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. 2021 May 22;20(1):231.
doi: 10.1186/s12936-021-03764-5.

Determinants of intermittent preventive treatment with sulfadoxine-pyrimethamine in pregnant women (IPTp-SP) in Mali, a household survey

Oumar Sangho  1   2 , Moctar Tounkara  3 , Lillian Joyce Whiting-Collins  4 , Madeleine Beebe  4 , Peter J Winch  4 , Seydou Doumbia  3
Affiliations

Determinants of intermittent preventive treatment with sulfadoxine-pyrimethamine in pregnant women (IPTp-SP) in Mali, a household survey

Oumar Sangho et al. Malar J. .

Abstract

Background: In malaria endemic regions, intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) is recommended for all pregnant women during prenatal consultation, from the fourth month of pregnancy up to the time of delivery. The Government of Mali is aiming for universal coverage of IPTp-SP. However, coverage is still low, estimated to be 18% for completion of three doses (IPTp-SP3). The objective of this study was to identify the factors that influence IPTp-SP adherence in the Health District of Sélingué, Mali.

Methods: This was a cross-sectional survey with 30 clusters, proportional to village size, with two stages of sampling. Data were collected electronically with Magpi software during face-to-face interviews/surveys. The data were analysed with SPSS version 20. A descriptive analysis and bivariate and multivariate logistic regression were performed. An equity analysis examined the effect of distance from health care facility on completion of three or more antenatal visits (ANC3 +) and three or more doses of intermittent preventive treatment (IPTp-SP3 +).

Results: Of the 1,021 women surveyed, 87.8% (n = 896) attended at least one ANC visit. Of these, 86.3% (n = 773) received at least one dose of IPTp-SP. Compliance with three or more doses of IPTp-SP was 63.7%. The determinants statistically related to ANC3 + were the early initiation of ANC (OR = 3.22 [1.22, 10.78]), and the presence of a community health centre (CHC) in the village (OR = 9.69 [1.09, 86.21]). The ability to read (OR = 1.60 [1.01, 2.55]), the early initiation of ANC (OR = 1.46 [1.06, 2.00], knowledge of the utility of the drug (OR = 2.38 [1.24, 4.57]), and knowledge of the recommended dose of the drug (OR = 6.11 [3.98, 9.39]) were related to completion of three or more treatments (IPTp-SP3 +).

Conclusion: The early initiation of ANC was a positive determinant of the completeness of both ANC3 + and IPTp-SP3 + . This study shows that a successful implementation of the IPTp strategy can be achieved by improving access to prenatal care at community health facilities, and strengthening patient-provider communication to ensure adequate knowledge on dosing of IPTp-SP and the benefits to mother and child.

Keywords: Access to care; Antenatal care; Geographic access; Intermittent preventive treatment; Malaria in pregnancy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of IPTp-SP intake among women surveyed in 2016, Sélingué, Mali
Fig. 2
Fig. 2
Curve of concentration of the realization of ANC3 + in the women surveyed in 2016, Sélingué, Mali
Fig. 3
Fig. 3
Curve of concentration of the realization of IPTp-SP3 + in the women surveyed in 2016, Sélingué, Mali
See this image and copyright information in PMC

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References

    1. World Health Organization. World malaria report 2020: 20 years of global progress & challenges. Geneva, World Health Organization; 2021. https://www.who.int/publications-detail-redirect/9789240015791
    1. Schantz-Dunn J, Nour NM. Malaria and pregnancy: a global health perspective. Rev Obstet Gynecol. 2009;2:186. - PMC - PubMed
    1. Desai M, ter Kuile FO, Nosten F, McGready R, Asamoa K, Brabin B, et al. Epidemiology and burden of malaria in pregnancy. Lancet Infect Dis. 2007;7:93–104. doi: 10.1016/S1473-3099(07)70021-X. - DOI - PubMed
    1. WHO. Intermittent preventive treatment in pregnancy (IPTp). Geneva: World Health Organization; 2018. http://www.who.int/malaria/areas/preventive_therapies/pregnancy/en/
    1. Programme National de Lutte contre le Paludisme (PNLP). Plan Stratégique de Lutte contre le Paludisme 2013–2017. Bamako, 2013. https://www.severemalaria.org/sites/www.severemalaria.org/files/content/...