Darteh Eugene Kofuor Maafo, Dickson Kwamena Sekyi, Ahinkorah Bright Opoku, Owusu Bernard Afriyie, Okyere Joshua, Salihu Tarif, Bio Bediako Vincent, Budu Eugene, Agbemavi Wonder, Edjah Jane Odurowaah, Seidu Abdul-Aziz
Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
Arch Public Health. 2021 Oct 21;79(1):182. doi: 10.1186/s13690-021-00707-z.
Intermittent Preventive Treatment (IPT) of malaria in pregnancy is a full therapeutic course of antimalarial sulfadoxine-pyrimethamine (SP) medicine given to pregnant women in their second trimester at routine antenatal care visits, regardless of whether the recipient is infected with malaria. Given the negative consequences of malaria in pregnancy, studies on Intermittent Preventive Therapy with Sulfadoxine-Pyrimethamine (IPTp-SP) are important benchmarks for understanding the extent of malaria control and prevention during pregnancy. We, therefore, examined the factors associated with the uptake of IPTp-SP among pregnant women in sub-Saharan Africa.
We used data from the current versions of the Malaria Indicators Survey of 12 countries in sub-Saharan Africa. Women aged 15-49 years participated in the surveys. The analyses were carried out using Stata version 14.2. Descriptive (frequencies and percentages) and multilevel regression analyses were carried out. The results of the multilevel regression analysis were presented as adjusted odds ratios (aOR) with 95% confidence intervals (CIs). RESULTS: The average prevalence of uptake of IPTp-SP among pregnant women in the studied sub-Saharan African countries was 30.69%, with the highest and lowest prevalences in Ghana (59.64%) and Madagascar (10.08%), respectively. Women aged 40-44 compared to those aged 15-19 (aOR = 1.147, 95%CI = [1.02,1.30) had higher odds of receiving 3 or more doses of IPTp-SP. Women with a secondary/higher level of education compared to those with no formal education (aOR = 1.12, 95%CI = 1.04,1.20] also had higher odds of receiving 3 or more doses of IPTp-SP. Women who were exposed to malaria messages on the radio (aOR = 1.07, 95%CI = 1.02,1.12] and television (aOR = 1.13,95%CI = [1.05,1.21]) had higher odds of receiving 3 or more doses of IPTp-SP compared to those who were not exposed.
Our study indicates that the uptake of IPTp-SP is relatively low among the countries included in this study, with significant inter-country variations. Higher educational level, exposure to media, low parity, and higher age group were associated with higher odds of optimal IPTp-SP uptake. National policies, programs, guidance services such as information service and counselling and other interventions aimed at improving the coverage and uptake of IPTp-SP must be targeted at women with low level of education, non-exposure to media, high parity, and younger age group to attain the desired outcome.
孕期疟疾间歇性预防治疗（IPT）是指在常规产前检查时，在妊娠中期给予孕妇一个完整疗程的抗疟药物磺胺多辛-乙胺嘧啶（SP），无论接受者是否感染疟疾。鉴于孕期疟疾的负面影响，关于磺胺多辛-乙胺嘧啶间歇性预防治疗（IPTp-SP）的研究是了解孕期疟疾控制和预防程度的重要基准。因此，我们研究了撒哈拉以南非洲地区孕妇接受IPTp-SP治疗的相关因素。
我们使用了撒哈拉以南非洲12个国家当前版本的疟疾指标调查数据。年龄在15 - 49岁的女性参与了调查。分析使用Stata 14.2版本进行。进行了描述性（频率和百分比）和多水平回归分析。多水平回归分析的结果以调整后的优势比（aOR）及其95%置信区间（CI）呈现。
在所研究的撒哈拉以南非洲国家中，孕妇接受IPTp-SP治疗的平均患病率为30.69%，其中加纳患病率最高（59.64%），马达加斯加最低（10.08%）。与15 - 19岁的女性相比，40 - 44岁的女性接受3剂或更多剂IPTp-SP治疗的几率更高（aOR = 1.147，95%CI = [1.02,1.30]）。与未接受正规教育的女性相比，接受过中等/高等教育的女性接受3剂或更多剂IPTp-SP治疗的几率也更高（aOR = 1.12，95%CI = 1.04,1.20）。与未接触过疟疾相关信息的女性相比，通过广播接触过疟疾信息的女性（aOR = 1.07，95%CI = 1.02,1.12）和通过电视接触过疟疾信息的女性（aOR = 1.13，95%CI = [1.05,1.21]）接受3剂或更多剂IPTp-SP治疗的几率更高。
我们的研究表明，本研究纳入的国家中IPTp-SP的接受率相对较低，且国家间存在显著差异。较高的教育水平、接触媒体、低生育次数和较高年龄组与接受最佳IPTp-SP治疗的较高几率相关。旨在提高IPTp-SP覆盖率和接受率的国家政策、项目、指导服务（如信息服务和咨询）及其他干预措施必须针对教育水平低、未接触媒体、高生育次数和年龄较小的女性群体，以实现预期效果。
