Intermittent Preventive Treatment of Malaria in Pregnancy with Sulphadoxine-Pyrimethamine and its Associated Factors in the Atwima Kwanwoma District, Ghana

Kumah, Emmanuel; Duvor, Ferguson; Otchere, Godfred; Ankomah, Samuel Egyakwa; Fusheini, Adam; Kokuro, Collins; Karikari, Akua Kusiwaa; Adom, Joseph

doi:10.5334/aogh.3560

Cited by 5 publications

(10 citation statements)

References 18 publications

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“…In this study, 42.4% of participants used the optimal dose (three or more doses), with 28.0%, 18.1%, and 7.1% using 3 doses, 4 doses, and 5 doses, respectively. The percentage of pregnant women who received three or more doses of SP is similar to previous studies [34,39,46,47] but lower than the findings of a study conducted in southern Ghana (71.0%) [26] and the 2019 GMIS findings (61.0%) [48]. However, the percentage recorded in this study is an improvement over the percentage (39.0%) reported by the 2014 Ghana Demographic and Health Survey [15] and the NMCP (24.6%) in 2014.…”

Section: Discussionsupporting

confidence: 87%

“…Education helps women to read literature, as well as listen to the radio and watch TV to understand the effects of malaria in pregnancy. It also helps people be inquisitive and to be open to new ideas [ 36 , 38 , 39 ] which in turn builds women's knowledge of health issues which helps them to make well-informed healthcare choices during pregnancy [ 40 ]. Educated women are better subscribers of malarial interventions and often complete their IPTp-SP dosage course [ 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

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Predictors of optimal uptake of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine and outcome of pregnancy in selected health facilities: a cross-sectional study in Northern Ghana

Agyeman

Bassoumah

Owusu-Marfo

2023

Malar J

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Background Ghana adopted the 2012 World Health Organization (WHO) policy on intermittent preventive treatment of malaria in pregnancy (IPTp) and implemented it in 2014 in all regions of Ghana. Despite the implementation of this policy, there has been an unacceptably low percentage of eligible women receiving the optimal dose of IPTp in Ghana which leaves millions of pregnant women unprotected from malaria. The study, therefore, assessed the predictors of three or more doses (optimal dose) of sulfadoxine-pyrimethamine (SP) in Northern Ghana. Methods A cross-sectional study was conducted among 1188 women in four selected health facilities in Northern Ghana from September 2016 to August 2017. Information on socio-demographic and obstetric characteristics reported SP use, and maternal and neonatal outcomes were collected which was double-checked from the maternal health book as well as the antenatal care register. Pearson chi-Square and ordered logistic regression were used to determine the predictors of reported optimal SP use. Results Out of the 1146 women, 42.4% received 3 or more doses of IPTp-SP as recommended by the national malaria control strategy. SP uptake was significantly associated with antenatal care (ANC) attendance (aOR 0.49, 95% CI 0.36–0.66, P < 0.001), primary education (aOR 0.70, 95% CI 0.52–0.95, P = 0.022), four or more antenatal care visits (aOR 1.65, 95% CI 1.11–2.45, P = 0.014), ANC care visit in second trimester (aOR 0.63, 95% CI 0.49–0.80, P < 0.001) and third trimester (aOR 0.38, 95% CI 0.19–0.75, P = 0.006) and malaria infection during late gestation (aOR 0.56, 95% CI 0.43–0.73, p < 0.001). Conclusion The percentage of pregnant women who received three or more doses is below the target of the National Malaria Control Programme (NMCP). The push factors for the optimal use of SP are higher educational attainment, four or more ANC visits, and early initiation of ANC. The study also confirmed earlier findings that IPTp-SP uptake of three or more doses prevents malaria in pregnancy and improves birth weight. The uptake of IPTp-SP among expectant women will be informed and increased by encouraging formal general education beyond the primary level and encouraging early initiation of ANC visits.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Predictors of optimal uptake of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine and outcome of pregnancy in selected health facilities: a cross-sectional study in Northern Ghana

