Antenatal visits are positively associated with uptake of tetanus toxoid and intermittent preventive treatment in pregnancy in Ivory Coast.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Antimalarials/*therapeutic use ; Malaria/*prevention & control ; Patient Acceptance of Health Care/*statistics & numerical data ; Pregnancy Complications, Infectious/*prevention & control ; Prenatal Care/*statistics & numerical data ; Tetanus/*prevention & control ; Tetanus Toxoid/*therapeutic use; Adolescent ; Adult ; Cote d'Ivoire ; Drug Combinations ; Female ; Humans ; Infant, Newborn ; Logistic Models ; Multivariate Analysis ; Pregnancy ; Pyrimethamine/therapeutic use ; Sulfadoxine/therapeutic use ; Surveys and Questionnaires ; Young Adult

Background: Malaria and tetanus infections among pregnant women represent two major public health problems in sub-Saharan Africa. Optimum use of Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (IPTp-SP) and immunization against tetanus among pregnant women during antenatal care (ANC) visits are recommended strategies to prevent these issues. Despite these recommendations, many women in Africa remain deprived of these cost-effective and life-saving interventions. In this study, we aimed to examine the prevalence of women using these two services, and the association between women's uptake of IPTp-SP and tetanus toxoid (TT) with antenatal care use in Ivory Coast.
Methods: This study was based on the fifth round of Multiple Indicator Cluster Survey (MICS 5) conducted in Ivory Coast in 2016. Participants were 9583 women aged between 15 and 49 years. Outcomes were TT and Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP). Data analysis was conducted using bivariate and multiple logistic regression.
Results: In this study, the prevalence of taking TT immunization and IPTp-SP drugs was 81.97 and 17.83% respectively. Of the participants who took these drugs at all, the prevalence of taking adequate doses of TT immunization was 78.75% and that of IPTp-SP was 35.46%. In the multivariable analysis model, higher age groups, 25-29 years (OR = 2.028, 95%CI = 1.120-3.669) were found to be positively associated with uptake of adequate doses of IPTp-SP drugs. Women who attended at least four ANC visits had higher odds of taking IPTp-SP drugs (OR = 1.656, 95%CI = 1.194-2.299) and TT immunization (OR = 2.347, 95%CI = 1.384-3.981), and also had higher odds of receiving adequate doses of IPTp-SP drugs (OR = 3.291, 95%CI = 2.157-5.020) and that of TT immunization (OR = 1.968, 95%CI = 1.398-2.771). The odds of taking IPTp-SP drugs were significantly higher among women with primary (OR = 2.504, 95%CI = 1.020-6.146) and secondary/higher education (OR = 3.298, 95%CI = 1.343-8.097) compared to those with no education. Also, women with higher parity had lower odds of taking TT immunization (OR = 0.218, 95%CI = 0.055-0.858) compared to those with lower parity. Findings from this study also revealed that the odds of taking adequate doses of IPTp-SP drugs were significantly lower among participants from Mandé du Nord ethnicity (OR = 0.378,95%CI = 0.145-0.983) compared to those from other ethnicities.
Conclusion: In this study, uptake of IPTp-SP drugs was much lower than TT immunization. High number of ANC visits were found to be significantly associated with taking IPTp-SP drugs and TT immunization and also with that of taking them in adequate doses. Vaccination promotion is necessary to protect pregnant women and reduce adverse health outcomes among the newborn in Ivory Coast.

