Factors affecting uptake of optimal doses of sulphadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy in six districts of Tanzania

Exavery, Amon; Mbaruku, Godfrey; Mbuyita, Selemani; Makemba, Ahmed; Kinyonge, Iddajovana P; Kweka, Hadija

doi:10.1186/1475-2875-13-22

Cited by 73Malaria Research and ControlGlobal Maternal and Child HealthHIV/AIDS Research and Interventions

Factors affecting uptake of optimal doses of sulphadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy in six districts of Tanzania

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Exavery, Amon, Mbaruku, Godfrey, Mbuyita, Selemani, Makemba, Ahmed, Kinyonge, Iddajovana P, Kweka, Hadija·2014·Malaria Journal

DOI 10.1186/1475-2875-13-22PMC PMC3898402

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Abstract

BACKGROUND: Intermittent preventive treatment during pregnancy (IPTp) with optimal doses (two+) of sulphadoxine-pyrimethamine (SP) protects pregnant women from malaria-related adverse outcomes. This study assesses the extent and predictors of uptake of optimal doses of IPTp-SP in six districts of Tanzania. METHODS: The data come from a cross-sectional survey of random households conducted in six districts in Tanzania in 2012. A total of 1,267 women, with children aged less than two years and who had sought antenatal care (ANC) at least once during pregnancy, were selected for the current analysis. Data analysis involved the use of Chi-Square (χ2) for associations and multivariate analysis was performed using multinomial logistic regression. RESULTS: Overall, 43.6% and 28.5% of the women received optimal (two+) and partial (one) doses of IPTp-SP respectively during pregnancy. Having had been counseled on the dangers of malaria during pregnancy was the most pervasive determinant of both optimal (RRR = 6.47, 95% CI 4.66-8.97) and partial (RRR = 4.24, 95% CI 3.00-6.00) uptake of IPTp-SP doses. Early ANC initiation was associated with a higher likelihood of uptake of optimal doses of IPTp-SP (RRR = 2.05, 95% CI 1.18-3.57). Also, women with secondary or higher education were almost twice as likely as those who had never been to school to have received optimal SP doses during pregnancy (RRR = 1.93, 95% CI 1.04-3.56). Being married was associated with a 60% decline in the partial uptake of IPTp-SP (RRR = 0.40, 95% CI 0.17-0.96). Inter-district variations in the uptake of both optimal and partial IPTp-SP doses existed (P < 0.05). CONCLUSION: Counseling to pregnant women on the dangers of malaria in pregnancy and formal education beyond primary school is important to enhance uptake of optimal doses of SP for malaria control in pregnancy in Tanzania. ANC initiation in the first trimester should be promoted to enhance coverage of optimal doses of IPTp-SP. Programmes should aim to curb geographical barriers due to place of residence to enhance optimal coverage of IPTp-SP in Tanzania.

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Higher optimal IPTp-SP uptake was expected because the main healthcare facility was located close to households and parturient were expected to frequently attend ANC and be sensitized about SP by well-trained health care personnel.
“Higher optimal IPTp-SP uptake was expected as reported recently in a hypoendemic area in Tanzania [12] since the main healthcare facility was located close to the households and parturient expected to frequently attend ANC and be sensitized about SP by well-trained health care personnel [41].”
From Intermittent preventive treatment with Sulphadoxine-Pyrimethamine (IPTp-SP) is associated with protection against sub-microscopic P. falciparum infection in pregnant women during the low transmission dry season in southwestern Cameroon: A Semi - longitudinal study (2022) · cites this paper as [41]

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Authors: Exavery, A., Mbaruku, G., Mbuyita, S., Makemba, A., Kinyonge, I. P., & Kweka, H.
Affiliations: Ifakara Health Institute (TZ)
Corresponding author: Exavery, Amon
ORCID: Exavery, Amon
Mbaruku, Godfrey
Mbuyita, Selemani
Venue: Malaria Journal
Publisher: Springer Science and Business Media LLC
Published: 2014-01-14
Volume: 13
Issue: 1
Pages: 22-22
ISSN: 1475-2875 (ISSN-L)
DOI: 10.1186/1475-2875-13-22
PMC: PMC3898402
OpenAlex: W2072864256
Cited by: 71
References: 25
Citations by year: 2026: 1 · 2025: 3 · 2024: 9 · 2023: 2 · 2022: 12 · 2021: 7 · 2020: 14 · 2019: 7 · 2018: 5 · 2017: 5 · 2016: 3 · 2015: 1 · 2014: 2
FWCI: 3.63
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Malaria Journal (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
IHI Repository (acceptedVersion)
Funders: Comic Relief
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords: intermittent preventive treatment in pregnancy, sulfadoxine-pyrimethamine, malaria in pregnancy, antenatal care initiation, maternal education, marital status, inter-district variation, Tanzania, malaria prevention in pregnancy
MeSH terms: Adolescent, Adult, Antimalarials, Cross-Sectional Studies, Dose-Response Relationship, Drug, Drug Combinations, Female, Humans, Malaria, Middle Aged, Models, Biological, Pregnancy, Pyrimethamine, Socioeconomic Factors, Sulfadoxine, Tanzania, Multivariate Analysis, Logistic Models, Young Adult

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Factors affecting uptake of optimal doses of sulphadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy in six districts of Tanzania

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