Determinants of timely uptake of ITN and SP (IPT) and pregnancy time protected against malaria in Bukoba, Tanzania.
OBJECTIVE
Insecticides treated nets (ITNs) and intermittent preventive therapy with two doses of sulfadoxine-pyrimethamine (SP IPTp) are the cornerstone for malaria control in pregnancy. Despite the coverage of these interventions being high, it is not known whether they confer optimal protection time against malaria in pregnancy. This study investigated the timing and determinants of timely uptake of SP(IPTp) and ITNs and the pregnancy time protected.


METHODS
A health facility based cross-sectional study was carried out in Bukoba urban district from 16th April to 29 May 2013. Involving pregnant women and post natal mothers attending Reproductive and Child Health (RCH) clinics. Data on their socio-economic background, pregnancy history and attendance to RCH, receipt of a voucher and acquisition of an ITN as well as SP for IPTp were collected. Their responses were validated from the records of antenatal cards. Data was analysed using SPSS computer program version 20.


RESULTS
A total of 530 mothers were recruited. The overall uptake of SP IPTp was 96 % and the uptake of two SP (IPTp) doses was 86 %. Timely uptake of 1st dose was predicted by early antenatal booking, [AOR 2.59; 95 % CI 1.51-4.46; P = 0.001], and the availability of SP at the facility [AOR 4.63; 95 % CI 2.51-8.54; P < 0.0001]. Uptake of 2nd dose was independent of any predictor factors. A total of 486 (91.6 %) women received ITNs discount vouchers at different gestational age and of these, less than a quarter (21.4 %) received timely. Timely receipt of discount voucher was highly predicted by early antenatal booking [AOR 200; 95 % CI 80.38-498; P < 0.0001].


CONCLUSIONS
Although there is a high coverage of SP IPTp and discount vouchers for ITNs, timely uptake and therefore optimal protection time depended on early antenatal booking, the availability of (SP IPTp) and discount voucher at the health facility.
Department of Community Health Nursing, Hubert Kairuki Memorial University, P.O. Box 65300, Dar Es Salaam, Tanzania. mlay.joyce@yahoo.com.
Joyce
J
Protas
Department of Parasitology, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
D
D
Tarimo
Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
C
C
Moshiro
D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data; D006801:Humans; D057148:Insecticide-Treated Bednets; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control*; D015999:Multivariate Analysis; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000469:parasitology / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods / Q000706:statistics & numerical data; D015995:Prevalence; D011739:Pyrimethamine / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000627:therapeutic use*; D013636:Tanzania / Q000453:epidemiology; D013997:Time Factors; D014504:Urban Health / Q000706:statistics & numerical data; D055815:Young Adult
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine
Determinants of timely uptake; Insectcides treated nets; Malaria in pregnancy; Prevention; Sulfadoxine-pyrimethamine