Uptake of Intermittent Preventive Treatment of Malaria With Sulfadoxine-Pyrimethamine and Pregnancy Outcomes in the Greater Accra Regional Hospital in Accra, Ghana

Abstract

Introduction: Malaria serves as a major public health threat all around the world, with pregnant women in sub-Saharan Africa among those who are most at risk. Malaria in pregnancy is known to lead to adverse pregnancy outcomes, including preterm delivery, low birthweight, and stillbirth. To prevent malaria during pregnancy, the World Health Organization recommends that pregnant women in malaria-endemic areas receive at least three doses of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (IPTp-SP). However, current data shows that many pregnant women in Ghana do not receive three or more doses of IPT. This study seeks to determine the proportion of IPTp-SP uptake among women at the Greater Accra Regional Hospital and to explore the association between IPTp uptake and specific pregnancy outcomes, while also identifying factors associated with IPTp uptake. Methods: A quantitative cross-sectional study design was implemented among 385 women aged 18-49 years at the Greater Accra Regional Hospital who gave birth in the six months preceding the study. Structured questionnaires were used to determine the proportions of IPTpSP uptake and pregnancy outcomes, and to assess sociodemographic, knowledge, and health system factors. Bivariate analysis in Stata V16 was used to determine which factors were significantly associated with IPTp uptake and Pearson chi-square test was used to assess the association between pregnancy outcomes and IPTp-SP uptake. Logistic regression modelling was used to assess the effect of specific IPTp doses on low birthweight and preterm delivery. Results: The proportion of IPTp-SP uptake was as follows: 4.4% of the women did not take any doses of IPT, 4.2% received only 1 dose of IPT, 6.5% received exactly 2 doses of IPT, 33.5% received exactly 3 doses of IPT, 23.6% received exactly 4 doses of IPT, 27.0% received exactly five doses of IPT, and 0.8% received more than five doses of IPT. Of the 385 women who participated, 15.1% received inadequate IPT (doses of IPT (IPT3+), and 27.8% achieved at least five doses of IPT (IPT5+).