Skip to main content
Top
Published in: Malaria Journal 1/2017

Open Access 01-12-2017 | Research

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

Authors: Ivy Owusu-Boateng, Francis Anto

Published in: Malaria Journal | Issue 1/2017

Login to get access

Abstract

Background

Malaria 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.

Methods

A 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.

Results

The 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.

Conclusions

The 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.
Appendix
Available only for authorised users
Literature
3.
go back to reference Bouyou-Akotet MK, Mawili-Mboumba DP, Kendjo E, Moutandou Chiesa S, Tshibola Mbuyi ML, Tsoumbou-Bakana G, et al. Decrease of microscopic Plasmodium falciparum infection prevalence during pregnancy following IPTp-SP implementation in urban cities of Gabon. Trans R Soc Trop Med Hyg. 2016;110:333–42.CrossRefPubMed Bouyou-Akotet MK, Mawili-Mboumba DP, Kendjo E, Moutandou Chiesa S, Tshibola Mbuyi ML, Tsoumbou-Bakana G, et al. Decrease of microscopic Plasmodium falciparum infection prevalence during pregnancy following IPTp-SP implementation in urban cities of Gabon. Trans R Soc Trop Med Hyg. 2016;110:333–42.CrossRefPubMed
5.
go back to reference Bouyou-Akotet MK, Mawili-Mboumba DP, Kombila M. Antenatal care visit attendance, intermittent preventive treatment and bed net use during pregnancy in Gabon. BMC Pregnancy Childbirth. 2013;13:52.CrossRefPubMedPubMedCentral Bouyou-Akotet MK, Mawili-Mboumba DP, Kombila M. Antenatal care visit attendance, intermittent preventive treatment and bed net use during pregnancy in Gabon. BMC Pregnancy Childbirth. 2013;13:52.CrossRefPubMedPubMedCentral
6.
go back to reference Toure OA, Kone PL, Coulibaly AAL, Ako BAA, Gbessi EA, Coulibaly B, et al. Coverage and efficacy of intermittent preventive treatment with sulfadoxine pyrimethamine against malaria in pregnancy in Côte d’Ivoire five years after its implementation. Parasit Vectors. 2014;7:495.PubMedPubMedCentral Toure OA, Kone PL, Coulibaly AAL, Ako BAA, Gbessi EA, Coulibaly B, et al. Coverage and efficacy of intermittent preventive treatment with sulfadoxine pyrimethamine against malaria in pregnancy in Côte d’Ivoire five years after its implementation. Parasit Vectors. 2014;7:495.PubMedPubMedCentral
7.
go back to reference Rurangirwa AA, Mogren I, Nyirazinyoye L, Ntaganira J, Krantz G. Determinants of poor utilization of antenatal care services among recently delivered women in Rwanda; a population based study. BMC Pregnancy Childbirth. 2017;17:142.CrossRefPubMedPubMedCentral Rurangirwa AA, Mogren I, Nyirazinyoye L, Ntaganira J, Krantz G. Determinants of poor utilization of antenatal care services among recently delivered women in Rwanda; a population based study. BMC Pregnancy Childbirth. 2017;17:142.CrossRefPubMedPubMedCentral
8.
go back to reference Ayubu MB, Kidima WB. Monitoring compliance and acceptability of intermittent preventive treatment of malaria using sulfadoxine pyrimethamine after ten years of implementation in Tanzania. Malar Res Treat. 2017;2017. doi:10.1155/2017/9761289. Ayubu MB, Kidima WB. Monitoring compliance and acceptability of intermittent preventive treatment of malaria using sulfadoxine pyrimethamine after ten years of implementation in Tanzania. Malar Res Treat. 2017;2017. doi:10.​1155/​2017/​9761289.
9.
