Antenatal care and adherence to intermittent preventive treatment for malaria during pregnancy with sulfadoxine-pyrimethamine in Gambia: an examination of Demographic and Health Survey data 2019–2020

Abstract

ABSTRACT Background Malaria during pregnancy is a major contributor to maternal and infant morbidity and mortality in Gambia. The World Health Organization recommends that women adhere to intermittent preventive treatment with sulfadoxine-pyrimethamine (SP-IPTp) provided through antenatal care (ANC) to prevent adverse outcomes. The aim of this study was to examine predictors of SP-IPTp adherence among women in Gambia. Methods Data analysis was conducted using the 2019–2020 Women's Health Survey from the Gambia Demographic and Health Survey dataset. χ2 tests and multivariate logistic regression were employed to assess the influence of ANC and sociodemographic characteristics on SP-IPTp adherence. Results Among 5381 women, less than half (47.3%) achieved adherence (three or more doses) to SP-IPTp. More than three-quarters (79.7%) attended four or more ANC visits. Women who attended four ANC visits were twice as likely to adhere to SP-IPTp than women who attended none to three ANC visits (adjusted odds ratio 2.042 [95% confidence interval 1.611 to 2.590]). Conclusions Attending four or more and earlier initiation of ANC visits may be related to improved SP-IPTp adherence. Additional research is needed to assess structural and healthcare system components that influence SP-IPTp adherence.