Diarra Souleymane S, Konaté Drissa, Diawara Sory I, Tall Mariam, Diakité Mahamadou, Doumbia Seydou
1 International Center for Excellence in Research, University of Sciences Techniques and Technology of Bamako, Point-G, Mali BP 1805.
2 National Program of Malaria Control, Mali, BP: 233, Badalabougou SEMA Bamako.
J Parasitol. 2019 Apr;105(2):299-302. doi: 10.1645/17-141.
Intermittent preventive treatment in pregnancy (IPTp) with 3 or more doses of sulfadoxine-pyrimethamine (SP) is recommended by the World Health Organization to prevent malaria in pregnant women living in high-risk areas. According to the 2015 malaria indicator survey in Mali, malaria prevalence is 34.6%. The high risk of malaria among pregnant women and children led the Malian government to provide free SP during antenatal clinics visits. The Malian National Program of Malaria Control recommends at least 3 doses during pregnancy. The proportion of pregnant women taking 3 or more doses of IPTp-SP (IPTp 3+) still remains low. In Mali, only 36.7% of pregnant women with a live birth in the past 2 yr received IPTp 3+. To investigate the factors associated with this low coverage, we carried out a secondary data analysis using the database of the Mali 2015 Malaria Indicator Survey. Multiple logistic regression was used to analyze these factors among 2,382 interviewed women. Taking less than 3 doses was higher among women below 20 yr (adjusted odds ratio [AOR] = 1.43, 95% confidence interval [CI, 1.03; 1.98]); however, media accessibility (listening to radio) (AOR = 0.71, 95% CI [0.53-0.95]) and residing in Segou (AOR = 0.56, 95% CI [0.35-0.90]) seem to favor the opposite after adjusting the potential confusion. Residence, educational level, and wealth index were not statistically associated with taking 3 doses of IPTp-SP. This study identifies that women less than 20 yr of age were significantly associated with taking lower than 3 doses of IPTp-SP.
世界卫生组织建议，对生活在高风险地区的孕妇采用3剂及以上剂量的磺胺多辛-乙胺嘧啶（SP）进行孕期间歇性预防治疗（IPTp），以预防疟疾。根据2015年马里疟疾指标调查，疟疾患病率为34.6%。孕妇和儿童中疟疾的高风险促使马里政府在产前检查期间免费提供SP。马里国家疟疾控制计划建议孕期至少服用3剂。服用3剂及以上剂量IPTp-SP（IPTp 3+）的孕妇比例仍然很低。在马里，过去2年中有活产的孕妇中只有36.7%接受了IPTp 3+。为了调查与这种低覆盖率相关的因素，我们使用2015年马里疟疾指标调查的数据库进行了二次数据分析。采用多因素logistic回归分析2382名受访女性中的这些因素。20岁以下女性服用少于3剂的比例更高（调整优势比[AOR]=1.43，95%置信区间[CI，1.03；1.98]）；然而，在调整潜在混杂因素后，媒体可及性（收听广播）（AOR=0.71，95%CI[0.53 - 0.95]）和居住在塞古（AOR=0.56，95%CI[0.35 - 0.90]）似乎有利于相反的情况。居住地、教育水平和财富指数与服用3剂IPTp-SP无统计学关联。本研究表明，20岁以下女性与服用低于3剂IPTp-SP显著相关。
