Malaria treatment practices and associated factors among pregnant women at Masafu and Dabani general hospitals, Busia district, eastern Uganda.

Abstract

Introduction: Globally, malaria causes 435,000 deaths. Uganda contributes 4% and 3% of the global malaria cases and deaths respectively. Malaria is still the leading cause of mortality and morbidity in Uganda accounting for over 0.6% of inpatient visits among pregnant women and 11% of the death of all ages in the country annually. Appropriate diagnosis and treatment are essential for reducing malaria related mortality. Despite the adoption of the test, treat and track policy where only malaria laboratory confirmed patients are meant to be treated, cases of presumptive treatments and test negatives being treated are still being reported in previous studies. General objectives: To determine the malaria treatment practices and associated factors among pregnant women at Masafu and Dabani general hospitals, Busia district eastern Uganda. Methods: A cross sectional study was conducted among 782 pregnant women aged 15-49 with fever attending antenatal services that consented to participate at Masafu and Dabani hospitals. Enrolled participants were consecutively sampled and interviewed using structured questionnaires and their medical records reviewed at the exit of antenatal clinic from February to June 2020. Medical records of each pregnant woman with fever were linked to the health workers’ malaria case management characteristics. The main outcome was whether a pregnant woman was appropriately treated for malaria by the health workers when they sought treatment while it’s associated factors were analyzed using a modified Poisson regression model with a 5% significance level Results: The prevalence of appropriate treatment among pregnant women was 81.5% (95%CI: 77.0-85.3%). Primary level of education [PR = 0.78 (95% CI: 0.64-0.95)], training in MCM in past one year [PR =1.10 (95% CI: 0.93- 1.29)], aware that the facility had malaria xiii treatment job aides [PR=1.19 (95% CI: 1.01- 1.39)] and availability of recommended drugs [PR =0.66 (95% CI: 0.47- 0.93)] were associated with appropriate malaria treatment practices. Conclusion and Recommendations: The prevalence of appropriate malaria treatment practices (81.5%) by health workers assessing pregnant women at antenatal clinic at Masafu and Dabani hospitals is lower than 90% target although it was higher than the national average (69%). Interventions like training in MCM, accessibility of malaria treatment job aides and availability of recommended drugs should be explored to improve adherence to these malaria treatment guidelines.