Determinants of uptake of intermittent preventive treatment during pregnancy: a review

Roman, Elaine; Andrejko, Kristin L; Wolf, Katherine; Henry, Marianne; Youll, Susan; Florey, Lia; Ferenchick, Erin; Gutman, Julie

doi:10.1186/s12936-019-3004-7

Cited by 24 publications

(20 citation statements)

References 51 publications

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“…Uganda's national policy for IPTp administration during pregnancy recommends early initiation of IPTp in the second trimester (at 13 weeks of gestation) for all women. Timely uptake of IPTp depends more on the practices of health workers at the health units coupled with quality improvement geared at improving services with accompanying strong leadership than individual characteristics of pregnant women [23]. The lower than expected uptake of IPT in our study could reflect suboptimal care at the antenatal clinics, possible stock out of drugs in the health units, and inadequate sensitization of health workers about the new guidelines on IPTp administration to pregnant women.…”

Section: Plos Onementioning

confidence: 68%

Malaria preventive practices and delivery outcomes: A cross-sectional study of parturient women in a tertiary hospital in Eastern Uganda

et al. 2020

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Background Uganda ranks third in the number of deaths attributable to malaria and has some of the highest recorded malaria transmission rates in the general population. Malaria in Pregnancy is associated with detrimental effects for the mother and unborn baby and these effects seem to have long term effects and consequences on the life of the baby. Despite the preventive measures put in place by the World Health Organization in antenatal care, the burden of malaria in pregnancy is still high. We determined the use of malaria preventive strategies during pregnancy and the presence of plasmodium infection, anemia, and low birth weight babies at delivery among parturient women at Mbale regional referral hospital in eastern Uganda. Methods A cross-sectional study was conducted among 210 women delivering at MRRH between July 2017 and January 2018. Information on demographics, antenatal care, and prevention practices was collected using an interviewer-administered questionnaire. Maternal venous blood and cord blood samples were screened for Plasmodium infection by both microscopy of Giemsa-stained blood films and Plasmodium falciparum rapid diagnostic test (pf. HPR2 mRDT). Polymerase Chain Reaction (PCR) was done on cord blood. The presence of anemia was determined by the use of an automated hemoglobin analyzer. Data were analyzed using descriptive and analytical statistics. Results Of the 210 women, 3 (1.4%) and 19(9.1%) tested positive for malaria by using Giemsa stained blood smear microscopy and malaria rapid diagnosticMRDT tests respectively. PCR detected 4(%) of Plasmodium in cord blood. Twenty-nine percent of the women had anaemia and 11 (5.2%) had low birth weight babies. Only 23.3% of the women received at

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Section: Plos Onementioning

confidence: 68%

Malaria preventive practices and delivery outcomes: A cross-sectional study of parturient women in a tertiary hospital in Eastern Uganda

et al. 2020

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“…Providers need to be encouraged and monitored to deliver the medicine to women consistently to increase uptake. Quality improvement processes such as supportive supervision has been prescribed to improve IPTp coverage [24,29].…”

Section: Implications For Obstetric Care and Policymentioning

confidence: 99%

Coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) influences delivery outcomes among women with obstetric referrals at the district level in Ghana

