乌干达东部孕妇对疟疾预防干预措施的接受度的决定因素。
Determinants of uptake of malaria preventive interventions among pregnant women in eastern Uganda.
机构信息
Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.
Department of Epidemiology and Social Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
出版信息
Malar J. 2021 Jan 3;20(1):5. doi: 10.1186/s12936-020-03558-1.
BACKGROUND
Consistent use of insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp) have been recommended as cost-effective interventions for malaria prevention during pregnancy in endemic areas. However, the coverage and utilization of these interventions during pregnancy in sub-Saharan Africa is still suboptimal. This study aimed to determine the uptake of IPTp and ITNs and associated factors among women during their recent pregnancy in Eastern Uganda.
METHODS
This was a cross-sectional study conducted among 2062 women who had delivered within the last 12 months prior to the start of the study in three districts of Eastern Uganda. The primary outcomes were consistent ITN use and optimal uptake (at least 3 doses) of IPTp. A modified Poisson regression was used to examine the association between consistent ITN use and the uptake of optimal doses of IPTp with independent variables. Data were analysed using Stata 14 software.
RESULTS
The level of uptake of IPTp3 (at least three doses) was 14.7%, while IPTp2 (at least two doses) was 60.0%. The majority (86.4%) of mothers reported regularly sleeping under mosquito nets for the full duration of pregnancy. Uptake of IPTp3 was associated with engaging in farming (adjusted PR = 1.71, 95% CI [1.28-2.28]) or business (adjusted PR = 1.60, 95% CI [1.05-2.44]), and attending at least 4 antenatal care (ANC) visits (adjusted PR = 1.72, 95% CI [1.34-2.22]). On the other hand, consistent ITN use was associated with belonging to the fourth wealth quintile (adjusted PR = 1.08, 95% CI [1.02-1.14]) or fifth wealth quintile (adjusted PR = 1.08, 95% CI [1.02-1.15]), and attending at least 4 ANC visits (adjusted PR = 1.07, 95% CI [1.03-1.11]).
CONCLUSION
Uptake of IPTp3 and consistent ITN use during pregnancy were lower and higher than the current Ugandan national targets, respectively. Study findings highlight the need for more efforts to enhance utilization of ANC services, which is likely to increase the uptake of these two key malaria preventive measures during pregnancy.
背景
在流行地区，持续使用经杀虫剂处理的蚊帐（ITNs）和孕妇间歇性预防治疗（IPTp）已被推荐为具有成本效益的预防妊娠疟疾干预措施。然而，在撒哈拉以南非洲，这些干预措施在妊娠期间的覆盖率和利用率仍然不理想。本研究旨在确定乌干达东部最近一次妊娠期间妇女接受 IPTp 和 ITN 的情况及其相关因素。
方法
这是一项横断面研究，在乌干达东部三个地区开展，共纳入了 2062 名在研究开始前 12 个月内分娩的妇女。主要结局为持续使用 ITN 和最佳剂量（至少 3 剂）的 IPTp。采用校正泊松回归分析来研究一致使用 ITN 与最佳剂量的 IPTp 之间的关系，其中独立变量包括。数据使用 Stata 14 软件进行分析。
结果
接受 IPTp3（至少 3 剂）的比例为 14.7%，而接受 IPTp2（至少 2 剂）的比例为 60.0%。大多数母亲（86.4%）报告在整个孕期定期使用蚊帐睡觉。接受 IPTp3 与从事农业（校正 PR=1.71，95%CI [1.28-2.28]）或商业（校正 PR=1.60，95%CI [1.05-2.44]）以及至少接受 4 次产前护理（ANC）就诊（校正 PR=1.72，95%CI [1.34-2.22]）相关。另一方面，持续使用 ITN 与属于第四财富五分位数（校正 PR=1.08，95%CI [1.02-1.14]）或第五财富五分位数（校正 PR=1.08，95%CI [1.02-1.15]）以及至少接受 4 次 ANC 就诊（校正 PR=1.07，95%CI [1.03-1.11]）相关。
结论
妊娠期间接受 IPTp3 和持续使用 ITN 的比例分别低于和高于当前乌干达国家目标。研究结果强调需要加大努力提高 ANC 服务的利用率，这可能会增加这两项关键疟疾预防措施在妊娠期间的利用率。
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