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Tytuł:
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Factors affecting uptake of ≥ 3 doses of Sulfadoxine-Pyrimethamine for malaria prevention in pregnancy in selected health facilities, Arusha region, Tanzania.
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Autorzy:
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Mchwampaka WM; Mount Meru Regional Referral Hospital (MMRRH), Preventive Section, P.O. Box 3010, Arusha, Tanzania. .
Tarimo D; Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
Chacky F; Tanzania National Malaria Control Programme (NMCP), Dar es Salaam, Tanzania.
Mohamed A; Tanzania Field Epidemiology and Laboratory Training Programme (TFELTP), Dar es Salaam, Tanzania.
Kishimba R; Tanzania Field Epidemiology and Laboratory Training Programme (TFELTP), Dar es Salaam, Tanzania.; Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Dar es Salaam, Tanzania.
Samwel A; Tanzania Field Epidemiology and Laboratory Training Programme (TFELTP), Dar es Salaam, Tanzania.
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Źródło:
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BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2019 Nov 27; Vol. 19 (1), pp. 440. Date of Electronic Publication: 2019 Nov 27.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: London : BioMed Central, [2001-
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MeSH Terms:
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Health Knowledge, Attitudes, Practice*
Antimalarials/*administration & dosage
Pregnancy Complications, Parasitic/*prevention & control
Pregnant Women/*psychology
Prenatal Care/*statistics & numerical data
Pyrimethamine/*administration & dosage
Sulfadoxine/*administration & dosage
Adolescent ; Adult ; Antimalarials/supply & distribution ; Cross-Sectional Studies ; Directly Observed Therapy/statistics & numerical data ; Drug Combinations ; Educational Status ; Female ; Health Facilities ; Health Personnel/psychology ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Patient Acceptance of Health Care/statistics & numerical data ; Pregnancy ; Pregnancy Trimester, First ; Pyrimethamine/supply & distribution ; Sulfadoxine/supply & distribution ; Surveys and Questionnaires ; Tanzania ; Young Adult
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References:
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Clin Infect Dis. 2011 Aug 1;53(3):215-23. (PMID: 21765069)
PLoS Med. 2013;10(7):e1001488. (PMID: 23935459)
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Malar J. 2014 Nov 24;13:455. (PMID: 25421496)
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Malar J. 2017 Jun 5;16(1):236. (PMID: 28583119)
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PLoS Med. 2009 Mar 24;6(3):e1000048. (PMID: 19323591)
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Contributed Indexing:
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Keywords: IPTp-SP uptake; Malaria prevention; Tanzania
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Substance Nomenclature:
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0 (Antimalarials)
0 (Drug Combinations)
37338-39-9 (fanasil, pyrimethamine drug combination)
88463U4SM5 (Sulfadoxine)
Z3614QOX8W (Pyrimethamine)
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Entry Date(s):
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Date Created: 20191129 Date Completed: 20200420 Latest Revision: 20200420
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Update Code:
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20240104
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PubMed Central ID:
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PMC6880562
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DOI:
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10.1186/s12884-019-2592-0
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PMID:
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31775686
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Background: Tanzania adopted the revised World Health Organization policy in 2013 recommending a minimum of ≥3 doses of Intermittent Preventive Treatment during pregnancy with Sulfadoxine-Pyrimethamine (IPTp-SP) to protect against malaria. A study in Tanzania in 2014 reported low (9%) uptake. We investigated health workers knowledge about IPTp-SP and factors that influenced uptake of > 3 doses of IPTp-SP among pregnant women.
Methods: We conducted a cross-sectional study in 2017 among post-delivery women and health care workers from nine randomly-selected public health facilities in three Districts of Arusha Region. Probability proportional to size methodology was used to determine number of participants per facility. We used a structured questionnaire to collect socio-demographic and obstetric data, information on doses of SP received, and knowledge of SP for IPTp. Health care workers were interviewed about their knowledge for IPTp- SP and challenges encountered in its uptake and use.
Results: We interviewed 556 persons (median age 26 years, range 16-42 years) with the response rate of 99.3%. Of these, 484 (87.1%) had > 3 Antenatal Care (ANC) visits. A total of 402 (72.3%) were multigravida with 362 (65.1%) having given birth at least once. Of the 556 participants, 219 (39.4%) made their first ANC booking at < 17 weeks of pregnancy and 269 (48.4%) had received > 3 doses of SP-IPTp. Factors associated with uptake of > 3 doses of IPTp-SP included having secondary or higher education [Adjusted Odds Ratio (AOR) =1.6, 95%CI 1.1-2.4], attending ≥4 ANC visits [AOR = 3.1, 95%CI 2.1-4.6], having first antenatal booking at < 17 weeks [AOR = 1.8, 95%CI 1.4-2.3], and adequate knowledge on IPTp-SP [AOR = 2.7, 95%CI 1.9-3.9]. Among 36 health care workers interviewed, 29(80.6%) had adequate knowledge about IPTp-SP. SP was available in seven (87.5%) of the visited health facilities and was administered under Direct Observed Therapy (DOT) in six (75%) facilities. Health care workers reported that stock outs of SP was a challenge.
Conclusions: Fewer than half of the women interviewed reported uptake of > 3 doses of IPTp-SP. That is below the Tanzania national target of 80%. Making > 4 ANC visits, having secondary or higher education, making an early first ANC visit and having adequate knowledge on IPTp-SP promoted uptake of > 3 doses. Further qualitative studies are needed to explore factors that might contribute to low uptake of SP.
