| dc.description.abstract | Pregnant women are vulnerable to malaria infection and the World Health Organization (WHO), therefore, recommends prompt and timely treatment of all malaria cases during pregnancy with an effective and safe anti-malarial drug. Artemisinin-based Combination Therapy (ACT) is a first line treatment of uncomplicated Plasmodium falciparum malaria. However, safety data regarding exposure to Artemisinin-based Combination Therapy in pregnancy are limited and more specifically, data on the safety of Artemether/ Lumefantrine (AL) therapy in the first trimester of pregnancy remain limited despite its widespread use in sub-Saharan Africa. This study, therefore, determined the effect of ACTs(AL) exposure in early pregnancy and evaluated the knowledge and perception on the use of ACTs amongst pregnant women attending ante-natal care clinics(ANC). A cross-sectional research study using quantitative research method was conducted in two hospitals -Bondo and Siaya hospitals of Siaya County between 2015 to 2019. A total sample size of 3040 respondents used but categorized in two groups. Data from 2803 participants were extracted from an ongoing pregnancy surveillance study and questionnaire administered to 237 respondents. Data analysis was done by the use of statistical analysis software version 9.2 (SAS v9.2, SAS Institute, Cary, NC, USA). The findings were as follow, the level of education was significant in relation to ACT exposure in early pregnancy (p -value = 0.019). Hypertensive women are more likely to have pregnancy complications when exposed to ACTs in early pregnancy (p-value = 0.042). As much as the majority of pregnant women seek treatment for malaria, unfortunately, the health care service providers neither recognized nor enquired about pregnancy status. This, therefore, suggested that there is a poor understanding of the implications of ACTs use in early pregnancy. Some important finding was the association of ACTs exposure in early pregnancy to miscarriage (p-value = 0.028), hypertension in pregnancy (p-value = 0.011), and antepartum hemorrhage (p-value = 0.05). The study identified these neonatal outcomes which were significant, low birth weight (<2500gm) (p-value = 0.021) and low birth length (<10thpercentile) of 0.019. The recommendation of this study was to create awareness both to the public and healthcare workers on malaria treatment in pregnancy. More researches should also be done using large sample sizes and in different sites. | en_US |