J Nutr Metab. 2018 Nov 22;2018:2839579. (PMID: 30595915)
BMC Pregnancy Childbirth. 2018 Apr 20;18(1):108. (PMID: 29678150)
Oncotarget. 2016 Sep 27;7(39):62898-62911. (PMID: 27588486)
Am J Public Health. 2003 Dec;93(12):2074-8. (PMID: 14652337)
Mediterr J Hematol Infect Dis. 2012;4(1):e2012013. (PMID: 22550559)
Hum Vaccin Immunother. 2019;15(2):283-286. (PMID: 30252609)
Vaccine. 2018 Jun 14;36(25):3573-3575. (PMID: 28427847)
Public Health. 2001 Sep;115(5):359-64. (PMID: 11593447)
Trop Med Infect Dis. 2018 Feb 11;3(1):null. (PMID: 30274416)
Lancet Infect Dis. 2007 Feb;7(2):93-104. (PMID: 17251080)
J Community Health. 2013 Jun;38(3):492-9. (PMID: 23161213)
Lancet Glob Health. 2017 Jan;5(1):e96-e103. (PMID: 27894851)
Am J Trop Med Hyg. 2011 Jul;85(1):12-21. (PMID: 21734118)
Cochrane Database Syst Rev. 2014 Oct 10;(10):CD000169. (PMID: 25300703)
PLoS One. 2017 Nov 1;12(11):e0187090. (PMID: 29091923)
Malar J. 2018 May 25;17(1):211. (PMID: 29793482)
PLoS Negl Trop Dis. 2018 Aug 30;12(8):e0006667. (PMID: 30161119)
PLoS One. 2010 Nov 29;5(11):e15066. (PMID: 21124732)
Malar J. 2018 Oct 16;17(1):364. (PMID: 30326904)
Lancet. 2015 Jan 31;385(9966):430-40. (PMID: 25280870)
PLoS One. 2015 Sep 01;10(9):e0132562. (PMID: 26325522)
Malar J. 2014 Nov 24;13:455. (PMID: 25421496)
Trop Med Int Health. 2004 Jan;9(1):77-82. (PMID: 14728610)
J Ayub Med Coll Abbottabad. 2010 Jul-Sep;22(3):136-40. (PMID: 22338439)
Am J Trop Med Hyg. 2013 May;88(5):855-61. (PMID: 23458956)
Afr Health Sci. 2015 Dec;15(4):1087-96. (PMID: 26958008)
Lancet. 2007 Dec 8;370(9603):1947-59. (PMID: 17854885)
Lancet. 2015 Jan 24;385(9965):362-70. (PMID: 25149223)
Malar J. 2017 Aug 10;16(1):323. (PMID: 28797296)
BMC Int Health Hum Rights. 2018 Jun 28;18(1):27. (PMID: 29950171)
Int J Womens Health. 2015 Feb 03;7:171-80. (PMID: 25678822)
Parasit Vectors. 2018 Jan 30;11(1):71. (PMID: 29382388)
Parasit Vectors. 2014 Nov 20;7:495. (PMID: 25410760)
Contemp Clin Trials Commun. 2017 Sep;7:57-63. (PMID: 29226266)
Obes Sci Pract. 2017 Mar 27;3(2):185-192. (PMID: 28706731)
Trop Med Infect Dis. 2019 Feb 07;4(1):null. (PMID: 30736456)
Arch Public Health. 2016 Feb 01;74:5. (PMID: 26835009)
BMC Public Health. 2015 Jun 07;15:540. (PMID: 26049737)
Malar J. 2014 Jan 14;13:22. (PMID: 24423279)
BMC Res Notes. 2016 Jun 21;9:318. (PMID: 27328717)
Am J Public Health. 2011 Feb;101(2):285-93. (PMID: 21164098)
PLoS One. 2012;7(8):e42857. (PMID: 22880123)
J Health Popul Nutr. 2013 Jun;31(2):243-51. (PMID: 23930343)
J Trop Med. 2018 Dec 4;2018:5019215. (PMID: 30631370)
Therapie. 2019 Sep;74(4):487-494. (PMID: 30904318)
Malar J. 2007 Nov 08;6:144. (PMID: 17996048)
Lancet. 2016 Oct 8;388(10053):1725-1774. (PMID: 27733285)
Lancet Infect Dis. 2005 Nov;5(11):695-708. (PMID: 16253887)
Lancet Glob Health. 2015 Oct;3(10):e617-28. (PMID: 26296450)
Pan Afr Med J. 2017 Oct 10;28:122. (PMID: 29515740)
Bull World Health Organ. 1984;62(4):647-69. (PMID: 6386211)
Hum Vaccin Immunother. 2013 Aug;9(8):1763-73. (PMID: 23584253)
BMC Pregnancy Childbirth. 2018 Jun 15;18(1):235. (PMID: 29907139)
Am J Trop Med Hyg. 2001 Jan-Feb;64(1-2 Suppl):28-35. (PMID: 11425175)
BMC Pregnancy Childbirth. 2019 Oct 15;19(1):354. (PMID: 31615454)
BMC Pregnancy Childbirth. 2018 Jun 7;18(1):216. (PMID: 29879939)
PLoS One. 2014 Mar 20;9(3):e92102. (PMID: 24651078)
Glob Health Res Policy. 2019 Mar 29;4:9. (PMID: 30976661)
Ecohealth. 2010 Dec;7(4):507-16. (PMID: 20694503)
Vaccine. 2015 Jun 12;33(26):2971-7. (PMID: 25936666)

Keywords: ANC visits; IPTp-SP drugs; Ivory Coast; Pregnant women; TT immunization

0 (Antimalarials)
0 (Drug Combinations)
0 (Tetanus Toxoid)
37338-39-9 (fanasil, pyrimethamine drug combination)
88463U4SM5 (Sulfadoxine)
Z3614QOX8W (Pyrimethamine)

Date Created: 20191108 Date Completed: 20200128 Latest Revision: 20200128

20240105

PMC6836543

10.1186/s12889-019-7847-1

31694607