Abstract
IntroductionMalaria continues to pose a public health challenge in Ghana particularly in pregnant women. Ghana adopted intermittent preventive treatment of malaria in pregnancy policy using sulphadoxine pyrimethamine. Despite its implementation, its coverage still remains low. This study sought to investigate factors that influence the uptake of intermittent preventive treatment of malaria in pregnancy in the Sunyani Municipality.MethodsThis was a cross sectional study which employed a quantitative method. The study was conducted in five selected facilities in the Sunyani Municipality within the period of January to June 2015. Structured questionnaires were administered to 400 pregnant women randomly sampled from antenatal clinics of selected health facilities. Descriptive, bivariate and multivariate analysis of quantitative data was done using Stata12.ResultsA total of 400 pregnant women at 36 weeks or more gestational age were studied. The study revealed that 98.5% of the pregnant women received at least one (1) dose of sulphadoxine pyrimethamine during the current pregnancy with 71% receiving optimal (at least 3 doses) doses of sulphadoxine pyrimethamine for intermittent preventive treatment of malaria in pregnancy at the time of study. The study revealed that women who attended ANC ≥4 times (Adjusted OR = 4.7, 95% CI 1.31-17.2), knowledge of malaria in pregnancy (Adjusted OR = 2.2, 95% CI 1.03-4.62) and knowledge of intermittent preventive treatment for malaria in pregnancy (Adjusted OR = 1.8, 95% CI 1.15-2.96) were found to be positively associated with the uptake of optimal doses of sulphadoxine pyrimethamine.ConclusionThis study has demonstrated that having a good knowledge of malaria in pregnancy and intermittent preventive treatment of malaria in pregnancy can significantly influence the uptake of optimal doses of sulphadoxine pyrimethamine. Encouraging women to attend antenatal care regularly (at least four visits) could also increase the optimal uptake of sulphadoxine pyrimethamine.
Highlights
Malaria continues to pose a public health challenge in Ghana in pregnant women
This model provides results of the association between client characteristics and the binary outcome {sub optimal (≤ 2 doses) or optimal (≥ 3 doses)} using chi-square test. It showed that educational status, antenatal care attendance of 4 or more visits, having good knowledge of MiP and IPTp were positively associated with optimal uptake of SP (P < 0.05)
This summarizes results of a further logistic regression of client characterizes and its influence on the uptake of IPTp using SP. It showed that antenatal care attendance of 4 or more visits, having good knowledge of MiP and IPTp were positively associated with optimal uptake of SP (P < 0.05)
Summary
Malaria continues to pose a public health challenge in Ghana in pregnant women. The study revealed that women who attended ANC ≥4 times (Adjusted OR = 4.7, 95% CI 1.31-17.2), knowledge of malaria in pregnancy (Adjusted OR = 2.2, 95% CI 1.03-4.62) and knowledge of intermittent preventive treatment for malaria in pregnancy (Adjusted OR = 1.8, 95% CI 1.15-2.96) were found to be positively associated with the uptake of optimal doses of sulphadoxine pyrimethamine. Even though adult women in malaria endemic areas have a high level of immunity, this generally is impaired during pregnancy in the first pregnancy, thereby increasing their risk of infection [7]. The country moved from the use of mono-therapy to combination therapy using Artemisinine-Based Combination Therapy [1] As part of this policy was the change from use of weekly Chloroquine Chemoprophylaxis to Sulphadoxine-Pyrimethamine (SP) as Intermittent Preventive Treatment (IPT) for malaria prevention during pregnancy
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