Coverage and Factors Associated with the Adherence to Unsupervised Daily Treatment Doses to Seasonal Malaria Chemoprevention in Builsa North District, Upper East Region of Ghana

Abstract

Background: Seasonal malaria chemoprevention (SMC) was recommended in 2012 for young children in the Sahel during the peak malaria transmission season. Since 2015, SMC with amodiaquine–sulfadoxine–pyrimethamine (AQ–SP) has been implemented during the high malaria transmission season in three region of Ghana. Adherence to the SMC is one of the key determinant for a successfull protection of children under five. In Ghana, there is limited evidence of factors associated with adherence to SMC. Objective: To explore the coverage and the risk factors associated with adherence to Seasonal Malaria Chemoprevention (SMC) among caregivers in Builsa North District. Methods: In four (4) sub-district households in the Builsa North District, a cross-sectional study was conducted. The district was stratified into six, and 4 subdistricts were selected using simple random sampling. The 438 participants were recruited via balloting using random sampling. Illustrative summary statistics performed for frequencies. The knowledge of caregivers on Malaria and SMC were assess through scoring of correct answers question related to malaria and SMC. The association between SMC adherence and independent variables were tested using Pearson’s chi-square test and Fisher Exact Test. Simple and multiple logistic regressions performed to determine associations and strength of associations between SMC adherence and the independent variables with all results interpreted at 95 % confidence level. Results: The SMC coverage and adherence rates among the caregivers in the Builsa North District were respectively 90.87% and 95.36% with an awareness at 97.94%. The reasons reported for non-adherence were child's refusal (38.46%), the child's vomiting of the drug (33.33%), the occurrence of an illness within the period of medication (15.38%), the forgetting to give the subsequent doses (12.82%). About the half (49.31%) of caregivers had a good knowledge of Malaria, while 66.51% had a fair knowledge of SMC. Significant predictors of SMC on multiple logistic regression were place of residence, caregivers’ satisfaction, the source of knowledge. Conclusion: The coverage of SMC of the in Builsa North District is 90.87% while the adherence is 95.36%. The keys factors that are associated with SMC Adherence are the being aware of SMC through a non-health professional source, place of residence, and the satisfaction of caregivers with the previous SMC campaign and household size.