Department of Education and Research of Biological and Medical Sciences, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
Malar J. 2021 May 22;20(1):231. doi: 10.1186/s12936-021-03764-5.
In malaria endemic regions, intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) is recommended for all pregnant women during prenatal consultation, from the fourth month of pregnancy up to the time of delivery. The Government of Mali is aiming for universal coverage of IPTp-SP. However, coverage is still low, estimated to be 18% for completion of three doses (IPTp-SP3). The objective of this study was to identify the factors that influence IPTp-SP adherence in the Health District of Sélingué, Mali.
This was a cross-sectional survey with 30 clusters, proportional to village size, with two stages of sampling. Data were collected electronically with Magpi software during face-to-face interviews/surveys. The data were analysed with SPSS version 20. A descriptive analysis and bivariate and multivariate logistic regression were performed. An equity analysis examined the effect of distance from health care facility on completion of three or more antenatal visits (ANC3 +) and three or more doses of intermittent preventive treatment (IPTp-SP3 +).
Of the 1,021 women surveyed, 87.8% (n = 896) attended at least one ANC visit. Of these, 86.3% (n = 773) received at least one dose of IPTp-SP. Compliance with three or more doses of IPTp-SP was 63.7%. The determinants statistically related to ANC3 + were the early initiation of ANC (OR = 3.22 [1.22, 10.78]), and the presence of a community health centre (CHC) in the village (OR = 9.69 [1.09, 86.21]). The ability to read (OR = 1.60 [1.01, 2.55]), the early initiation of ANC (OR = 1.46 [1.06, 2.00], knowledge of the utility of the drug (OR = 2.38 [1.24, 4.57]), and knowledge of the recommended dose of the drug (OR = 6.11 [3.98, 9.39]) were related to completion of three or more treatments (IPTp-SP3 +).
The early initiation of ANC was a positive determinant of the completeness of both ANC3 + and IPTp-SP3 + . This study shows that a successful implementation of the IPTp strategy can be achieved by improving access to prenatal care at community health facilities, and strengthening patient-provider communication to ensure adequate knowledge on dosing of IPTp-SP and the benefits to mother and child.
在疟疾流行地区，建议所有孕妇在产前检查时，从怀孕第四个月到分娩时，每四周接受一次磺胺多辛-乙胺嘧啶（IPTp-SP）间歇性预防治疗。马里政府旨在实现 IPTp-SP 的普遍覆盖。然而，覆盖率仍然很低，估计只有 18%的孕妇完成了三剂（IPTp-SP3）。本研究的目的是确定影响马里塞林盖卫生区妇女接受 IPTp-SP 的因素。
这是一项横断面调查，共 30 个聚类，按村庄规模成比例，采用两阶段抽样。数据通过 Magpi 软件在面对面访谈/调查中以电子方式收集。使用 SPSS 版本 20 进行数据分析。进行描述性分析和单变量及多变量逻辑回归分析。公平性分析检查了距医疗保健设施的距离对完成三次或更多产前检查（ANC3+）和三次或更多剂量间歇性预防治疗（IPTp-SP3+）的影响。
在所调查的 1021 名妇女中，87.8%（n=896）至少接受过一次 ANC 检查。其中，86.3%（n=773）至少接受过一剂 IPTp-SP。完成三剂或更多剂量 IPTp-SP 的依从率为 63.7%。与 ANC3+相关的统计学决定因素是 ANC 的早期开始（OR=3.22[1.22，10.78]）和村庄内有社区卫生中心（CHC）（OR=9.69[1.09，86.21]）。能够阅读（OR=1.60[1.01，2.55]）、ANC 的早期开始（OR=1.46[1.06，2.00]）、对药物用途的了解（OR=2.38[1.24，4.57]）和对药物推荐剂量的了解（OR=6.11[3.98，9.39]）与完成三剂或更多治疗（IPTp-SP3+）相关。
ANC 的早期开始是 ANC3+和 IPTp-SP3+完全性的积极决定因素。本研究表明，通过改善社区卫生设施的产前保健服务获取途径，并加强医患沟通，确保充分了解 IPTp-SP 的剂量和对母婴的益处，可实现成功实施 IPTp 策略。
