Intermittent Preventive Treatment of Malaria in Pregnancy: Uptake of Three-To-Five Dose Regimen of Sulphadoxine Pyrimethamine at Osu Government Maternity Home

Abstract

Introduction: Malaria in pregnancy poses great risk to both mother and foetus. In Ghana, among pregnant women, malaria accounts for 3.4% of deaths and 16.8% of all admissions. In 2014, Ghana updated its policy on intermittent preventive treatment of malaria in pregnancy with sulphdoxine pyrimethamine (IPTP-SP) to reflect the updated policy of WHO (2012) of IPTP-SP. The purpose of this study is to determine the level of uptake of three to five dose of sulphdoxine pyrimethamine (SP) and to determine the stock levels of SP at the Osu Government Maternity Home. Methods: A crossectional study was carried out among 255 nursing mothers who have delivered within the past twelve weeks using interviewer structured questionnaire. Antenatal record books of mothers were reviewed to collect accurate information on their ANC characteristics during their recent pregnancy. Data on SP stock levels and stock out at the pharmacy for the past six months prior to the study were also reviewed using data extraction form. Data collected was analysed using Stata version 12. Pearson Chi-Square/Fischer Exact was used to test association between uptake of IPTp-SP and measured variables, and also further logistic regression analysis was carried out to determine the strength of antenatal indicators on uptake of IPTp-SP. Results: The proportion of uptake of three to five doses of IPTp-SP among the study participants were IPT3 (87.5%), IPT4 (55.7%) and IPT5 (14.5%). The proportion of women who received the first dose of IPTp-SP at sixteen weeks was 21.3%. Women who made ≥four visits were more likely to receive ≥ three doses of IPTp-SP than those who made < four visits (AOR=4.57, 95%CI 1.15-18.16, p<0.05). Women receiving the first dose of IPTp-SP in the third trimester were less likely to receive ≥ three doses of IPTp-SP than those who received in the second trimester (AOR=0.04, 95%CI 0.01-0.16, p<0.05). Stock levels of SP were adequate to meet the demands of IPTp-SP by the pregnant women at the Maternity Home for the period of review. Conclusion: The uptake of ≥ three doses of IPTp-SP was high in the study area. Frequent visits to the antenatal clinic and early uptake of the first dose of IPTp-SP by pregnant women were found to be necessary to achieve a high uptake of IPTp.