Malaria in pregnancy: Assessment of doctors’ conformity to monthly intermittent preventive treatment in a Sub-Saharan African Country

Abstract

Background: Administration of intermittent preventive treatment (IPT) in pregnancy is recommended for all pregnant women living in areas of stable malaria transmission. In order to increase the chances of a parturient receiving adequate number of IPT in pregnancy, World Health Organization (WHO) now recommends that it should be commenced from second trimester and given every month (at least 4 weeks apart) until the time of delivery, however, this recommendation is not being practiced by all doctors attending to pregnant women. Objective: To determine the conformity of Doctors to monthly prescription of IPT till delivery. Materials and Methods: This was a cross-sectional survey of antenatal clinic Doctors’ prescription of IPT during pregnancy in Enugu state. Information obtained included the socio-demographic characteristics of the Doctors, knowledge of IPT in pregnancy for malaria and implementation of the new IPT policy. A P-value of <0.05 was considered statistically significant. Results: A total of 119 doctors participated in the study. The mean age of the doctors was 36.15 +/- 2.42 years. One hundred and seven (89.9%) of the respondents had good knowledge that IPT is for prevention of malaria. One hundred and eighteen (99.2%) used sulphadoxine-pyrimethamine for IPT. One hundred and fourteen (95.8%) respondents knew that IPT should be commenced in second trimester, and 85.7% conformed to the new monthly policy of IPT prescription. Among the 20.2% of doctors who prescribed IPT only for 2 – 3 times during pregnancy, 13 (54.2%) gave the reason that they were comfortable with the old pattern of stopping at 36 weeks. There was significant association between knowledge of IPT in pregnancy and year of attainment of MBBS (P = 0.015). Age (P = 0.006) and level of practice (P = 0.002) were significantly associated with practice of the new IPT in pregnancy policy. Conclusion: There was high conformity to monthly IPT prescription until delivery among doctors in Enugu, Nigeria.