Abstract
Introductionmalaria in pregnancy can lead to medical emergencies. Utilization of intermittent preventive treatment for prevention of malaria in pregnancy with Sulphadoxine- Pyrimethamine (IPTp-SP) has remained low in developing countries in sub-Saharan Africa. This study aimed to identify the factors determining uptake of IPTp-SP in Nigeria using the 2013 Nigeria Demographic Health Survey.Methodswe conducted a secondary analysis of data extracted from the National Demographic Health Survey 2013 which used a three stage stratified sampling method to select respondents. Independent variables considered were age, marital status, the level of education of respondents and their spouses, region, location of residence, wealth-index and birth order. The dependent variable was the use of two or more doses of SP for IPTp in the two years before the survey. Descriptive statistics for socio-demographic and selected characteristics was done. Chi-square test was used to test associations between sociodemographic characteristics and IPTp-SP uptake. Multiple logistic regressions at 95% confidence interval were used to determine predictors of IPTp utilization using STATA version14 software.Resultsof the 38,948 women interviewed 12,473 (32%) had given birth two years preceding the survey and 15% used at least two doses of SP for IPTp. Women aged 30 years and above [aOR 1.4, C.I:1.1-1.7], in the middle class or higher wealth index [aOR 1.5, CI: 1.1-2.0], with two or more ANC visits [aOR 4.2, CI: 1.4 - 12.5], were more likely to use IPTp.Conclusionlate initiation of IPTp after the second trimester was a contributory factor for poor SP utilization. Interventions targeted at ensuring pregnant women attend ANC and use of IPTp-SP after quickening should be promoted.
Highlights
About 3.2 billion people remain at risk of malaria globally
110 million clinical cases of malaria are diagnosed each year in Nigeria and malaria contributes up to 25% of infant mortality and 30% of under-5 mortality and overburdens the already-weakened health care system in the country [2]
In determining the predictors of IPTp -SP utilization, we found that women aged greater than or equal to 30 years, those living in urban areas and of the middle to upper wealth index with two or more antenatal care (ANC) attendance visits had higher odds of IPTp-SP utilization
Summary
About 3.2 billion people remain at risk of malaria globally. An estimated 214 million new cases of malaria and 438,000 deaths occurred in 2015 alone [1]. 110 million clinical cases of malaria are diagnosed each year in Nigeria and malaria contributes up to 25% of infant mortality and 30% of under-5 mortality and overburdens the already-weakened health care system in the country [2]. Malaria in pregnancy (MIP) is an obstetric, social, economic and medical emergency and is a major, preventable cause of maternal morbidity, mortality and poor birth outcomes in sub-Saharan Africa. It is responsible for 11% of maternal deaths, 2-5% of maternal anemia, 8-15% low birthweight infants and 3-8% of infant deaths in Nigeria [3, 4]. The proportion of women attending antenatal care (ANC) clinics and those receiving the first and subsequent doses of SP vary which suggests missed opportunities for intermittent preventive treatment of malaria with Sulphadoxine-Pyrimethamine (IPTp-SP) in pregnancy [1]
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