Determinants of uptake of malaria preventive interventions among pregnant women in eastern Uganda

Abstract

Background Consistent use of insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp) have been recommended as cost-effective interventions for malaria prevention during pregnancy in endemic areas. However, the coverage and utilization of these interventions during pregnancy in sub-Saharan Africa is still suboptimal. This study aimed to determine the uptake of IPTp and ITNs and associated factors among women during their recent pregnancy in Eastern Uganda. Methods This was a cross-sectional study conducted among 2062 women who had delivered within the last 12 months prior to the start of the study in three districts of Eastern Uganda. The primary outcomes were consistent ITN use and optimal uptake (at least 3 doses) of IPTp. A modified Poisson regression was used to examine the association between consistent ITN use and the uptake of optimal doses of IPTp with independent variables. Data were analysed using Stata 14 software. Results The level of uptake of IPTp3 (at least three doses) was 14.7%, while IPTp2 (at least two doses) was 60.0%. The majority (86.4%) of mothers reported regularly sleeping under mosquito nets for the full duration of pregnancy. Uptake of IPTp3 was associated with engaging in farming (adjusted PR = 1.71, 95% CI [1.28–2.28]) or business (adjusted PR = 1.60, 95% CI [1.05–2.44]), and attending at least 4 antenatal care (ANC) visits (adjusted PR = 1.72, 95% CI [1.34–2.22]). On the other hand, consistent ITN use was associated with belonging to the fourth wealth quintile (adjusted PR = 1.08, 95% CI [1.02–1.14]) or fifth wealth quintile (adjusted PR = 1.08, 95% CI [1.02–1.15]), and attending at least 4 ANC visits (adjusted PR = 1.07, 95% CI [1.03–1.11]). Conclusion Uptake of IPTp3 and consistent ITN use during pregnancy were lower and higher than the current Ugandan national targets, respectively. Study findings highlight the need for more efforts to enhance utilization of ANC services, which is likely to increase the uptake of these two key malaria preventive measures during pregnancy.

Treatment-seeking and uptake of malaria prevention strategies among pregnant women and caregivers of children under-five years during COVID-19 pandemic in rural communities in South West Uganda: a qualitative study

“…Concurrently, a pandemic: the new corona virus disease-2019 (COVID- 19) outbreak was declared by the WHO in March 2020 as a global pandemic. The seriousness of the pandemic necessitated an immediate response to curtail its spread and avert the associated effects.…”

“…Despite the proven efficacy of prevention programs, the burden of malaria remains unacceptably high due to challenges related to new pyrethroid-resistant mosquito strains, and laxity in uptake of prevention measures [9,[14][15][16][17][18][19]. A 2016 field survey in a rural district in Uganda [17], showed high malaria cases in the communities, despite the household possession of ITNs.…”

Determinants of utilization of malaria preventive measures during pregnancy among women aged 15 to 49 years in Kenya: an analysis of the Malaria Indicator Survey 2020

“…Previous studies have reported that women classified as poor may have little or no access to the antenatal care clinic due to a lack of transport costs and payments at the clinic [ 37 ]. Therefore, access to the freely administered IPTpSP and a free issue of ITN during pregnancy at the ANC clinic might not be possible [ 37 , 38 ].…”

“…Similar findings have been reported where IPTpSP use was associated with ANC visits but not ITN use during pregnancy [ 36 ]. In Uganda, a study that looked at the determinants of utilization of ITN and IPTpSP reported that women who attended the ANC clinic were more likely to use malaria preventive measures [ 38 ]. On the contrary, a study that looked at the uptake of ITN and IPT in Gabon did not find any association between ANC clinic attendance and the uptake of malaria preventive measures during pregnancy [ 39 ].…”

Predictors of knowledge and use of long-lasting insecticidal nets for the prevention of malaria among the pregnant women in Pakistan

“…Therefore, there is a need to scale-up programmes, which aim at creating awareness regarding malaria among pregnant women. This analysis may help streamline interventions to enhance uptake of LLINs (along with intermittent preventive treatment in pregnancy) [ 38 ]. It is recommended that health policy makers may focus on female education and start awareness programmes on malaria prevention through regular mobile phone messages.…”