Trends and inequalities in the use of deworming medication during pregnancy in Sierra Leone, 2008-2019.

IF 3.6 Q1 TROPICAL MEDICINE Tropical Medicine and Health Pub Date : 2024-11-04 DOI:10.1186/s41182-024-00638-9
Augustus Osborne, Alpha Umaru Bai-Sesay, Alieu Tommy, Camilla Bangura, Bright Opoku Ahinkorah
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Abstract

Background: Intestinal worm infections are a significant public health concern for pregnant women in low- and middle-income countries. These infections can lead to anaemia, malnutrition, and adverse pregnancy outcomes, including premature birth and low birth weight. Deworming medication during pregnancy is a safe and effective strategy to prevent these complications and improve maternal and child health. This study aims to investigate the trends and inequalities in the use of deworming medication during pregnancy among women in Sierra Leone between 2008 and 2019.

Methods: The study utilised data from the Sierra Leone Demographic Health Surveys conducted in 2008, 2013, and 2019. We used the Health Equity Assessment Toolkit developed by the World Health Organisation to calculate various measures of inequality, including difference, ratio, population attributable risk, and population attributable fraction. An inequality assessment was conducted for five stratifiers: age, economic status, level of education, place of residence, and sub-national province.

Results: The prevalence of deworming medication during pregnancy was 43.8% in 2008, 72.4% in 2013, and 83.5% in 2019 in Sierra Leone. There was a decrease in age-related inequality from a difference of 3.7% in 2008 to -0.8% in 2019. Economic-related inequality increased from a difference of -8.5% in 2008 to -8.2% in 2019. Both population attributable fraction and population attributable risk were zero in all survey years for economic status, indicating no improvement in the setting average without economic-related inequality. Inequality in education increased from a difference of -8.9% in 2008 to -8.4% in 2019 and decreased from a difference of -2.6% in 2008 to -5.5% in 2019 for place of residence. Provincial inequality decreased from a difference of 29.5% in 2008 to 11.8% in 2019. The population attributable risk for province reveals that the setting average could have been 10.5 percentage points lower in 2008, 8.2 percentage points lower in 2013, and 5.9 percentage points lower in 2019 without provincial inequality.

Conclusion: The prevalence of deworming medication use during pregnancy substantially increased from 2008 to 2019 (43.8% to 83.5%) in Sierra Leone. This suggests a positive public health trend in maternal healthcare access and education. Inequalities related to economic status and education increased slightly while age-related, place of residence and provincial inequalities decreased. This indicates an inequitable distribution of this essential healthcare intervention across these stratifiers. The government and policymakers should continue efforts to raise awareness and promote the use of deworming medication during pregnancy.

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2008-2019 年塞拉利昂孕期使用驱虫药的趋势和不平等现象。
背景:肠道蠕虫感染是中低收入国家孕妇的一个重大公共卫生问题。这些感染可导致贫血、营养不良和不良妊娠结局,包括早产和出生体重不足。孕期驱虫药是预防这些并发症和改善母婴健康的安全有效的策略。本研究旨在调查 2008 年至 2019 年期间塞拉利昂妇女在孕期使用驱虫药的趋势和不平等现象:研究利用了 2008 年、2013 年和 2019 年进行的塞拉利昂人口健康调查的数据。我们使用世界卫生组织开发的健康公平评估工具包来计算各种不平等度量,包括差异、比率、人口可归因风险和人口可归因分数。对年龄、经济状况、教育水平、居住地和次国家级省份这五个分层因素进行了不平等评估:塞拉利昂孕期驱虫药的使用率在 2008 年为 43.8%,2013 年为 72.4%,2019 年为 83.5%。与年龄相关的不平等有所减少,从 2008 年的 3.7% 降至 2019 年的-0.8%。与经济相关的不平等从 2008 年的-8.5% 增加到 2019 年的-8.2%。在经济状况的所有调查年份中,人口可归因分数和人口可归因风险均为零,表明在没有经济相关不平等的情况下,环境平均值没有改善。教育方面的不平等从 2008 年的-8.9%增至 2019 年的-8.4%,居住地方面的不平等从 2008 年的-2.6%降至 2019 年的-5.5%。各省的不平等从 2008 年的 29.5%下降到 2019 年的 11.8%。各省的人口可归因风险显示,如果没有各省的不平等,2008 年的环境平均值可能会降低 10.5 个百分点,2013 年降低 8.2 个百分点,2019 年降低 5.9 个百分点:从 2008 年到 2019 年,塞拉利昂的孕期驱虫药使用率大幅提高(从 43.8% 提高到 83.5%)。这表明在孕产妇保健和教育方面出现了积极的公共卫生趋势。与经济地位和教育有关的不平等略有增加,而与年龄、居住地和省份有关的不平等则有所减少。这表明,在这些分层中,这一基本医疗保健干预措施的分配并不公平。政府和政策制定者应继续努力提高人们的认识,促进孕期驱虫药的使用。
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来源期刊
Tropical Medicine and Health
Tropical Medicine and Health TROPICAL MEDICINE-
CiteScore
7.00
自引率
2.20%
发文量
90
审稿时长
11 weeks
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