Malaria Prevention Measures among Pregnant Women: A Population-Based Survey in Nnewi, Nigeria

Abstract

We examined factors related to the uptake of two malaria prevention measures, insecticide-treated bed-nets and prophylactic sulphadoxine-pyrimethamine (SP), among pregnant women in Nnewi, Nigeria. The survey had a quantitative and qualitative part. For each part, the subjects meeting our inclusion criteria were systematically identified in a population-based manner. For the qualitative part, focused group discussions, in-depth interviews with a wide variety of stakeholders (e.g., health workers, males whose wives are pregnant, and drug and net sellers), and key informants including doctors and nurses were held. All data covered various aspects related to the topics. A total of 384 subjects participated. The mean age was 28.9 years (95% CI 23.4–34.5). The primigravidae (odds 1.8–2.3) and illiterates (odds 4.1–13.5) were less likely to sleep under the net. Primigravidae were 2.0x less likely to uptake adequate SP. The uptake was also associated with having adequate knowledge on SP (2.4x), completing usual (≥4 visits) antenatal visits (3.9x), and being in the best (≥9 visits) antenatal visit scenario (10.5x). Other barriers identified were thermal discomfort, lack of availability, cost, and unsupervised uptake of SP. Based on a representative sample, systematic procedures, and within current evaluation limits, we conclude that primigravidae and those with no formal education and inadequate antenatal visits should be the foremost group for encouraging uptake of malaria prevention measures. The policymakers should resolve issues of thermal discomfort, availability, cost, unsupervised uptake, and inadequate awareness and confidence on SP prophylaxis. The solutions are available and should be actively sought.

Pregnant Women and Malaria Preventive Measures: A Case of Tamale Teaching Hospital, Ghana

“…Similar to Bhalla et al study, educational level of pregnant women was associated with malaria preventive measures, but economic status and knowledge were not associated with preventive measures [33]. Furthermore, in this present study, those with tertiary educational levels were 6.8 times more likely to practice malaria prevention as compared to those without education.…”

Utilization of malaria preventive strategies among pregnant women at Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria

“…Similarly, the use of long-lasting insecticidal nets significantly decreased the risk of occurrence of the first malaria infection in early pregnancy in a study that assessed the use and effectiveness of long-lasting insecticidal nets in early pregnancy in Benin and its impact on malaria infection risk [25]. This finding supports reports that the use of ITNs substantially reduced the risk of malaria in pregnancy and, therefore, was a protective factor against developing malaria in pregnancy [26][27][28][29].…”

Variations in the use of malaria preventive measures among pregnant women in Guinea: a secondary analysis of the 2012 and 2018 demographic and health surveys

“…Data from the 2012 DHS revealed that marital status and relationship with the head of household were significantly associated with MPMs use. Indeed, married women were more likely to use MPMs during pregnancy than single women, who require special attention because they can remain hidden and resort to self-medication [ 31 ]. In fact, in Nigeria, women reported needing the support or consent of their husbands before going to an ANC or taking the medication [ 28 ].…”