Table 2

ENAT Enhanced infection management package (EIMP) components

InfectionEIMP activity
Urinary tract infection/asymptomatic bacteriuriaScreen: Urine culture and antibiotic sensitivity.
Treat: Initially per clinical protocol, then based on culture results with targeted antibiotic treatment-based on antibiotic resistance patterns.
Sexually transmitted/
reproductive tract infections
Screen:
  1. ALL pregnant women screened for gonorrhoea and chlamydia using accurate rapid diagnostic nucleic acid amplification testing (Cepheid GeneXpert).

  2. Pregnant women with symptoms are additionally screened for trichomonas and bacterial vaginosis (point of care diagnostics, TrichOSM and BVBlue)


Treat: All positive cases and partners (for gonorrhoea, chlamydia, trichomonas) are treated.
Chlamydia: azithromycin 1gm po
Gonorrhea: ceftriaxone 250 gm IM and azithromycin 1gm po
Trichomonas: metronidazole 2 gm po once
Bacterial vaginosis: metronidazole 500 mg po bid x 7 days
GeohelminthsPresumptive deworming at enrolment with mebendazole 500 mg or albendazole 400 mg once as per FMOH guideline; followed by stool screen and treatment for parasitic infections at least 4 weeks after initial deworming. If positive, treatment for intestinal parasites per FMOH guidelines.
  • ENAT, Enhancing Nutrition and Antenatal Infection Treatment; FMOH, Ethiopian Federal Ministry of Health.