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Uptake of four or more doses of sulfadoxine pyrimethamine for intermittent preventive treatment of malaria during pregnancy in Zambia: findings from the 2018 malaria in pregnancy survey.
- Source :
-
BMJ open [BMJ Open] 2023 May 26; Vol. 13 (5), pp. e073287. Date of Electronic Publication: 2023 May 26. - Publication Year :
- 2023
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Abstract
- Objective: To determine the prevalence and predictors of the uptake of four or more doses of sulfadoxine pyrimethamine (IPTp-SP 4+) in Zambia.<br />Design: A cross-sectional study using secondary data from the malaria in pregnancy survey (Malaria Indicator Survey) data set conducted from April to May 2018.<br />Setting: The primary survey was conducted at community level and covered all the 10 provinces of Zambia.<br />Participants: A total of 3686 women of reproductive age (15-45 years) who gave birth within the 5 years before the survey.<br />Primary Outcome: Proportion of participants with four or more doses of IPTp-SP.<br />Statistical Analysis: All analyses were conducted using RStudio statistical software V.4.2.1. Descriptive statistics were computed to summarise participant characteristics and IPTp-SP uptake. Univariate logistic regression was carried out to determine association between the explanatory and outcome variables. Explanatory variables with a p value less than 0.20 on univariate analysis were included in the multivariable logistic regression model and crude and adjusted ORs (aORs) along with their 95% CIs were computed (p<0.05).<br />Results: Of the total sample of 1163, only 7.5% of participants received IPTp-SP 4+. Province of residence and wealth tertile were associated with uptake of IPTp-SP doses; participants from Luapula (aOR=8.72, 95% CI (1.72 to 44.26, p=0.009)) and Muchinga (aOR=6.67, 95% CI (1.19 to 37.47, p=0.031)) provinces were more likely to receive IPTp-SP 4+ compared with to those from Copperbelt province. Conversely, women in the highest wealth tertile were less likely to receive IPTp-SP 4+ doses compared with those in the lowest quintile (aOR=0.32; 95% CI (0.13 to 0.79, p=0.014)).<br />Conclusion: These findings confirm a low uptake of four or more doses of IPTp-SP in the country. Strategies should focus on increased coverage of IPTp-SP in provinces with much higher malaria burden where the risk is greatest and the ability to afford healthcare lowest.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Pregnancy
Female
Humans
Adolescent
Young Adult
Adult
Middle Aged
Pyrimethamine therapeutic use
Sulfadoxine therapeutic use
Zambia epidemiology
Cross-Sectional Studies
Surveys and Questionnaires
Drug Combinations
Antimalarials therapeutic use
Pregnancy Complications, Parasitic prevention & control
Pregnancy Complications, Parasitic drug therapy
Malaria epidemiology
Malaria prevention & control
Malaria drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2044-6055
- Volume :
- 13
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- BMJ open
- Publication Type :
- Academic Journal
- Accession number :
- 37236665
- Full Text :
- https://doi.org/10.1136/bmjopen-2023-073287