PREVENTIVE TREATMENT OF MALARIA IN PREGNANCY USING SULPHADOXINE PYRIMETHAMINE IN THE SUNYANI MUNICIPALITY, GHANA

ABSTRACT

Introduction Ghana adopted a new Intermittent Preventive Treatment (IPT) of malaria in pregnancy policy in 2004, thus, from use of weekly Chloroquine chemoprophylaxis to use of Sulphadoxine-Pyrimethamine (SP) at intervals of four weeks as IPT for malaria in pregnancy. Despite its full implementation, the coverage still remains below the set target of 100% of at least IPT2. This study sought factors affecting IPT-SP uptake among pregnant women in the Sunyani Municipality Methodology

This was a cross sectional study of 400 pregnant women attending services in 5 major Ante natal clinics in Sunyani from May to June 2015. Structured questionnaires were used to collect data on pregnant women’s socio demographic, knowledge of IPTp and malaria in pregnancy, and perceived staff attitude. In-depth interviews were conducted on service providers. Thematic presentations were used for manual analysis of qualitative data after tape recording and transcription. Quantitative data was analysed using Stata12. Categorical variables were presented as frequencies while factors were assessed using logistic regression and presented as odds ratios with 95% confidence intervals. Results

A total of 400 pregnant women at 36 weeks or more gestational age were studied. The mean age of women was 29.1±4.9 (range 16 -44) years. IPTp-SP was ever received by 98.5% of the pregnant women during the current pregnancy with 71% receiving optimal IPTp-SP doses at the time of study. Number of visits [aOR=4.7 (95% CI 1.31-17.2)], knowledge of IPTp [aOR=1.8 (95% CI 1.2-2.9)] and knowledge of malaria in pregnancy [aOR=2.2 (95% CI1.1-4.6)] were significantly associated with SP IPTp uptake. Conclusion There is good level of uptake of IPTp-SP in the Sunyani Municipality. Pregnant women’s knowledge of malaria in pregnancy and IPTp significantly influenced the uptake of IPTp in Sunyani. Staff attitude, availability of water and SP at ANCs and practice of DOT were identified to affect the uptake of optimal SP doses. Continuous education of women at ANC visits on IPTp and malaria is encouraged.