Intermittent preventive therapy in pregnancy with sulfadoxine/pyrimethamine for malaria prophylaxis among parturients in Ilorin, Nigeria

Abstract

Background: The use of intermittent preventive treatment in pregnancy with sulfadoxine/pyrimethamine (IPTp-SP) for malaria remains an important tool for improving pregnancy outcome in malaria endemic areas. Objective: To assess the knowledge, attitude, and factors associated with the use of IPTp-SP among antenatal clinic attendees in Ilorin. Materials and Methods: A prospective, multicentre, cross-sectional study among consenting parturients receiving antenatal care at three public health facilities in Ilorin, Nigeria. Statistical analysis was conducted with the Statistical Package for the Social Sciences version 20.0 software (SPSS Inc., Chicago, IL, United States) with the calculation of percentages, chi square, odds ratios (ORs), and confidence intervals (CIs); P < 0.05 was considered significant. Results: There were 422 participants with mean age of 28.8 ± 4.7 years and 368 (87.2%) were aware of the use of IPTp-SP for malaria prevention, while 388 (91.9%) were willing to use IPTp-SP. Only 154 (36.5%) had prescription for IPTp-SP among whom 139 (90.3%) were compliant; IPTp-SP uptake in preceding pregnancy was 148 (59.7%). The most common reason for the nonuse of IPTp-SP prescribed was the fear of harm to the fetus (53.3%). Significant determinants of willingness to use IPTp-SP were maternal age (P = 0.007) and monthly income (P = 0.013), IPTp-SP use in preceding pregnancy (P = 0.001), and the treatment for malaria in index pregnancy (P = 0.014). On logistic regression, maternal age <20 years (OR = 36.457, 95% CI = 2.260–588.011; P = 0.011) and the use of IPTp-SP in preceding pregnancy (OR = 0.051, 95% CI = 0.010–0.252; P = 0.001) were significant predictors of willingness to use IPTp-SP. Conclusion: Parturients desire IPTp-SP, but the prescription rate by healthcare providers was low. Healthcare providers should increase the prescription and address the concerns about its teratogenicity. Governments and other agencies should prioritize free provision and the availability of SP at health facilities.