The use of intermittent preventive treatment with sulphadoxine-pyrimethamine in pregnancy in Ibadan, Nigeria: Implications for policy

Abstract

Malaria in pregnancy (MIP) remains a major public health concern, inspite of the adoption of WHO recommended intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine (SP) for its control in Nigeria. Using interviewer administered questionnaires, information on knowledge of the burden, consequences and the use of SP for malaria control in pregnancy was obtained from 800 mothers within 24 h after delivery at two health centres in Ibadan. Women who attended antenatal care (ANC) at the secondary facility were less likely to demonstrate poor knowledge of causes (OR = 0.18, 95% CI = 0.08, 0.38), consequences (OR = 0.37, 95% CI = 0.24, 0.55) and control strategies (OR = 0.32, 95% = 0.18, 0.59) compared with tertiary facility. Only 56.4% of all the mothers were aware of IPTp SP as government policy for prevention of MIP out of which 16.9% used IPTp SP in index pregnancy. Overall, only 18.4% of all mothers used IPTp SP. Being unaware of the existing government policy and educational attainment of ≤9 years independently predicted non-usage of IPTp SP. This study revealed that the uptake of IPTp SP in pregnancy is poor in spite of good knowledge of burden of malaria in pregnancy and underscores the need to scale up awareness campaign and monitor implementation at all levels of health care. Key words: Malaria in pregnancy, intermittent preventive treatment, sulphadoxine-pyrimethamine.