go back to reference Wanzira H, Katamba H, Okullo AE, Rubahika D. The challenge of using intermittent preventive therapy with sulfadoxine/pyrimethamine among pregnant women in Uganda. Malar J. 2016;15:401.CrossRefPubMedPubMedCentral Wanzira H, Katamba H, Okullo AE, Rubahika D. The challenge of using intermittent preventive therapy with sulfadoxine/pyrimethamine among pregnant women in Uganda. Malar J. 2016;15:401.CrossRefPubMedPubMedCentral
10.
go back to reference Salomão C, Sacarlal J, Gudo ES. Assessment of coverage of preventive treatment and insecticide-treated mosquito nets in pregnant women attending antenatal care services in 11 districts in Mozambique in 2011: the critical role of supply chain. Malar J. 2017;16:223.CrossRefPubMedPubMedCentral Salomão C, Sacarlal J, Gudo ES. Assessment of coverage of preventive treatment and insecticide-treated mosquito nets in pregnant women attending antenatal care services in 11 districts in Mozambique in 2011: the critical role of supply chain. Malar J. 2017;16:223.CrossRefPubMedPubMedCentral
11.
go back to reference Sangaré LR, Stergachis A, Brentlinger PE, Richardson BA, Staedke SG, Kiwuwa MS, et al. Determinants of use of intermittent preventive treatment of malaria in pregnancy: Jinja, Uganda. PLoS ONE. 2010;5:e15066.CrossRefPubMedPubMedCentral Sangaré LR, Stergachis A, Brentlinger PE, Richardson BA, Staedke SG, Kiwuwa MS, et al. Determinants of use of intermittent preventive treatment of malaria in pregnancy: Jinja, Uganda. PLoS ONE. 2010;5:e15066.CrossRefPubMedPubMedCentral
13.
go back to reference Doku DT, Zankawah MM, Adu-Gyamfi AB. Factors influencing dropout rate of intermittent preventive treatment of malaria during pregnancy. BMC Res Notes. 2016;9:460.CrossRefPubMedPubMedCentral Doku DT, Zankawah MM, Adu-Gyamfi AB. Factors influencing dropout rate of intermittent preventive treatment of malaria during pregnancy. BMC Res Notes. 2016;9:460.CrossRefPubMedPubMedCentral
14.
go back to reference Tutu EO, Lawson B, Browne E. The effectiveness and perception of the use of sulphadoxine–pyrimethamine in intermittent preventive treatment of malaria in pregnancy programme in Offinso district of Ashanti region, Ghana. Malar J. 2011;10:385.CrossRefPubMedPubMedCentral Tutu EO, Lawson B, Browne E. The effectiveness and perception of the use of sulphadoxine–pyrimethamine in intermittent preventive treatment of malaria in pregnancy programme in Offinso district of Ashanti region, Ghana. Malar J. 2011;10:385.CrossRefPubMedPubMedCentral
15.
go back to reference Hommerich L, von Oertzen C, Bedu-Addo G, Holmberg V, Acquah PA, Eggelte TA, Bienzle U, et al. Decline of placental malaria in southern Ghana after the implementation of intermittent preventive treatment in pregnancy. Malar J. 2007;6:144.CrossRefPubMedPubMedCentral Hommerich L, von Oertzen C, Bedu-Addo G, Holmberg V, Acquah PA, Eggelte TA, Bienzle U, et al. Decline of placental malaria in southern Ghana after the implementation of intermittent preventive treatment in pregnancy. Malar J. 2007;6:144.CrossRefPubMedPubMedCentral
16.
go back to reference Cochran WG. Sampling Techniques. 2nd ed. New York: Wiley; 1963. Cochran WG. Sampling Techniques. 2nd ed. New York: Wiley; 1963.
17.
go back to reference Osu Government Maternity Home. Annual Report. 2013. Osu Government Maternity Home. Annual Report. 2013.
19.
go back to reference Thogarapalli N, Mkandawire P, Kangmennaang J, Luginaah I, Arku G. Gestational age at first antenatal visit in Namibia. Int J Public Health. 2016;61:1089–97.CrossRefPubMed Thogarapalli N, Mkandawire P, Kangmennaang J, Luginaah I, Arku G. Gestational age at first antenatal visit in Namibia. Int J Public Health. 2016;61:1089–97.CrossRefPubMed
20.
