School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Malar J. 2018 May 25;17(1):211. doi: 10.1186/s12936-018-2360-z.
Malaria in pregnancy is a critical public health challenge, and intermittent preventive treatment for malaria during pregnancy (IPTp) has proven to be an effective intervention. However, access to and use of malaria interventions, including IPTp, remains a considerable problem among African women. This cross-sectional study investigated factors, including antenatal care (ANC) attendance (both numbers of visits and timing of the first visit) and socio-demographics, associated with the uptake of the recommended IPTp dose among Malawian women.
A nationally representative sample of women with a live birth in the 2 years preceding the survey from the Malawi Demographic Health Survey 2015-2016 dataset was analysed. Self-reported data on socio-demographics, ANC attendance and IPTp uptake were collected using a questionnaire and analysed using logistic models.
Of the 6549 included women, 1981 (30.2%) took the recommended three or more IPTp doses. Despite inadequate ANC visits, early ANC initiation increased the likelihood of these women taking the recommended IPTp dose; women who initiated ANC in the first [adjusted odds ratio (aOR) = 2.24; 95% confidence interval (CI) = 1.44-3.49] and second (aOR = 2.19; 95% CI = 1.56-3.08) trimesters were more likely to take the recommended IPTp dose compared to late initiators. The effect of the number of ANC visits on IPTp uptake was significant in married women (aOR = 1.68, 95% CI = 1.42-1.98), and the timing of first ANC visit was associated with IPTp uptake only among rural women (aOR = 2.13, 95% CI = 1.54-2.95).
ANC attendance is vital in IPTp uptake. The results highlight the need for health care providers to encourage women, particularly those in high-risk groups, to make frequent ANC visits and receive early ANC initiation to ensure high coverage of the recommended IPTp dose.
孕期疟疾是一个严重的公共卫生挑战，而孕期间歇性预防治疗疟疾（IPTp）已被证明是一种有效的干预措施。然而，在非洲妇女中，获得和使用疟疾干预措施，包括 IPTp，仍然是一个相当大的问题。本横断面研究调查了与马拉维妇女接受推荐剂量的 IPTp 相关的因素，包括产前保健（ANC）就诊（就诊次数和首次就诊时间）和社会人口统计学因素。
分析了来自 2015-2016 年马拉维人口健康调查的全国代表性样本中，在调查前 2 年内有活产的妇女。使用问卷收集社会人口统计学、ANC 就诊和 IPTp 使用率的自我报告数据，并使用逻辑模型进行分析。
在纳入的 6549 名妇女中，有 1981 名（30.2%）接受了推荐的 3 剂或更多 IPTp 剂量。尽管 ANC 就诊次数不足，但早期 ANC 启动增加了这些妇女接受推荐剂量的 IPTp 的可能性；在第一[调整后的优势比（aOR）=2.24；95%置信区间（CI）=1.44-3.49]和第二（aOR=2.19；95% CI=1.56-3.08）孕期接受 ANC 的妇女比晚期接受 ANC 的妇女更有可能接受推荐剂量的 IPTp。在已婚妇女中，ANC 就诊次数对 IPTp 使用率的影响是显著的（aOR=1.68，95% CI=1.42-1.98），而首次 ANC 就诊时间仅与农村妇女的 IPTp 使用率相关（aOR=2.13，95% CI=1.54-2.95）。
ANC 就诊对 IPTp 的接受至关重要。研究结果强调，医疗保健提供者需要鼓励妇女，特别是高危人群，经常进行 ANC 就诊并尽早开始 ANC，以确保推荐剂量的 IPTp 得到高覆盖率。
