Determinants of Uptake of Malaria Preventive Interventions among Pregnant Women in Eastern Uganda

Abstract

Background Consistent use of insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp) have been recommended as cost-effective interventions for malaria prevention during pregnancy in endemic areas. However, the coverage of these interventions during pregnancy in sub-Saharan Africa is still suboptimal. In this study, we investigated the uptake of IPTp and ITNs, and associated factors among women during their recent pregnancy in Eastern Uganda. Methods This was a cross-sectional study conducted among 2,062 women who had delivered within the last 12 months in three districts in Eastern Uganda. The primary outcomes were consistent ITN use and optimal uptake (at least 3 doses) of IPTp. A modified Poisson regression was used to examine the association between consistent ITN use and the uptake of optimal doses of IPTp with independent variables. Data were analyzed using Stata 14 software. Results The level of uptake of IPTp3 (at least three doses) was 14.7 %, while IPTp2 (at least two doses) was 60.0%. The majority (86.4%) of mothers reported regularly sleeping under mosquito nets for the full duration of pregnancy. Uptake of IPTp3 was associated with engaging in farming (adjusted PR = 1.71, 95% CI [1.28 – 2.28]) or business (adjusted PR = 1.60, 95% CI [1.05 – 2.44]), and attending at least 4 antenatal care (ANC) visits (adjusted PR = 1.72, 95%CI [1.34 – 2.22]). On the other hand, consistent ITN use was associated with belonging to the fourth wealth quintile (adjusted PR = 1.08, 95% CI [1.02 – 1.14]) or fifth wealth quintile (adjusted PR = 1.08, 95% CI [1.02- 1.15]), and attending at least 4 ANC visits (adjusted PR = 1.07, 95% CI [1.03- 1.11]). Conclusion Uptake of IPTp3 and consistent ITN use during pregnancy were lower than recommended guidelines, thus threatening the progress so far made towards malaria elimination. Our findings highlight the need for more efforts to enhance utilisation of ANC services, which is likely to increase the uptake of these two key malaria preventive measures during pregnancy.