go back to reference Njim TN. Late pregnancy outcomes among women who attended and women who did not attend first trimester antenatal care visits in a suburban regional hospital in Cameroon. Int J MCH AIDS. 2016;5:14–23.CrossRefPubMedPubMedCentral Njim TN. Late pregnancy outcomes among women who attended and women who did not attend first trimester antenatal care visits in a suburban regional hospital in Cameroon. Int J MCH AIDS. 2016;5:14–23.CrossRefPubMedPubMedCentral
21.
go back to reference Nsibu CN, Manianga C, Kapanga S, Mona E, Pululu P, Aloni MN. Determinants of antenatal care attendance among pregnant women living in endemic malaria settings: experience from the Democratic Republic of Congo. Obstet Gynecol Int. 2016;2016:5423413.CrossRefPubMedPubMedCentral Nsibu CN, Manianga C, Kapanga S, Mona E, Pululu P, Aloni MN. Determinants of antenatal care attendance among pregnant women living in endemic malaria settings: experience from the Democratic Republic of Congo. Obstet Gynecol Int. 2016;2016:5423413.CrossRefPubMedPubMedCentral
22.
go back to reference Gulema H, Berhane Y. Timing of first antenatal care visit and its associated factors among pregnant women attending public health facilities in Addis Ababa, Ethiopia. Ethiop J Health Sci. 2017;27:139–46.CrossRefPubMedPubMedCentral Gulema H, Berhane Y. Timing of first antenatal care visit and its associated factors among pregnant women attending public health facilities in Addis Ababa, Ethiopia. Ethiop J Health Sci. 2017;27:139–46.CrossRefPubMedPubMedCentral
23.
go back to reference Stephens JK, Kyei-Baafour E, Dickson EK, Ofori JK, Ofori MF, Wilson ML, et al. Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana. Malar J. 2017;16:224.CrossRefPubMedPubMedCentral Stephens JK, Kyei-Baafour E, Dickson EK, Ofori JK, Ofori MF, Wilson ML, et al. Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana. Malar J. 2017;16:224.CrossRefPubMedPubMedCentral
24.
go back to reference Sylvester B, Gasarasi DB, Aboud S, Tarimo D, Massawe S, Mpembeni R, Swedberg G. Prenatal exposure to Plasmodium falciparum increases frequency and shortens time from birth to first clinical malaria episodes during the first two years of life: prospective birth cohort study. Malar J. 2016;15:379.CrossRefPubMedPubMedCentral Sylvester B, Gasarasi DB, Aboud S, Tarimo D, Massawe S, Mpembeni R, Swedberg G. Prenatal exposure to Plasmodium falciparum increases frequency and shortens time from birth to first clinical malaria episodes during the first two years of life: prospective birth cohort study. Malar J. 2016;15:379.CrossRefPubMedPubMedCentral
25.
go back to reference Mpogoro FJ, Matovelo D, Dosani A, Ngallaba S, Mugono M, Mazigo HD. Uptake of intermittent preventive treatment with sulphadoxine–pyrimethamine for malaria during pregnancy and pregnancy outcomes: a cross-sectional study in Geita district, North-Western Tanzania. Malar J. 2014;13:455.CrossRefPubMedPubMedCentral Mpogoro FJ, Matovelo D, Dosani A, Ngallaba S, Mugono M, Mazigo HD. Uptake of intermittent preventive treatment with sulphadoxine–pyrimethamine for malaria during pregnancy and pregnancy outcomes: a cross-sectional study in Geita district, North-Western Tanzania. Malar J. 2014;13:455.CrossRefPubMedPubMedCentral
26.
go back to reference Leonard N, Eric FB, Judith AK, Samuel W. Factors associated to the use of insecticide treated nets and intermittent preventive treatment for malaria control during pregnancy in Cameroon. Arch Public Health. 2016;74:5.CrossRefPubMedPubMedCentral Leonard N, Eric FB, Judith AK, Samuel W. Factors associated to the use of insecticide treated nets and intermittent preventive treatment for malaria control during pregnancy in Cameroon. Arch Public Health. 2016;74:5.CrossRefPubMedPubMedCentral