Agyeman

Bassoumah

Owusu-Marfo

2023

Malar J

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“…The median age of participants was 24 years (IQR= [20][21][22][23][24][25][26][27][28]). The youngest pregnant woman in this study was 14 years old and the oldest 47 years old.…”

Section: Socio-demographic Characteristicsmentioning

confidence: 99%

“…Globally, studies have reported potential determinants associated with the uptake of at least two doses of SP. Higher odds of optimal IPTp-SP uptake have been reported to be associated with time of rst ANC visit, number of ANC visits, parity, gravidity, higher age group and education level in Cameroon Tanzania and Ghana [17][18][19][20][21][22][23]. Whereas Okethwangu et al2019 reported that parity, age (being > 34 years) and time of rst ANC visit is associated with decrease uptake in Uganda [24].…”

Section: Introductionmentioning

confidence: 99%

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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

Cissé¹,

Cissé²,

Sirima³

et al. 2022

Preprint

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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.

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Spatial distribution and determinants of intermittent preventive treatment for malaria during pregnancy: a secondary data analysis of the 2019 Ghana malaria indicators survey

Ndayishimiye,

Teg-Nefaah Tabong

2024

BMC Pregnancy Childbirth

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Background Malaria during pregnancy is associated with poor maternal, foetal, and neonatal outcomes. To prevent malaria infection during pregnancy, the World Health Organization recommended the use of intermittent preventive therapy with sulfadoxine-pyrimethamine (IPTp-SP) in addition to vector control strategies. Although Ghana’s target is to ensure that all pregnant women receive at least three (optimal) doses of SP, the uptake of SP has remained low; between 2020 and 2022, only 60% of pregnant women received optimal SP during their most recent pregnancy. This study sought to map the geospatial distribution and identify factors associated with SP uptake during pregnancy in Ghana. Methods Secondary data analysis was conducted using the 2019 Ghana Malaria Indicator Survey dataset. The data analysed were restricted to women aged 15–49 years who reported having a live birth within the two years preceding the survey. A modified Poisson regression model was used to determine factors associated with SP uptake during pregnancy. Geospatial analysis was employed to map the spatial distribution of optimal SP uptake across the ten regions of Ghana using R software. Results The likelihood that pregnant women received optimal SP correlated with early initiation of first antenatal care (ANC), number of ANC contacts, woman’s age, region of residence, and family size. Overall, the greater the number of ANC contacts, the more likely for pregnant women to receive optimal SP. Women with four or more ANC contacts were 2 times (aPR: 2.16; 95% CI: [1.34–3.25]) more likely to receive optimal SP than pregnant women with fewer than four ANC contacts. In addition, early initiation and a high number of ANC contacts were associated with a high number of times a pregnant woman received SP. Regarding spatial distribution, a high uptake of optimal SP was significantly observed in the Upper East and Upper West Regions, whereas the lowest was observed in the Eastern Region of Ghana. Conclusions In Ghana, there were regional disparities in the uptake of SP during pregnancy, with the uptake mainly correlated with the provision of ANC services. To achieve the country’s target for malaria control during pregnancy, there is a need to strengthen intermittent preventive treatment for malaria during pregnancy by prioritizing comprehensive ANC services.

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Intermittent Preventive Treatment of Malaria in Pregnancy with Sulphadoxine-Pyrimethamine and its Associated Factors in the Atwima Kwanwoma District, Ghana

Cited by 5 publications

References 18 publications

Predictors of optimal uptake of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine and outcome of pregnancy in selected health facilities: a cross-sectional study in Northern Ghana

Predictors of optimal uptake of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine and outcome of pregnancy in selected health facilities: a cross-sectional study in Northern Ghana

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

Spatial distribution and determinants of intermittent preventive treatment for malaria during pregnancy: a secondary data analysis of the 2019 Ghana malaria indicators survey

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