Predictors of the use of interventions to prevent malaria in pregnancy in Cameroon

• Published in: Malaria Journal
• Main Authors: Jodie Dionne-Odom, Andrew O. Westfall, Tobias O. Apinjoh, Judith Anchang-Kimbi, Eric A. Achidi, Alan T. N. Tita
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2017
• Subjects: Malaria in pregnancy; Malaria prevention; Sulfadoxine–pyrimethamine (SP); Bed nets; Cameroon; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-017-1786-z; https://doaj.org/article/9bbd94d18e604d4cb491dd65658d458c

Abstract Background Malaria in pregnancy is common in sub-Saharan Africa where it contributes to perinatal morbidity and mortality. Use of insecticide-treated bed nets and intermittent preventive therapy with sulfadoxine–pyrimethamine during pregnancy are effective but underutilized interventions to prevent infection. Factors associated with bed net ownership and usage, and use of prophylaxis among recently pregnant women in Cameroon were investigated. Methods National data from the 2011 Cameroon Demographic Health Survey was used to identify women with a pregnancy within the previous 5 years. Logistic regression models were created to assess for independent predictors of reported bed net ownership, bed net usage, and the use of malaria prophylaxis medications during pregnancy. Results Nearly one in two women surveyed had a recent pregnancy (n = 7647). In this group, bed net ownership and usage rates were low (33.7 and 16.9%, respectively); 61.6% used medication for malaria prophylaxis during pregnancy. Bed net ownership and usage were associated with maternal literacy (aOR 1.4 for net usage, 95% CI 1.1–1.8) and the presence of children under age 5 in the home (aOR 2.3 for net usage, 95% CI 1.6–3.3). The use of malaria prophylaxis medication was associated with measures of healthcare access (aOR 17.8, 95% CI 13–24.5 for ≥4 antenatal care visits), higher maternal education (aOR 1.5, 95% CI 1.1–2.1) and maternal literacy (aOR 1.4, 95% CI 1.1–1.7). Conclusions Women in Cameroon and their antenatal providers missed many opportunities to prevent malaria in pregnancy. Efforts toward ensuring universal bed net provision, consistent antenatal care and the education of girls are likely to improve birth outcomes attributable to malaria infection.