Factors Associated With Uptake of Intermittent Preventive Treatment for Malaria in Pregnant Women in Prestea Huni- Valley District in Western Region

Abstract

Background Individuals in endemic areas are susceptibility to malaria. Nevertheless, when women become pregnant mostly for the first time, they become more susceptibility to malaria. It is believed that malaria is the cause of persistent mild to severe anaemia, in spite of the fact that malaria in pregnancy may not be seen as a severe illness. In addition, low birth-weight of infants may be a cause of malaria in pregnancy. This happens when there is an obstruction with the maternal-fetal exchange that occurs at the placenta site. Ghana embraced a new Intermittent Preventive Treatment (IPT) using Sulphadoxine-Pyrimethamine (SP) policy in 2004, to prevent malaria in pregnancy. The coverage of IPTp-SP remains below the target (80%). The study intended to determine factors associated with IPT-SP uptake among pregnant women in the Prestea Huni-Valley. Methods This study employed cross-sectional design covered 333 pregnant mothers, 36 weeks of gestation and above, at Antenatal Care (ANC) in three health facilities. They were interviewed using a structured questionnaire in Prestea Huni-Valley District between May and June. Categorical variables were analysed as frequencies. Chi-square was used to measure the association between socio-demographic factors, practice at ANC on IPTp and knowledge on IPTp, and IPTp-SP use. The strengths of association were assessed using logistic regression. A 95% confidence interval and p-value < 0.05 show a statistically significant association. The data were analysed using STATA 15. Results A total of 333 pregnant women at 36 weeks or more gestational age were studied. The mean age of the women was 27.56, standard deviation was ± 6.20 and the range was 18-45 years. IPTp-SP coverage among pregnant women during the current pregnancy was 99.4% (irrespective of the number of doses), but only 65.5% received ≥3 doses at the time of the study. Factors such as educational level, receiving information on IPTp-SP from ANC staff, attending ANC in the first trimester were significant in the unadjusted regression model but not significant in the multiple logistic regression models. Pregnant women who had their first SP dose at 24 weeks or more were 8.5 times more likely to take less than 3 doses of SP (AOR: 8.46, 95% CI: 2.03 - 35.21). Conclusion This study suggests that the use of IPTp-SP among pregnant women in Prestea Huni-Valley is below the national target for three or more doses. The knowledge level on IPTp-SP among women pregnant 36 weeks of gestation and above is inadequate. Gestational age of first SP dose significantly associated with the uptake of SP. Refresher training on IPTp-SP policy for ANC staff and continuous education within the community on the benefits of IPTp is required.