Intermittent preventive treatment of malaria in pregnancy: a cross-sectional survey to assess uptake of the new sulfadoxine–pyrimethamine five dose policy in Ghana

Abstract

BackgroundMalaria in pregnancy poses a great risk to both mother and fetus. In Ghana, malaria accounts for 3.4% of deaths and 16.8% of all hospital admissions in pregnant women. In 2014, Ghana updated her policy on intermittent preventive treatment of malaria in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) to reflect the updated policy of the WHO. This study determined the level of uptake of sulfadoxine pyrimethamine (SP) to serve as baseline for monitoring progress and also reviewed stock levels of SP, a key factor in the programme implementation.MethodsA cross-sectional hospital-based study was carried out among nursing mothers who had delivered within 12 weeks and were seeking postnatal care at Osu Government Maternity Home in Accra. Antenatal record books of the mothers were reviewed and data collected on number of visits and receipt of IPTp-SP. Mothers were interviewed and data collected on their background characteristics and obstetric history. Data on SP stock levels for the past 6 months were also reviewed. Logistic regression analysis was carried out to determine antenatal indicators on uptake of IPTp-SP using Stata version 12.ResultsThe proportion of uptake of three-five doses of SP were: IPT3 (87.5%), IPT4 (55.7%) and IPT5 (14.5%). The proportion of women who received the first dose of SP at 16 weeks of gestation was 21.3%. Women who made ≥4 visits were more likely to receive ≥3 doses of SP than those who made <4 visits (AOR = 4.57, 95% CI 1.15–18.16, p < 0.05). Women receiving the first dose of SP in the third trimester were less likely to receive ≥3 doses of SP than those who received the drug in the second trimester (AOR = 0.04, 95% CI 0.01–0.16, p < 0.05). Stock levels of SP were adequate to meet the demands by the pregnant women at the Maternity Home for the period under review.ConclusionsThe uptake of ≥3 doses of SP was high in the study area. Frequent visits to the antenatal clinic and early uptake of the first dose of SP by pregnant women are necessary to achieve the new target of five or more doses of SP.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-017-1969-7) contains supplementary material, which is available to authorized users.

Factors Influencing Adherence to the New Intermittent Preventive Treatment of Malaria in Pregnancy Policy in Keta District of the Volta Region, Ghana

“….9% which appears to be lower than those found in the present study (16). However, in the same year, a study conducted in the Accra Metropolitan area in Ghana had similar findings to the current study and reported IPTp1 to be 98.8%, IPTp 2-94.9%, IPTp3 -87.5%, IPTp 4 -55.7%, IPTp 5 -14.5% (17).…”

Predictors for the Uptake of Optimal Doses of Sulfadoxine-pyrimethamine for Intermittent Preventive Treatment of Malaria During Pregnancy in Tanzania: Further Analysis of 2015-2016 Tanzania Demographic and Health Survey and Malaria Indicator Survey Data

“…The more the pregnant women attend to clinic, the higher the exposure toward health information on IPTp-SP hence the higher likelihood of receiving optimal doses of SP. The ndings are consistent with the studies conducted in Malawi, Ghana and Cameroon (21,27,28). Also, attending ANC visits only once or at late such as after 36 weeks where SP cannot be administered were observed to be a barrier towards the uptake of optimal doses of SP (25).…”

Factors Influencing Adherence to the New Intermittent Preventive Treatment of Malaria in Pregnancy Policy in Keta District of the Volta Region, Ghana

“…This is shown in Table 5.a Discussion 9 According to National Malaria Control Programme, IPTp-SP coverage for Volta region in 2017 was IPTp 1-63.7%, IPTp 2 -53.0%, IPTp 3 -37.5%, IPTp 4 -18.8%, IPT 5 -5.9% which appears to be lower than those found in the present study (16). However, in the same year, a study conducted in the Accra Metropolitan area in Ghana had similar findings to the current study and reported IPTp1 to be 98.8%, IPTp 2-94.9%, IPTp3 -87.5%, IPTp 4 -55.7%, IPTp -14.5% (17).…”