Knowledge, attitude and practices on usage of low dose aspirin amongst women with pre-eclampsia seeking care at Kawempe National Referral Hospital

Abstract

Introduction: Preeclampsia is the second commonest cause of maternal morbidity and mortality and it complicates 2-18% of pregnancies globally. Complications of hypertensive disorders in pregnancy ranked as the second highest cause of maternal deaths in Kawempe National Referral hospital in 2021 based on the Maternal and Perinatal Death Surveillance report in 2021. Studies have shown that low dose aspirin reduces the occurrence of pre-eclampsia in women with identifiable risk factors. Unfortunately, recent studies have revealed significant gaps in knowledge and usage of low dose aspirin. Objectives: To assess knowledge, attitude, practices and factors associated with usage of low dose aspirin amongst women with pre-eclampsia seeking care at Kawempe National Referral hospital Methods: It was a quantitative study employing a descriptive and analytical cross-sectional study design. Data was obtained from 254 pregnant women with pre-eclampsia seeking care at Kawempe National Referral Hospital. An interviewer administered questionnaire was used to collect data which was analyzed using STATA 14. The responses to questions assessing knowledge, attitude and practices were summarized using frequencies and percentages. To determine the factors associated with usage of low dose aspirin, bivariate followed by multivariate analysis was done. Results: A small proportion (13%) of the respondents knew low dose aspirin. Overall attitude about low dose aspirin was poor and usage was low (11.42%). Majority of the respondents (66.5%) strongly disagreed that enough information is provided at the health facilities about low dose aspirin. Those who had completed tertiary level of education had usage of low dose aspirin that was 2.9 times higher than that of women who had completed primary level [APR=2.9, 95% CI: 1.9-7.7, P=0.001]. Respondents who had knowledge about low dose aspirin had usage that was 5.1 times higher than those who were not knowledgeable about it [APR=5.1, 95% CI: 2.8-10.3, P=0.001]. xi Those to whom the physician had ever recommended use of low dose aspirin had usage that was 4.3 times higher than those to whom it had never been recommended [APR=4.3, 95% CI: 2.2-7.2, P=0.020]. Conclusion: The knowledge about usage of low dose aspirin is low amongst women with pre-eclampsia seeking care at Kawempe National Referral hospital. Attitude about low dose aspirin was poor and usage was low. Most of these women strongly disagreed that enough information about low dose aspirin is provided by health workers. Negative perceptions and myths against low dose aspirin were elicited amongst the study population. All these factors contributed to the noted low levels of low aspirin usage. Recommendations: The Ministry of Health and its partners should integrate sensitization about pre-eclampsia and low dose aspirin in existent maternal health programmes to enhance pre-eclampsia prevention.