Factors associated with non-use of insecticide-treated bed nets among pregnant women in Zambia

Utilization of long-lasting insecticide-treated net and its associated factors among pregnant women in Dawo district, Southwest Shoa Zone, Oromia, Ethiopia, 2023

Introduction

The use of long-lasting insecticide-treated net (LLIN) is one of the most effective malaria prevention strategies, particularly among pregnant women. It has mosquito-killing repellent and physical barrier properties. Pregnant women, children under 5 years of age, and patients with HIV/AIDS, as well as non-immune migrants, mobile populations, and travelers, are the most vulnerable groups to malaria. Even when pregnant women are given priority, not all nets owned by households are used by pregnant women. Therefore, the risk of the occurrence of malaria during pregnancy is also high.

Objective

This study aimed to assess the utilization of long-lasting insecticide-treated net and its associated factors among pregnant women in Dawo district, Southwest Shoa Zone, Oromia, Ethiopia, 2023.

Methods

A community-based analytical cross-sectional study was carried out in Dawo district, Southwest Shoa Zone, Oromia, Ethiopia, from 21 to 30 April 2023. A total of 353 pregnant women were chosen through simple random sampling and interviewed face-to-face using a structured and pre-tested questionnaire. Before being exported to the Statistical Package for Social Science (SPSS) version 23, the data were coded and entered into EPIDATA version 4.6. The study examined the prevalence of long-lasting insecticide-treated net use among pregnant women in the Dawo district using descriptive statistics. Analytical statistics, such as bivariable and multivariable logistic regression analyses, were used to determine the relationship between independent and dependent variables. Statistical significance was determined using a P-value of <0.05 and adjusted odd ratios with 95% confidence intervals.

Results

Long-lasting insecticide-treated nets were utilized by 55.5% (95% CI: 50.4-60.7%) of all pregnant participants in the study, which was below the national target. Pregnant women who have antenatal care (ANC) contact for current pregnancy adjusted odds ratio (AOR = 4.66, 95% CI: 1.95, 11.10), community-based health insurance (CBHI) enrollment (AOR = 2.38, 95% confidence intervals, CI: 1.38, 4.11), children under 5 years of age (AOR = 2.68, 95% CI: 1.62, 4.43), understanding that malaria poses a risk to fetuses (AOR = 3.25, 95% CI: 1.26, 8.41), and LLINs access (AOR = 12.47, 95% CI: 3.98, 39.08), were factors that significantly associated with LLIN utilization.

Conclusion

In conclusion, the utilization of LLINs was relatively low. ANC contact for current pregnancy, CBHI enrollment, having children under the age of 5, having a high income, and understanding that malaria poses a risk to fetuses were factors significantly associated with LLIN utilization among pregnant women.

Interventions for malaria prevention in pregnancy; factors influencing uptake and their effect on pregnancy outcomes among post-natal women in a tertiary facility in the Volta Region of Ghana

Objectives

Malaria in pregnancy is associated with adverse pregnancy outcomes including maternal anaemia and low birthweight. Uptake of preventive interventions is sub-optimal in sub-Saharan Africa including Ghana. Understanding local-level factors that influence uptake of these interventions can enhance control. The study assessed uptake of intermittent preventive treatment of malaria during pregnancy using sulphadoxine-pyrimethamine (IPTp-SP) and insecticide-treated net (ITN) use, their determinants and effects on pregnancy outcomes.

Methods

A cross-sectional study involving 349 post-partum women was conducted from 25 August 2022 to 9 October 2022 at the Ho Teaching Hospital. A structured questionnaire was used to collect data on participant socio-demographics, ITN use, number of doses of sulphadoxine-pyrimethamine received, knowledge of malaria in pregnancy, haemoglobin levels and birth weight among others. Summary statistics were reported as frequencies, percentages and means. Associations between exposure and outcome variables were assessed using logistic regression methods and odds ratios reported with 95% confidence intervals. Statistical significance was concluded at p < 0.05.

Results

More than 80% (291) of respondents received ⩾3 doses of intermittent preventive treatment using sulphadoxine-pyrimethamine and 64.8% (226) slept under ITNs the night before the survey. Age >25 years, employment, good knowledge of malaria in pregnancy, parity ⩾2 and initiating antenatal care visits in the first trimester facilitated the uptake of these interventions. Receiving ⩾3 doses of sulphadoxine-pyrimethamine was associated with having normal-weight babies (adjusted odds ratio 2.80, 95% CI: 1.07, 7.34; p = 0.036) while ITN use was associated with having term babies (adjusted odds ratio 2.72, 95% CI: 1.24, 5.90; p = 0.013) and normal maternal haemoglobin concentration at term (adjusted odds ratio 1.57, 95% CI: 1.01, 2.47; p = 0.044).

Conclusions

The interventions were beneficial against low birthweight and preterm births which predispose to neonatal deaths and poor cognitive function in children. Malaria in pregnancy health campaigns should be intensified, especially among younger-aged primigravidae, to increase their knowledge of the condition as a way to further improve uptake of these preventive interventions.