27.
go back to reference Hill J, Dellicour S, Bruce J, Ouma P, Smedley J, Otieno P, Ombock M, et al. Effectiveness of antenatal clinics to deliver intermittent preventive treatment and insecticide treated nets for the control of malaria in pregnancy in Kenya. PLoS ONE. 2013;8:e64913.CrossRefPubMedPubMedCentral Hill J, Dellicour S, Bruce J, Ouma P, Smedley J, Otieno P, Ombock M, et al. Effectiveness of antenatal clinics to deliver intermittent preventive treatment and insecticide treated nets for the control of malaria in pregnancy in Kenya. PLoS ONE. 2013;8:e64913.CrossRefPubMedPubMedCentral
28.
go back to reference Olliaro PL, Delenne H, Cisse M, Badiane M, Olliaro A, Vaillant M, et al. Implementation of intermittent preventive treatment in pregnancy with sulphadoxine/pyrimethamine (IPTp-SP) at a district health centre in rural Senegal. Malar J. 2008;7:234.CrossRefPubMedPubMedCentral Olliaro PL, Delenne H, Cisse M, Badiane M, Olliaro A, Vaillant M, et al. Implementation of intermittent preventive treatment in pregnancy with sulphadoxine/pyrimethamine (IPTp-SP) at a district health centre in rural Senegal. Malar J. 2008;7:234.CrossRefPubMedPubMedCentral
29.
go back to reference Ameh S, Owoaje E, Oyo-Ita A, Kabiru CW, Akpet OE, Etokidem A, Enembe O, et al. Barriers to and determinants of the use of intermittent preventive treatment of malaria in pregnancy in Cross River State, Nigeria: a cross-sectional study. BMC Pregnancy Childbirth. 2016;16:99.CrossRefPubMedPubMedCentral Ameh S, Owoaje E, Oyo-Ita A, Kabiru CW, Akpet OE, Etokidem A, Enembe O, et al. Barriers to and determinants of the use of intermittent preventive treatment of malaria in pregnancy in Cross River State, Nigeria: a cross-sectional study. BMC Pregnancy Childbirth. 2016;16:99.CrossRefPubMedPubMedCentral
30.
go back to reference Muhumuza E, Namuhani N, Balugaba BE, Namata J, Ekirapa Kiracho E. Factors associated with use of malaria control interventions by pregnant women in Buwunga subcounty, Bugiri District. Malar J. 2016;15:342.CrossRefPubMedPubMedCentral Muhumuza E, Namuhani N, Balugaba BE, Namata J, Ekirapa Kiracho E. Factors associated with use of malaria control interventions by pregnant women in Buwunga subcounty, Bugiri District. Malar J. 2016;15:342.CrossRefPubMedPubMedCentral
31.
go back to reference Thiam S, Kimotho V, Gatonga P. Why are IPTp coverage targets so elusive in sub-Saharan Africa ? A systematic review of health system barriers. Malar J. 2013;12:353.CrossRefPubMedPubMedCentral Thiam S, Kimotho V, Gatonga P. Why are IPTp coverage targets so elusive in sub-Saharan Africa ? A systematic review of health system barriers. Malar J. 2013;12:353.CrossRefPubMedPubMedCentral
32.
go back to reference Amoran OE, Ariba AA, Iyaniwura CA. Determinants of intermittent preventive treatment of malaria during pregnancy (IPTp) utilization in a rural town in Western Nigeria. Reprod Health. 2012;9:12.CrossRefPubMedPubMedCentral Amoran OE, Ariba AA, Iyaniwura CA. Determinants of intermittent preventive treatment of malaria during pregnancy (IPTp) utilization in a rural town in Western Nigeria. Reprod Health. 2012;9:12.CrossRefPubMedPubMedCentral
Metadata
Title
Intermittent preventive treatment of malaria in pregnancy: a cross-sectional survey to assess uptake of the new sulfadoxine–pyrimethamine five dose policy in Ghana
Authors
Ivy Owusu-Boateng
Francis Anto
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2017
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-017-1969-7

Other articles of this Issue 1/2017

Malaria Journal 1/2017 Go to the issue