Awareness and Level of Usage of Intermittent Preventive Treatment for Malaria among Pregnant Women Attending Antenatal Clinics in Rural Communities in Abia State, Nigeria

Abstract

Background: Malaria in pregnancy (MiP) is a major public health concern in sub-Saharan Africa, contributing to maternal and neonatal morbidity and mortality. Intermittent Preventive Treatment in pregnancy using Sulphadoxine-Pyrimethamine (IPTp-SP) is a key strategy endorsed by the WHO to prevent MiP. However, uptake remains suboptimal, particularly in rural settings. Objective: The present study aimed to assess the awareness and level of usage of IPTp-SP among pregnant women attending antenatal clinics in selected rural communities in Abia State, Nigeria. Methods: A descriptive cross-sectional study was conducted among 422 pregnant women using a multistage sampling technique in Ugwunagbo, Isiala Ngwa South, and Ukwa East LGAs. Data were collected using a pre-tested, interviewer-administered semi-structured questionnaire adapted from validated instruments. Descriptive statistics, Chi-square tests, and Pearson correlation analysis were conducted using SPSS version 25. A p-value <0.01 was considered statistically significant. Results: Out of 422 respondents, 80.8% were aware of IPTp, and 73.0% had received at least one dose of SP during pregnancy. However, only 26.3% received the recommended three doses or more. Awareness of IPTp was significantly associated with educational level (χ² = 18.94, p = 0.0003), and IPTp usage was significantly associated with frequency of antenatal visits (χ² = 25.72, p<0.001). Pearson correlation analysis showed strong positive associations between IPTp use and ANC visits (r = 0.62), and negative associations with distance to the health facility (r = -0.47). Major barriers to IPTp uptake included a lack of awareness, unavailability of SP, and fear of side effects. Respondents recommended increased awareness campaigns (73.0%), drug availability (64.7%), and improved healthcare worker attitudes (48.3%). Conclusion: While awareness and usage of IPTp-SP among pregnant women in rural Abia State are relatively high, gaps remain in achieving the full dosage regimen. Targeted interventions to improve education, ensure SP availability, and enhance antenatal service delivery are essential for optimal uptake and malaria prevention in pregnancy.