Barriers to and determinants of the use of intermittent preventive treatment of malaria in pregnancy in Cross River State, Nigeria: a cross-sectional study

被引:27
作者
Ameh, Soter [1 ,2 ]
Owoaje, Eme [3 ]
Oyo-Ita, Angela [1 ]
Kabiru, Caroline W. [4 ]
Akpet, Obaji E. O. [1 ]
Etokidem, Aniekan [1 ]
Enembe, Okokon [1 ]
Ekpenyong, Nnette [1 ]
机构
[1] Univ Calabar, Coll Med Sci, Dept Community Med, Calabar, Cross River Sta, Nigeria
[2] Univ Witwatersrand, Sch Publ Hlth, Fac Hlth Sci, MRC,Wits Rural Publ Hlth & Hlth Transit, Johannesburg, South Africa
[3] Univ Ibadan, Coll Med, Dept Community Med, Ibadan, Oyo State, Nigeria
[4] African Populat & Hlth Res Ctr, Nairobi, Kenya
关键词
Determinants; Barriers; Use; Sulfadoxine-pyrimethamine; Intermittent preventive treatment of malaria in pregnancy; Cross River State; Nigeria; ADHERENCE; KNOWLEDGE; DELIVERY; WOMEN; IPTP;
D O I
10.1186/s12884-016-0883-2
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Background: Malaria in pregnancy (MIP) has serious consequences for the woman, unborn child and newborn. The use of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (SP-IPTp) is low in malaria endemic areas, including some regions of Nigeria. However, little is known about pregnant women's compliance with the SP-IPTp national guidelines in primary health care (PHC) facilities in the south-south region of Nigeria. The aim of this study was to identify the barriers to and determinants of the use of SP-IPTp among pregnant women attending ANC in PHC facilities in Cross River State, south-south region of Nigeria. Methods: A cross-sectional survey was conducted in 2011 among 400 ANC attendees aged 15-49 years recruited through multistage sampling. Binary logistic regression was used to determine the factors associated with the use of SP-IPTp in the study population. Results: Use of SP-IPTp was self-reported by 41 % of the total respondents. Lack of autonomy in the households to receive sulfadoxine-pyrimethamine (SP) during ANC was the main barrier to use of IPTp (83 %). Other barriers were stock-outs of free SP (33 %) and poor supervision of SP ingestion by directly observed treatment among those who obtained SP from ANC clinics (36/110 = 33 %). In the multivariate logistic regression, the odds of using SP-IPTp was increased by the knowledge of the use of insecticide treated nets (ITNs) (OR = 2.13, 95 % CI: 1.70-3.73) and SP (OR = 22.13, 95 % CI: 8.10-43.20) for the prevention of MIP. Use of ITNs also increased the odds of using SP-IPTp (OR = 2.38, 95 % CI: 1.24-12.31). Conclusions: Use of SP-IPTp was low and was associated with knowledge of the use of ITNs and SP as well as the use of ITNs for the prevention of MIP. There is a need to strengthen PHC systems and address barriers to the usage of SP-IPTp in order to reduce the burden of MIP.
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页数:9
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