Adewole Adefisoye Oluwaseun, Fawole Olufunmilayo, Ajayi IkeOluwapo, Yusuf Bidemi, Oladimeji Abisola, Waziri Endie, Nguku Patrick, Ajumobi Olufemi
Nigeria Field Epidemiology and Laboratory Training Program (NFELTP), Abuja, Nigeria.
Department of Community Medicine Ladoke Akintola University of Technology Teaching Hospital (LAUTECH) Ogbomoso, Oyo State, Nigeria.
Pan Afr Med J. 2019 Jun 11;33:101. doi: 10.11604/pamj.2019.33.101.14800. eCollection 2019.
Despite the effectiveness of intermittent preventive treatment in pregnancy using sulphadoxine-pyrimethamine (IPTp-SP), the uptake and coverage in southwest Nigeria are low. We assessed the factors influencing utilisation of IPTp-SP.
A multistage sampling technique was used to select 400 pregnant women from six primary healthcare centers in Oyo State. Data on socio-demographic characteristics, knowledge, attitude towards IPTp-SP and its utilisation were obtained using a semi-structured questionnaire. Data were analyzed using SPSS software. Focus group discussions (FGD) and key informant interviews (KII) were held for pregnant women and healthcare workers and analysed thematically.
Mean age of respondents was 27.2 (SD ± 5.5) years. Mean gestational age was 29.5 weeks (SD ± 5.4). Overall, 320 (80.0%) took SP, of which 152 (47.5%) took 2 doses and 112 (35.0%) took under directly observed therapy (DOT). We found that early booking for ANC, more than two visits to ANC (adjusted odds ratio (aOR) = 5.6; 95% CI: 1.2 - 26.6), good knowledge on IPTp (aOR = 9.3; 95% CI: 5.4 - 16.0), positive attitude towards IPTp (aOR = 2.1; 95% CI: 1.5 - 2.9) and being employed (aOR = 1.4; 95% CI: 1.1 - 1.7) were factors associated with IPTp-SP utilisation. The FGD and KII revealed that IPTp-SP drugs were mostly taken at home due to stock out.
Late ANC booking with stock out of IPTp-SP drugs was responsible for its low utilisation. There is need to encourage pregnant women to book early for ANC. Adherence to the practice of DOT scheme is recommended to improve IPTp-SP utilisation.
尽管使用周效磺胺-乙胺嘧啶进行孕期间歇性预防治疗（IPTp-SP）有效，但尼日利亚西南部地区对其的接受率和覆盖率较低。我们评估了影响IPTp-SP使用的因素。
采用多阶段抽样技术，从奥约州的六个初级卫生保健中心选取400名孕妇。使用半结构化问卷获取社会人口学特征、对IPTp-SP的知识、态度及其使用情况的数据。使用SPSS软件进行数据分析。对孕妇和医护人员进行了焦点小组讨论（FGD）和关键 informant 访谈（KII），并进行了主题分析。
受访者的平均年龄为27.2（标准差±5.5）岁。平均孕周为29.5周（标准差±5.4）。总体而言，320名（80.0%）服用了周效磺胺，其中152名（47.5%）服用了2剂，112名（35.0%）在直接观察治疗（DOT）下服用。我们发现，早孕检查、超过两次的早孕检查就诊（调整后的优势比（aOR）=5.6；95%置信区间：1.2 - 26.6）、对IPTp的良好了解（aOR = 9.3；95%置信区间：5.4 - 16.0）、对IPTp的积极态度（aOR = 2.1；95%置信区间：1.5 - 2.9）以及就业（aOR = 1.4；95%置信区间：1.1 - 1.7）是与IPTp-SP使用相关的因素。FGD和KII显示，由于药品缺货，IPTp-SP药物大多在家中服用。
早孕检查延迟和IPTp-SP药物缺货导致其使用率较低。需要鼓励孕妇尽早进行早孕检查。建议坚持直接观察治疗方案以提高IPTp-SP的使用率。
