Abstract
Malaria infection during pregnancy is a major public health problem in sub-Saharan Africa. The World Health Organization (WHO) recommends that gestational and congenital malaria can be prevented by using intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). IPTp-SP is a full therapeutic course of antimalarial medicine administered during pregnancy as a component of antenatal care. This study’s objective was to assess the prevalence and predictors of IPTp-SP uptake in pregnancy in Sierra Leone. This study was based on the fifth round of the Multiple Indicator Cluster Survey (MICS 5) conducted in Sierra Leone in 2016. Participants were 8526 women aged between 15–49 years. Outcome variables were uptake of IPTp-SP during the last pregnancy. Data were analysed using cross-tabulation and logistic regression methods. Results showed that the prevalence of taking IPTp-SP was 94.81% (92.40, 96.14), and that the prevalence of taking at least three doses was 93.24% (92.50, 94.81). In the multivariate logistic regression, education, parity, and antenatal care (ANC) use were significant predictors of IPTp-SP uptake. Women with higher education had lower odds of taking IPTp-SP (Odds Ratio = 0.647, 95%CI = 0.444, 0.943); having higher parity (>4) was associated with lower odds of taking IPTp-SP (OR = 0.663; 95%CI = 0.442, 0.994) and adequate ANC use increased the odds of taking IPTp-SP in both urban (OR = 1.450, 95%CI = 1.158, 3.128) and rural areas (OR = 1.903, 95%CI = 1.069, 1.966). In contrast, the positive association between ANC visits and adequate doses of taking IPTp-SP was true for rural women only (OR = 1.408, 95%CI = 1.174, 1.689). In conclusion, the use of IPTp-SP is close to being universal, with the prevalence being relatively higher in the rural areas. Based on our findings, promoting adequate antenatal care visits should be regarded as a key strategy to improve the use of IPTp-SP in Sierra Leone. Further studies could focus on exploring other predictors of IPTp-SP uptake that are not captured by MICS in Sierra Leone.
Highlights
Malaria, a parasitic infection transmitted by mosquitoes, is one of the most devastating infectious diseases, killing more than 1 million people annually
125 million women are at risk of malaria every year and in sub-Saharan Africa, the area most burdened by malaria, the disease is thought to cause as many as 10,000 cases of malaria-related deaths in pregnancy, between 75,000 and 200,000 infants deaths annually resulting from malarial infection during pregnancy, and approximately 11% (100,000) of neonatal deaths due to low birth weight resulting from Plasmodium falciparum infections in pregnancy [2]
The results show that the percentage of taking intermittent preventive therapy with sulfadoxine-pyrimethamine (IPTp-SP) was higher in women aged 25–29 years (24.7%), residents of rural areas (59.4%), individuals in the North region (35.2%), women with primary level education (55.1%), women of Limba ethnicity (32.1%), participants from households in the poorest wealth quintile (22.0%), those who have given birth twice (47.7%), and those who respectively do not use the radio, TV, and internet (58.2%, 76.0%, and 95.7%, respectively)
Summary
A parasitic infection transmitted by mosquitoes, is one of the most devastating infectious diseases, killing more than 1 million people annually. 125 million women are at risk of malaria every year and in sub-Saharan Africa, the area most burdened by malaria, the disease is thought to cause as many as 10,000 cases of malaria-related deaths in pregnancy, between 75,000 and 200,000 infants deaths annually resulting from malarial infection during pregnancy, and approximately 11% (100,000) of neonatal deaths due to low birth weight resulting from Plasmodium falciparum infections in pregnancy [2]. It has been reported that malaria-associated maternal illness and low birth weight is mostly the result of Plasmodium falciparum infection and it occurs predominantly in Africa [4]. Pregnant women are more susceptible than the general population to malaria—they are more likely to become infected, have a recurrence, develop severe complications, and to die from the disease [5]
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