Determinants of uptake of intermittent preventive treatment for malaria with sulfadoxine pyrimethamine in pregnancy: a cross-sectional analytical study in the Sekondi-Takoradi Metropolis of Ghana

• Published in: Archives of public health = Archives belges de santé publique 2021-10, Vol.79 (1), p.1-177, Article 177
• Main Authors: Anto, Francis, Ayepah, Christabel, Awini, Elizabeth, Bimi, Langbong
• Format: Article
• Language: English
• Subjects: Adaptive immunity; Analysis; Anemia; Antenatal care; Antimalarials; Birth weight; Drug therapy; Gestational age; Health facilities; Hospitals; Infections; Intermittent preventive treatment; Malaria; Malaria in pregnancy; Medicine, Preventive; Mothers; Obstetrics; Pregnancy; Pregnant women; Prenatal care; Preventive health services; Public health; Pyrimethamine; Questionnaires; Regression analysis; Secondi Takoradi Metropolis; Sociodemographics; Sulfadoxine pyrimethamine; Vector-borne diseases; Womens health
• ISSN: 2049-3258; 0778-7367; 2049-3258
• DOI: 10.1186/s13690-021-00694-1

Background Ghana malaria control programme recommends the uptake of five doses of sulfadoxine pyrimethamine (SP) during pregnancy following the review of the World Health Organization 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 SP for intermittent preventive treatment of malaria in pregnancy (IPTp-SP). Methods A cross-sectional analytical 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 antenatal care (ANC), number of visits, time of first dose of SP and number of doses were collected. ANC books were also reviewed. Logistic and ordered logistic regression analysis were done to determine respondent factors associated with uptake of IPTp-SP using Stata 15. Results Out 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), [greater than or equai to] 2 doses was 92.75 (460/496), [greater than or equai to] 3 doses was 80.65% (400/496) and [greater than or equai to] 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 [greater than or equai to] 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 [greater than or equai to]5 doses of SP. Keywords: Intermittent preventive treatment, Sulfadoxine pyrimethamine, Malaria in pregnancy, Secondi Takoradi Metropolis, Antenatal care