Abstract:
Southern Sudan lies in areas of high malaria transmission where pregnant women
are at a greater risk of malaria infection, especially from the most severe form
caused by Plasmodium falciparum, which can cause maternal or foetal
complications. The disease is a leading cause of maternal mortality. According to
WHO recommendations, the Ministry of Health (MOH) of the Government of
Southern Sudan has adopted the treatment of clinical malaria, use of insecticide
treated nets (ITN’s) and intermittent presumptive therapy (IPT) to reduce the
burden of malaria in pregnancy. To date there is no dearth on ITN and IPT use in
pregnancy in Southern Sudan. This study sought to determine the adherence of
pregnant women using ITNs and IPT and factors that affect their use in Juba
Teaching Hospital. A facility-based cross-sectional study was conducted in Juba
Teaching Hospital in 2009. The study participants were recruited from women in
their second or third trimesters who came for ANC services and those women in
the post delivery period. Using a semi-structured questionnaire, 334 study
participants were enrolled by systematic random sampling technique. The data was
analyzed using Epi info version 3.5.1(2008). The overall IPT usage among the
participants was 61%, and ITN usage was 87%. Participants who made three or
more ANC visits were four times more likely to use IPT than those who made
fewer visits (p=<0.05), while those who used indoor residual spraying were two
times more likely to use IPT (p=0.01). The study participants who bought ITNs
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were five hundred and four times more likely to use ITNs (p=<0.05), while those
who use indoor residual spraying were sixteen times more likely to use ITN
(p=<0.03). A household income of $90 or below hindered the use of IPT and ITN
in pregnancy. Giving of free or subsidized ITNs, encouraging frequent ANC visits
and use of indoor residual spraying can improve the coverage of IPT and ITN use
in pregnancy. Finally, a community-based study needs to be done to provide
further information on the use of IPT and ITN in pregnancy.
