Uptake of sulfadoxine-pyrimethamine for intermittent preventive treatment and weeks of pregnancy protected in Mbeya urban district, Tanzania.

Abstract

Background: The time-point in pregnancy at which optimal Intermittent Preventive Treatment (IPTp) with Sulfadoxine-Pyrimethamine (SP) is delivered is crucial as optimal protection only occurs when the intervention is used for the entire period when the baby is at greatest risk to placental malaria infection. Placental malaria is known to peak in the 2^nd trimester; thus for SP to confer optimal protection to the baby, the 1^st and 2^nd dose of SP must be received between 20^th to 26^th and 28^th to 34^th weeks of gestation.
Objective: This study investigated the number of visits made for antenatal care (ANC), timing of delivery of SP and number of doses received, and the pregnancy time protected.
Methodology: A facility based cross-sectional study was carried out in the Meta maternity hospital, Ruanda and Kiwanja Mpaka health centers located in Mbeya urban district. Consecutive pregnant women on elective delivery and postnatal mothers were recruited in the study. Participants were asked a series of closed questions about their socio-economic background, pregnancy history and attendance for ANC; and receipt of SP for IPTp.
Results: A total of 299 mothers were studied; only about half (52.8%) received one dose of SP in the 2^nd or 3^rd trimester of pregnancy and were thus protected against malaria for only 12 weeks. About a third (34.8%) received the 2^nd dose in the 3^rd trimester of pregnancy and was thus protected for 24 week. Only less than a quarter (23.4%) received the 1^st dose of SP in the 2^nd trimester between the 20^th to 26^th weeks of gestation Having made > ANC visits was significantly associated with receipt of 1^st and 2^nd doses of SP.
Conclusions: The overall SP coverage (34.8%) was far below the RBM target of 80.0%. Further studies are needed so as to identify the barriers for making > ANC visits that is associated with a high likelihood of receiving optimal doses of SP for IPTp.
 

Key words: Pregnancy, malaria, Sulfadoxine-Pyrimethamine, intermittent preventive treatment (IPTp), Tanzania