Coverage and factors influencing uptake of the optimal dose of intermittent preventive treatment with sulfadoxine-pyrimethamine in rural areas before the adoption of the new World Health Organization guidelines in Burkina Faso

Abstract

Background Malaria in pregnancy is a major public health problem in developing countries, with a high impact on maternal and child morbidity and mortality. Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine during pregnancy (IPTp-SP) is one of the strategies recommended by the World Health Organization (WHO) to fight against this flail. However, data on its use in rural Burkina Faso are scarce. The aim of our study was to determine the coverage and factors associated with uptake of the optimal dose (2 doses) of IPTp-SP in the Rural Health District of Houndé before the adoption of the new WHO guidelines. Methods A cross-sectional study was conducted from 1 January 2006 to 31 December 2012 among 7188 pregnant women who showed up at least once for an antenatal consultation (ANC) in five rural primary healthcare centres in Health District of Houndé and for whom information on dispensation was available. Sociodemographic and IPTp-SP data were collected from ANC registries using a structured collection form. Factors influencing uptake of the optimal dose of IPTp-SP were explored using logistic regression. Results A total of 5103 pregnant women out of 7188 (70.99%) had met the optimal dose of IPTp-SP recommended by WHO. Half of them had performed at most 3 ANCs. The median age of the participants was 24 years (IQR: [20–28]). Having performed a least 4 ANCs was associated with compliance (adjusted odds ratio [95% CI] = 1.66 [1.48–1.88]), but also compliance with the optimal dose varied significantly between primary healthcare centres (p < 0.001) Conclusion We found that from 2006 to 2012, the uptake of optimal IPTp-SP doses was low in Houndé. The target of 80% coverage of the optimal dose of IPTg-SP was not achieved in rural areas before the new WHO guidelines were adopted. Strategies must be adopted to encourage women to perform ANC and to make sexual and reproductive health services more accessible.