Community knowledge attitudes and practices on intermittent presumptive treatment of malaria in pregnant women in Tororo District – Uganda.

Abstract

Introduction: Utilization of intermittent presumptive treatment (IPT) of malaria for pregnant women is still low in Tororo district. IPT1 coverage from July 2005 to July 2006 was 45% and IPT2 was not established. All pregnant mothers are perceived as susceptible or at risk but more at risk are adolescent mothers, primegravida and second pregnancy, sickle cell, HIV positive mothers, malnourished and travellers/ migrants to endemic areas. Most rural pregnant women lack access to IPT services and are economically constrained. The MoH initiated IPT as one of the national strategies to control malaria in pregnancy. Similarly in Tororo district IPT was introduced in 2002. Lack of knowledge, poor attitudes and practices among others could be contributing to low utilization of IPT of malaria in Tororo district. Methods: A descriptive cross sectional study, which was a community based was conducted. Knowledge, attitudes and practices on IPT of malaria were assessed among 240 women. Key informants (KIs) and focus group discussion (FGD) interviews were conducted. Data was analyzed using SPSS for windows and presented in tables and figures. Results: Fifty six of the 240 respondents interviewed, had high level of knowledge about IPT, while the majority 82% knew fansidar as one of the medicines used for prevention of malaria. More than 56% of the respondents correctly described the required dose of three tablets of SP at a single visit for prevention of malaria in pregnancy. 36% of respondents acknowledged that SP prevents malaria during pregnancy. 81% had a good attitude about the use of IPT and 80% had used SP in the previous pregnancies. Uneducated women were less likely to have knowledge about IPT (OR = 2.15, CI = 1.11-10.49) than the educated. The distance to the health centre was a limiting factor in accessing the IPT. Conclusion: Education and prior usage of SP were positively associated with good knowledge; and they also had a good attitude towards the use of IPT. The practice of women to use IPT was affected by distance to the health centre. The district health workers should intensify health education of women and entire community on the use of IPT for malaria prevention. The Ministry of Health should ensure that the health centers are closer to the community and are well stocked with fansidar.