Natuhamya Charles, Mwebesa Edson, Tumwesigye Nazarius Mbona
Makerere University School of Public Health, Kampala, Uganda.
Muni University, Arua District, Uganda.
PLoS One. 2025 Apr 15;20(4):e0320893. doi: 10.1371/journal.pone.0320893. eCollection 2025.
Malaria still remains a global health issue. In response, the World Health Organisation has continuously recommended the use of Sulfadoxine-Pyrimethamine (SP) for Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) as a malaria preventive measure for the mother and fetus, which has been implemented by the Ugandan government. In collaboration with partners, the government has created awareness of using SP for IPTp (SP-IPTp) among women mainly through media. Studies have investigated the effect of a woman's education attainment on SP-IPTp. However, the effect of knowledge of SP as prophylaxis for malaria on SP-IPTp has not been studied. Notably, education does not necessarily have an effect on knowledge of SP for malaria prevention, and knowledge of SP as prophylaxis may not result in its significant uptake for IPTp. The purpose of this study, therefore, was to ensure baseline covariate balance and determine the effect of knowledge of SP as preventive chemotherapy on its uptake for IPTp.
The study utilised the Ugandan Malaria Indicator Survey dataset of 2018-19. Women aged 15-49 years who indicated their uptake status of SP during their last pregnancy formed the sample of this study. The inverse Probability Weighted Regression Adjustment technique was applied to assess the study objective.
The findings revealed a positive and significant effect of knowledge of SP as malaria prophylaxis on its uptake for IPTp (Average Treatment Effect of the Treated or ATET = 0.163; 95% CI = 0.138-0.188).
Ensuring covariate balance while applying IPWRA resulted in more precise estimates of treatment effects. Programmes and policies that create awareness of using SP as malaria prophylaxis may serve as effective interventions towards SP-IPTp in Uganda.
疟疾仍然是一个全球卫生问题。作为回应，世界卫生组织持续推荐使用周效磺胺-乙胺嘧啶（SP）进行孕期疟疾间歇性预防治疗（IPTp），以此作为针对母亲和胎儿的疟疾预防措施，乌干达政府已实施该措施。政府与合作伙伴协作，主要通过媒体在女性群体中宣传使用SP进行IPTp（SP-IPTp）。已有研究调查了女性受教育程度对SP-IPTp的影响。然而，关于将SP作为疟疾预防用药的知识对SP-IPTp的影响尚未得到研究。值得注意的是，教育不一定会对关于使用SP预防疟疾的知识产生影响，而且将SP作为预防用药的知识也不一定会导致其在IPTp中得到大量应用。因此，本研究的目的是确保基线协变量平衡，并确定将SP作为预防性化疗用药的知识对其在IPTp中的应用的影响。
本研究使用了2018 - 2019年乌干达疟疾指标调查数据集。年龄在15 - 49岁且表明其在上次孕期使用SP情况的女性构成了本研究的样本。采用逆概率加权回归调整技术来评估研究目标。
研究结果显示，将SP作为疟疾预防用药的知识对其在IPTp中的应用具有积极且显著的影响（处理组的平均治疗效果或ATET = 0.163；95%置信区间 = 0.138 - 0.188）。
在应用逆概率加权回归调整时确保协变量平衡能更精确地估计治疗效果。开展关于将SP作为疟疾预防用药的宣传的项目和政策可能是乌干达针对SP-IPTp的有效干预措施。
