Determinants of Uptake of Intermittent Preventive Treatment for Malaria With Sulfadoxine Pyrimethamine in Pregnancy: A Cross-Sectional Study in the Sekondi-Takoradi Metropolis of Ghana

Abstract

BackgroundGhana malaria control programme recommends the uptake of five doses of SP during pregnancy following the review of the WHO recommendations in 2012. The uptake of higher doses of SP since the implementation of the new policy in 2016, has been low across the country. The current study determined factors that can be improved to increase uptake of IPTp-SP in malaria endemic regions. MethodsA descriptive cross-sectional study was carried out among women who had just delivered in selected health facilities in the Sekondi-Takoradi Metropolis of Ghana. Participants were enrolled from the lying-in wards of the study facilities after delivery. Data including time of initiating ANC, number of visits, time of first dose of SP and number of doses were collected. ANC books were also reviewed. Logistic and multinomial logistic regression analyses were done to determine respondent factors associated with uptake of IPTp-SP using Stata 15. ResultsOut of the 496 mothers who participated in the study, 370 (74.60%) initiated ANC during the first trimester, 123 (24.80%) during the second, with only three (0.60%) starting during the third trimester. Majority (463/496, 93.35%) made > 4 visits. Uptake of at least one dose of SP was 98.79% (490/496), ≥ 2 doses was 92.75 (460/496), ≥ 3 doses was 80.65% (400/496) and ≥ 4 doses was 40.32% (200/496). Uptake of IPTp 5 was very low (6.65%, 33/490). A unit increase of one ANC visit was associated with 20% higher odds of receiving 3-4 doses of SP with respect to receiving 1-2 doses (p<0.001). The probability of receiving 5 or more doses of SP with respect to 1-2 doses was 26% higher with a unit increase of one ANC visit. Conclusion Uptake of 3-4 doses and ≥ 5 doses of SP were associated with making more ANC visits. Encouraging and motivating expectant mothers to make more ANC visits can improve uptake of ≥ 5 doses of SP.

Factors associated with optimal uptake of sulphadoxine-pyrimethamine in pregnancy: a facility-based cross-sectional study in the Ningo-Prampram district of Ghana

“…The level of IPTp5 uptake (15.3%) in the current study is comparable to results from our earlier studies carried out in some parts of the country. Our rst hospital-based study conducted in Accra, the capital city and reported in 2017, documented 14% uptake of IPTp5, the second, this time in a rural setting (Navrongo) reported 16.0% in 2019 (5,25), and the third study reported a much lower level of uptake (< 7.0 %) in 2021 from Secondi-Takoradi (29).…”

Spatial distribution and determinants of optimal intermittent preventive treatment for malaria during pregnancy: A secondary data analysis of the 2019 Ghana Malaria Indicators Survey

“…Despite this progress, providing long-lasting insecticidal nets to rst-time mothers and extending SP to all pregnant women attending ANC services will signi cantly improve maternal and birth outcomes in Ghana (18). Previous studies conducted in Ghana have shown a correlation between SP uptake during pregnancy and several factors (19)(20)(21)(22)(23). For instance, De-Gaulle et al (2022) found that untrained health staff and stock-outs decreased SP uptake, while in a study by Kumah et al (2022), the number of ANC contacts, women's educational level, and time to the rst ANC contact were found to be predictive factors of SP uptake.…”