaginal discharge with fishy smell, and genital or vaginal ulcers - respectively. Only 24%, 27%, 33%, and 26% of these women received treatment for their STIs/RTIs symptoms, respectively. The public health implications of these results are evident. Although between 65-70% of pregnant women recognise the potential harm of malaria infection and curable STIs/RTIs in pregnancy, 20-25% of women do not know, or do not believe, that these infections may be harmful to their pregnancies. Malaria treatment is given too commonly without diagnosis, and only one-quarter to one-third of pregnant women with symptoms of curable STIs/RTIs are treated.