Determinants of Intermittent Presumptive Treatment Uptake in the Prevention of Placenta Malaria among Women in Fishing Communities in Entebbe, Uganda - Abstract
Background: The burden and effects of malaria during pregnancy remains high in Uganda. To mitigate its effect, apt and effective use of Intermittent Presumptive Treatment (IPTp) has been widely recognized. Although with proven impact, access and use of IPTp remains at stake due to a number of factors. We explored the determinants of IPTp uptake among women living in Nakiwogo and Kigungu fishing sites in Entebbe District.
Methods: A cross sectional study among fishing communities was done. We enrolled households with pregnant women, and/or children aged 4/6 months using Simple random sampling. Data was collected using a structured questionnaire, focus group discussion and key informant interviews among the Municipal Health Officer and Health Inspectors on the use of IPT for the prevention of malaria in pregnancy. The key informants were selected using purposive sampling method. Pearson Correlations Coefficient and Adjusted Odds Ratio were used to ascertain factors that influenced IPT-2 uptake.
Results: The study enrolled 125 women. Of these, 51(40.8%) were aged between 18 to 25 years, 91(72.8%) reported having utilized IPTp and only 59 (47.2%) had not experienced malaria. Pregnant women and women with babies less than 4/ 6 months were 78(62.4%) and 47(37.6%) in number respectively The factors and their adjusted odds ratio (AOR) that were significantly associated with IPTp uptake are: age [AOR, 2.80, p-value, 0.008, CI, 2.74-3.00], Attendance to ANC services [AOR, 1.18, p-value 0.001, CI, 1.61-1.91], Knowledge about IPT [AOR, 3.86, p-value 0.005, CI, 2.87-3.96], Adherence to ANC services [AOR, 2.95, p-value, 0.001, CI, 1.54-2.98].Income, [AOR, 1.66, p-value, 0.003, CI, 1.18-2.77], marital status, [AOR, 2.86, p-value, 0.007, CI, 2.11-3.76] and spousal support [AOR, 1.55, p-vale 0.012, CI, 1.00-2.22], availability of IPT drugs [AOR, 1.16, p-value, 0.009, CI 1.05-2.01], availability of skilled staff [AOR, 3.87, p-value, 0.011, CI, 2.21-3.91] and community sensitization [AOR, 2.19, p-value, 0.010, CI, 1.88-2.29].
Conclusions and recommendation: The level of IPT uptake among women was high at 91(72.8%). The determinants of IPT-2 were age, ANC attendance and adherence, knowledge about IPT, higher income, being married and with spousal support, availability of IPT drugs, skilled staff and community sensitization. To this, it’s critical that the Ministry of Health ought to strategize for malaria prevention through free IPTp drug in a highly malaria endemic set up.