Comparative Analysis of Malaria Awareness among Parturients on Intermittent Preventive Treatment with Sulphadoxine–Pyrimethamine (IPT-SP) Against Malaria in Pregnancy and Their Controls at Owerri Nigeria
Keywords:
Awareness, Antenatal course, Knowledge, Malaria endemicity, Malaria in pregnancy, Sulphadoxine-Pyrimethamine.Abstract
Background: The emphasis placed on malaria prevention during pregnancy especially in malaria endemic areas need not be overemphasized. For this reason, the World Health Organization (WHO) introduced the Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPT-SP). The introduction and adequate uptake are aimed at reducing malaria in pregnancy (MIP) and its attendant problems. Preterm labours, low birth weight, small for date babies and anaemias are some of the problems of MIP etc. To help the IPT-SP program work, pregnant women and their care givers require adequate awareness, knowledge, attitude and practice of this IPT-SP. Clear and directed public health Campaigns and on-site Antenatal lecturers are required to ensure correct practices and uptake of the recommended regimen. By so doing, the IPT-SP will help pregnant women enjoy uneventful pregnancies as well as avert most complications of MIP including preterm births, neonatal anaemias, intrauterine growth retardations (IUGR), increased admissions into special care baby units (SCBU) and even neonatal deaths.
Objectives: We comparatively analyzed the awareness of malaria in pregnancy among parturients on intermittent preventive treatment with sulphadoxine–pyrimethamine against malaria in pregnancy and their controls.
Method: The study was done at the Federal Medical Centre (FMC) Owerri, a region whose malaria endemicity is typical of that of Sub-Saharan Africa. The ethics committee of the health facility approved the Ethical clearance enabling commencement of a longitudinal recruitment of participants after adequate counseling and informed consent involving both groups. The study involved antenatal clinic recruitment, assessment of the awareness, knowledge, attitude and practice of IPT-SP among the participants. The recruited 296 participants of both groups satisfied the inclusion criteria for either the study or control groups as allotted. Follow up of the participants throughout their entire antenatal course till delivery was done.
Data analysis: Analysis and computation of the data obtained was done using the computer Software Package for Social Sciences (SPSS) version 20.0 (SPSS, Inc, 2007, Chicago) while descriptive statistics (mean, standard deviation, range, percentages etc.) were determined for continuous variables. P-value less than (<0.05) at 95% confidence interval was considered statistically significant.
Result: All the studied women knew about malaria infection in the past. While almost all the women in both groups have suffered malaria in the past, only one woman (0.7%) in the control group responded negatively. All participants usually experience malaria symptoms. Most of them in both groups usually present with Fever: study (85.1%); and control (89.9%); Headache: study (77.0%) and control (76.4%) etc.
Majority identified mosquito bites as the mode of transmission of malaria: 87.2% (study) and 79.1% (control) groups. On malaria awareness of the participating women, 91.9% (study) and 93.9% (control) groups knew other problems of malaria in Pregnancy (MIP): miscarriage (study= 63.5%, control= 66.2%), shortage of blood (study = 64.2%, control = 68.2%), severe malaria (study = 65.5%, control= 72.3%). On the preventive drugs for MIP: SP (fansidar) recorded the highest response of 90.5% among the study group while for the control group fairly had 69.6%. On assessment of IPT-SP awareness of the women only (14.9%) of the study/treatment group were not aware of it which is relatively low compared to 45 (30.4%) gotten from the control group. On the drug type used for IPT, 81% of the study group responded correctly, Sulphadoxine-Pyrimethamine alone as against 54.7% from the control.
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