Abstract
Intermittent preventive therapy (IPTp) using sulphadoxine-pyrimethamine (SP) is a key component of malaria prevention strategy in pregnant women. A pregnant woman is required to receive at least 3 doses of SP during her pregnancy, with each dose being given at least 1 month apart, starting the first dose in the earliest second trimester of pregnancy. Therefore, a descriptive cross-sectional study was designed to assess the knowledge and uptake of IPTp-SP among pregnant women living in low malaria prevalent region. The questionnaires were used to collect data on sociodemographic characteristics, obstetric history, and knowledge scale while information about SP use was extracted from antenatal clinic cards. Overall, 389 pregnant women with a mean age (± standard deviation) of 29 years (5.3) participated in the study where majority of them (80.7%) were married. Majority of the study participants (77.1%) were in the third trimester of pregnancy and multigravida (42.9%). Of 389, 37 (9.5%), 288 (74%), and 64 (16.5%) were found to have low, moderate, and high level of knowledge about the use of IPTp-SP respectively. Of 300 pregnant women who were in the third trimester, 37 (12.3%) did not take SP at all while 109 (36.3%), 61 (20.3%), and 93 (31%) had taken a single, two doses, three, or more SP doses respectively. Although majority of pregnant women had moderate to high level of knowledge about the use of IPTp-SP, but only one third of pregnant women did take three or more IPTp-SP doses.
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Takem EN, D’Alessandro U. Malaria in pregnancy. Mediterr J Hematol Infect Dis. 2013;5(1):e2013010. https://doi.org/10.4084/MJHID.2013.010.
Rogerson SJ. Malaria in pregnancy and the newborn. Adv Exp Med Biol. 2010;659:139–52. https://doi.org/10.1007/978-1-4419-0981-7_12.
Menendez C. Malaria during pregnancy. Curr Mol Med. 2006;6:269–73. https://doi.org/10.2174/156652406776055186.
Kourtis AP, Read JS, Jamieson DJ. Pregnancy and infection. N Engl J Med. 2014;370(23):2211–8. https://doi.org/10.1056/NEJMra1213566.
Lufele E, Umbers A, Ordi J, et al. Risk factors and pregnancy outcomes associated with placental malaria in a prospective cohort of Papua New Guinean women. Malar J. 2017;16:427. https://doi.org/10.1186/s12936-017-2077-4.
World Health Organization, intermittent preventive treatment in pregnancy, 2019[http://www.who.int/malaria/areas/preventive_therapies/pregnancy/en/].
Tanzania Treatment Guidelines. 2013. https://www.who.int/selection_medicines/country_lists/Tanzania_STG_052013.pdf
World Health Organization policy brief for the implementation of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) April 2013 (revised January 2014) [http://www.who.int/malaria/publications/atoz/iptp-sp-updated-policy-brief-24jan2014.pdf].
Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF. 2016. Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2017. Dar es Salaam, Tanzania, and Rockville, Maryland, USA: MoHCDGEC, MoH, NBS, OCGS, and ICF. https://www.dhsprogram.com/pubs/pdf/SR233/SR233.pdf
Bouyou-Akotet MK, Mawili-Mboumba DP, Kombila M. Antenatal care visit attendance, intermittent preventive treatment and bed net use during pregnancy in Gabon. BMC Pregnancy Childbirth. 2013;13:52. https://doi.org/10.1186/1471-2393-13-52.
TACAIDS, ZAC & OCGS, ICF, N., 2013. HIV/AIDS and Malaria Indicator Survey 2011–12. Tanzania. Dar es Salaam, Tanzania: Tanzania. pp. 103–110.
Yimer M, Abera B, Mulu W, Bezabih B. Knowledge, attitude and practices of high risk populations on louse-borne relapsing fever in Bahir Dar city, north-west Ethiopia. Sci J Public Health. 2014;2(1):15–22. https://doi.org/10.11648/j.sjph.20140201.13.
Sangare LR, Stergachis A, Brentlinger PE, Richardson BA, Staedke SG, Kiwuwa MS, et al. Determinants of use of intermittent preventive treatment of malaria in pregnancy: Jinja Uganda. PLoS One. 2010;5:e15066. https://doi.org/10.1371/journal.pone.0015066.
Kinney MV, Kerber KJ, Black RE, Cohen B, Nkumah F, Coovadia H, et al. Science in action: saving the lives of Africa’s mothers, newborns, and children working group sub-Saharan Africa’s mothers, newborns and children: where and why do they die? PLoS Med. 2010;7:e1000294. https://doi.org/10.1371/journal.pmed.1000294.
Kibusi SM, Kimunai E, Hines CS. Predictors for uptake of intermittent preventive treatment of malaria in pregnancy (IPTp) in Tanzania. BMC Public Health. 2015;15:540. https://doi.org/10.1186/s12889-015-1905-0.
Amoran OE, Ariba AA, Iyaniwura CA. Determinants of intermittent preventive treatment of malaria during pregnancy (IPTp) utilization in a rural town in Western Nigeria. Reprod Health. 2012;9:12. https://doi.org/10.1186/1742-4755-9-12.
de Kock M, Tarning J, Workman L, Nyunt MM, Adam I, Barnes KI, et al. Pharmacokinetics of sulfadoxine and pyrimethamine for intermittent preventive treatment of malaria during pregnancy and after delivery. CPT Pharmacometrics Syst Pharmacol. 2017;6(7):430–8. https://doi.org/10.1002/psp4.12181.
Hickman MR, et al. Pharmacokinetics and pharmacodynamics of antimalarial drugs used in combination therapy. 1st ed. Sharjah: Bentham Science Publishers; 2015. https://doi.org/10.2174/97816810805431150101.
Odongo CO, Bisaso KR, Ntale M, Odia G, Ojara FW, Byamugisha J, et al. Trimester-specific population pharmacokinetics and other correlates of variability in sulphadoxine–pyrimethamine disposition among Ugandan pregnant women. Drugs R&D. 2015;15(4):351–62. https://doi.org/10.1007/s40268-015-0110-z.
Charpiat B, et al. For the Eurotoxo group (panel 2). Systematic search and analysis of published pharmacokinetic data related to sulfadoxine [unpublished report]. Bordeaux (France): The Eurotoxo Group; 2004.
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The study received ethics approval from the institutional review board of Muhimbili University of Health and Allied Sciences (MUHAS). Participants were informed about the aim of the study and gave written consent before participating in the study. Additionally, an assent was obtained from the legal guardian/parent of participant with age below 18 years.
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Ngapanya, S.A., Mikomangwa, W.P., Bwire, G.M. et al. Uptake of Intermittent Preventive Therapy Among Pregnant Women Living in Dar es Salaam, Tanzania: a Descriptive Cross-sectional Study. SN Compr. Clin. Med. 2, 408–413 (2020). https://doi.org/10.1007/s42399-020-00250-y
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DOI: https://doi.org/10.1007/s42399-020-00250-y