Knowledge, attitude and practices on intermittent preventive treatment in pregnant women with malaria: a mixed method facility-based study in Western Kenya.

Abstract

Intermittent preventive treatment remains a core strategy for malaria prevention in pregnancy. Sulfadoxine-pyrimethamine is recommended for all pregnant women in malaria prone zones. It is scheduled monthly at each antenatal care visit up to 36 weeks. Here, we sought to assess the knowledge, attitude and practices on intermittent preventive treatment in pregnant women with malaria in Webuye hospital. Prior to the enrollment, ethical approval and permissions were sought from relevant institutions, as well as consents obtained from 140 participants aged between 18-49 years with gestation about 16 weeks. Malaria test was conducted via either microscopy or rapid test and participants were split into malaria positive and negative cohorts. Closed and open-ended questionnaire were administered to the participants and two focus group discussions were organized to collect their views. The results were expressed in percentage and Chi-square of association at a p-value equal or less than 0.05 (95%). Qualitative data were analyzed by the means of MAXQDA software. Our analysis revealed that there was a significant difference between the proportion of negative and positive groups among mothers’ knowledgeable on the side effects (p-value = 0.001), different doses (p-value = 0.012). Those who were informed about intermittent preventive treatment before administration (p-value = 0.003). The proportion of mothers knowledgeable about side effects and different doses were higher among the malaria positive group as compare to the negative with 52.9% versus 25.7% and 20.0% versus 5.7% respectively. Moreover, 76.3% of respondents reported that intermittent preventive treatment prevents malaria, 30.9% had the opinion that it causes abortion. Expectant women who were aware of the benefits of this strategy had this to say; “This medicine helps to reduce the effects of malaria and prevents mother to contract malaria”. However, those unaware had this to say; “I have never been told about something like that but it prevents diseases”. Those who knew about the schedule and side effects said “It is given three doses during each antenatal visit”. Therefore, good knowledge, attitude and practices of intermittent preventive treatment are key for control and prevention of malaria in endemic prone areas.