School of Public Health (ETDs)

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Browsing School of Public Health (ETDs) by Author "Chisiba, Charlotte"

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    The association between intermittent preventive treatment uptake and anaemia amongst pregnant women in Zambia in 2018: a spatial analysis
    (University of the Witwatersrand, Johannesburg, 2024) Chisiba, Charlotte; Musenge, Eustasius; Mapuroma, Relebogile
    Background: This study investigated the association between Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) uptake and anaemia among Zambian pregnant women aged 15-49 in 2018. Despite WHO's endorsement of IPTp-SP to combat malaria-related anaemia, its prevalence continued to rise, significantly impacting maternal health. Methodology: Using Zambia Demographic Health Survey 2018 data, 665 pregnant women receiving IPTp-SP were analysed for haemoglobin levels, determining anaemia through blood tests. Statistical methods included survey-adjusted proportions, means, bivariate analysis, multiple linear regression, and multi-level ordinal logistic models with spatial random effects. Spatial analyses used ArcMap for coverage analysis, ordinary least squares, and geographically weighted regression maps (GWR) techniques in R and Stata. Results: Optimal IPTp-SP doses resulted in 36.98% anaemia prevalence (124/369), and suboptimal doses led to 42.85% (112/296). Factors associated with anaemia included household size, rich wealth index, high parity, and employment during pregnancy. Associations between IPTp-SP uptake and anaemia were identified: household size (four to six: AOR= 0.53; 95% CI 0.34 to 0.80; seven or more: AOR=0.57; 95% CI 0.35 to 0.91), adequate antenatal visits (AOR=0.68; 95% CI 0.48 to 0.97), and rich wealth index (AOR= 0.68; 95% CI 0.34 to 0.98). Spatial analysis revealed anaemia hotspots in Southern, Luapula, and Eastern provinces, with iron supplements and household size identified as influential factors. Conclusion: Despite IPTp-SP use, overall anaemia prevalence was 40%, with the highest rates in Southern, Luapula, and Western provinces. Targeted strategies focusing on improving iron tablet access, antenatal care attendance, and utilising spatial maps are crucial for mitigating adverse anaemia outcomes in these region