Factors associated with uptake of intermittent preventive treatment of malaria among pregnant women in the Sene East District, Ghana

Paapa Gondong; Mavis Pearl Kwabla; Jacob Munukpah; Usera Iddrisu; George Wak

doi:10.51867/ajernet.7.1.61

Autores

Paapa Gondong Ghana Health Service, Sene East District Health Directorate, Box 38, Kajaji, Bono-East Region, Ghana https://orcid.org/0009-0004-8341-9209
Mavis Pearl Kwabla Fred Binka School of Public Health, University of Health and Allied Sciences, PMB 31, Ho, Volta Region, Ghana https://orcid.org/0000-0002-1435-0795
Jacob Munukpah Ghana Health Service, Bolgatanga Regional Health Directorate, PMB, Upper East Region, Ghana
Usera Iddrisu Ghana Health Service, Sene East District Health Directorate, Box 38, Kajaji, Bono-East Region, Ghana
George Wak
gwak@uhas.edu.gh
Fred Binka School of Public Health, University of Health and Allied Sciences, PMB 31, Ho, Volta Region, Ghana https://orcid.org/0000-0001-6892-1007

Palavras-chave:

Intermittent Preventive Treatment, Sulfadoxine-Pyrimethamine, Malaria, Pregnancy, Antenatal care, Ghana

Resumo

Malaria poses a significant risk to pregnant women and infants, particularly in sub-Saharan Africa. Intermittent Preventive Treatment with Sulfadoxine Pyrimethamine (IPTp-SP) for malaria in pregnancy is an effective intervention recommended by the World Health Organization (WHO) to protect this vulnerable group. However, uptake of IPTp has been suboptimal in most settings in Ghana, due to several factors. This study, therefore, sought to determine the factors associated with the uptake of IPTp-SP among pregnant women in the Sene-East District of Ghana. The study adopted the facility-based cross-sectional design, where the Cochrane formula for sample size determination was used to select 433 pregnant women with a gestational age of 36+ weeks, as well as postpartum women of at most 4 weeks after birth, at Antenatal Care (ANC) centres in six selected health facilities in the district. The theory underpinning this research was the Health Belief Model (HBM). The model seeks to explain and predict the pathways through which individuals behave to improve health based on their attitudes and beliefs. Data were collected using structured questionnaires and analyzed using logistic regression to assess factors associated with IPTp-SP uptake. Results showed that the level of IPT3+ uptake was 58.4% among the study participants, which is below the WHO-recommended optimal level of IPTp uptake among pregnant women. In the multivariate analysis, women who had some education had higher odds of completing 3+ doses (aOR=1.72, 95% CI:1.002-2.961, p=0.049) compared to those without education. Also, multiparous women were 2.4 times more likely to have 3+ doses of IPTp compared to nulliparous women (aOR: 2.35; 95% CI: 1.341 - 4.128, p=0.003). Pregnant women who took the first dose of IPTp in the 3rd trimester were about 95% less likely to adhere to 3+ doses of IPTp-SP compared to those who started uptake of IPTp-SP at the 2nd trimester (aOR=0.055, p<0.001). Other factors associated with IPTp-SP uptake included knowledge of the ideal number of doses, where women with higher knowledge were more likely to receive the optimal number of IPTp-SP doses. Gestational age at first IPTp-SP uptake was another factor that was associated with optimal uptake of IPTp-SP. Specifically, women who took their first IPTp-SP in the first trimester were more likely to receive all 3+ doses. To improve IPTp-SP adherence, it is essential for stakeholders to engage in the education of younger and first-time mothers about the importance of early IPTp-SP uptake.

Dimensions

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