Amoakoh-Coleman

Arhinful

Klipstein‐Grobusch

et al. 2020

Malar J

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Background: The aim of the study was to determine the coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) and its relationship with delivery outcomes among obstetric referral cases at the district level of healthcare. Methods: An implementation research within three districts of the Greater Accra region was conducted from May 2017 to February 2018, to assess the role of an enhanced inter-facility communication system on processes and outcomes of obstetric referrals. A cross-sectional analysis of the data on IPTp coverage as well as delivery outcomes for the period of study was conducted, for all the referrals ending up in deliveries. Primary outcomes were maternal and neonatal complications at delivery. IPTp coverage was determined as percentages and classified as adequate or inadequate. Associated factors were determined using Chi square. Odds ratios (OR, 95% CI) were estimated for predictors of adequate IPTp dose coverage for associations with delivery outcomes, with statistical significance set at p = 0.05. Results: From a total of 460 obstetric referrals from 16 lower level facilities who delivered at the three district hospitals, only 223 (48.5%) received adequate (at least 3) doses of IPTp. The district, type of facility where ANC is attended, insurance status, marital status and number of antenatal clinic visits significantly affected IPTp doses received. Adjusted ORs show that adequate IPTp coverage was significantly associated with newborn complication [0.80 (0.65-0.98); p = 0.03], low birth weight [0.51 (0.38-0.68); p < 0.01], preterm delivery [0.71 (0.55-0.90); p = 0.01] and malaria as indication for referral [0.70 (0.56-0.87); p < 0.01]. Positive association with maternal complication at delivery was seen but was not significant. Conclusion: IPTp coverage remains low in the study setting and is affected by type of health facility that ANC is received at, access to health insurance and number of times a woman attends ANC during pregnancy. This study also confirmed earlier findings that, as an intervention IPTp prevents bad outcomes of pregnancy, even among women

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“…In 2014/2015, it slightly increased to 28% [21] but then reduced to 17% in 2016 [22]. This is comparable to majority of the SSA countries whose coverage of optimal doses of IPTp-SP remains dismal according to a synthesis of results from the most recent country malaria indicator, demographic health and multiple indicator cluster surveys [23]. The results from this synthesis also showed that only Ghana, Zambia, Malawi, Sierra Leonne and Guinea had coverage of optimal doses of IPTp-SP of at least 30% [23].…”

mentioning

confidence: 94%

Correlates of uptake of optimal doses of sulfadoxine-pyrimethamine for prevention of malaria during pregnancy in East-Central Uganda

Mbonye

Kirwana

Ndugga

et al. 2020

Malar J

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Background: In 2012, the World Health Organization recommended that pregnant women in malaria-endemic countries complete at least three (optimal) doses of intermittent preventive treatment (IPTp) using sulfadoxinepyrimethamine (SP) to prevent malaria and related adverse events during pregnancy. Uganda adopted this recommendation, but uptake remains low in East-Central and information to explain this low uptake remains scanty. This analysis determined correlates of uptake of optimal doses of IPTp-SP in East-Central Uganda. Methods:This was a secondary analysis of the 2016 Uganda Demographic Health Survey data on 579 women (15-49 years) who attended at least one antenatal care (ANC) visit and had a live birth within 2 years preceding the survey. Uptake of IPTp-SP was defined as optimal if a woman received at least three doses; partial if they received 1-2 doses or none if they received no dose. Multivariate analysis using multinomial logistic regression was used to determine correlates of IPTp-SP uptake. Results:Overall, 22.3% of women received optimal doses of IPTp-SP, 48.2% partial and 29.5% none. Attending ANC at a lower-level health centre relative to a hospital was associated with reduced likelihood of receiving optimal doses of IPTp-SP. Belonging to other religious faiths relative to Catholic, belonging to a household in the middle relative to poorest wealth index, and age 30 and above years relative to 25-29 years were associated with higher likelihood of receiving optimal doses of IPTp-SP. Conclusions:In East-Central Uganda, uptake of optimal doses of IPTp-SP is very low. Improving institutional delivery and household wealth, involving religious leaders in programmes to improve uptake of IPTp-SP, and strengthening IPTp-SP activities at lower level health centers may improve uptake of IPTp-SP in the East-Central Uganda.

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Determinants of uptake of intermittent preventive treatment during pregnancy: a review

Cited by 24 publications

References 51 publications

Malaria preventive practices and delivery outcomes: A cross-sectional study of parturient women in a tertiary hospital in Eastern Uganda

Malaria preventive practices and delivery outcomes: A cross-sectional study of parturient women in a tertiary hospital in Eastern Uganda

Coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) influences delivery outcomes among women with obstetric referrals at the district level in Ghana

Correlates of uptake of optimal doses of sulfadoxine-pyrimethamine for prevention of malaria during pregnancy in East-Central Uganda

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