Abstract

BackgroundMalaria in pregnancy has adverse effects on maternal and child health. Intermittent preventive treatment (IPTp) with three doses of Sulfadoxine/Pyrimethamine is an effective preventive measure for malaria in pregnancy. However, 24.0% of women use this prophylactic regimen in Ebonyi State. Previous studies have focused on the level of uptake with less attention given to factors influencing uptake. Therefore, we examined the predictors of IPTp uptake in the last pregnancy among women in Ebonyi State, Nigeria.MethodsThis was a community-based cross-sectional study among 340 women of reproductive age selected using multistage sampling technique. A semi-structured interviewer administered questionnaire was used to collect data on socio-demographic characteristics of respondents, IPTp uptake and reasons for not taking IPTp. Adherence was judged adequate if three or more doses of IPTp were taken, otherwise inadequate. Data were analyzed using descriptive statistics, Chi- square test and logistic regression model at 5% level of significance.ResultsMean age of respondents was 28.8 ± 5.2 years, 96.5% were married, 19.4% had tertiary education, and 11.2% were from polygamous family. Uptake of IPTp was 74.2%. The level of IPTp uptake was 12.5 and 41.0% among women with no formal and tertiary education respectively. A similar pattern of IPTp uptake was observed among women from monogamous (38.0%) and polygamous (39.5%) families. Women education, husband education and family type were associated with uptake of IPTp, however only husband education remained a predictor of uptake. Women whose husband had secondary education (aOR = 4.1, 95%CI: 1.66–10.06) and tertiary education (aOR = 4.8, 95%CI: 1.76–12.90) were more likely to have IPTp uptake than those whose husbands had below secondary education.ConclusionAdequate IPTp uptake among women in their last pregnancy was below WHO recommendation. Intervention aimed at improving couple’s education could facilitate increase in IPTp uptake in Ebonyi State.

Highlights

  • Malaria in pregnancy has adverse effects on maternal and child health

  • More parasitemia had been reported among pregnant women who did not received Intermittent Prophylactic Treatment in Pregnancy (IPTp) in Ebonyi State, there appears to be paucity of studies documenting the uptake levels of IPTp and exploring the factors associated with uptake [8]

  • Measurement of variables The dependent variable was IPTp uptake which was categorized based on the number of doses of IPTp they took during the pregnancy in the year preceding the survey

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Summary

Methods

The 2019 projected population of Ebonyi State and population of women of reproductive age were 3,112,220 and 684,688 respectively as obtained from the State Ministry of Health. Measurement of variables The dependent variable was IPTp uptake which was categorized based on the number of doses of IPTp they took during the pregnancy in the year preceding the survey. Data collection and analysis A semi-structured interviewer administered questionnaire was used to collect data on socio-demographic characteristics of respondents, uptake of intermittent preventive treatment for malaria in pregnancy, health facility type and spouse information. Ethical considerations We obtained ethical approval from the Research and Ethics Committee of Ebonyi State Ministry of Health (approval reference number: SMOH/ERC/054/19). Participation in the study was voluntary and the information obtained were handled with strict confidentiality

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