Browsing by Author "Ameyaw, Edward Kwabena"

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    Individual, community and region level predictors of insecticide-treated net use among women in Uganda: a multilevel analysis
    (Malaria journal, 2020) Ameyaw, Edward Kwabena; Olushola, Yusuf Kareem; Yaya, Sanni
    Background Use of insecticide-treated net (ITN) has been identified by the World Health Organization as an effective approach for malaria prevention. The government of Uganda has instituted measures to enhance ITN supply over the past decade, however, the country ranks third towards the global malaria burden. As a result, this study investigated how individual, community and region level factors affect ITN use among women of reproductive age in Uganda. Methods The 2018–2019 Malaria Indicator Survey of Uganda involving 7798 women aged 15–49 was utilized. The descriptive summaries of ITN use were analysed by individual, community and region level factors. Based on the hierarchical nature of the data, four distinct binomial multilevel logistic regression models were fitted using the MLwiN 3.05 module in Stata. The parameters were estimated using the Markov Chain Monte Carlo (MCMC) estimation procedure and Bayesian Deviance Information Criterion was used to identify the model with a better fit. Results The proportion of women who use ITN was 78.2% (n = 6097). Poor household wealth status [aOR = 1.66, Crl = 1.55–1.80], knowing that sleeping under ITN prevents malaria [aOR = 1.11, Crl = 1.05–1.24] and that destroying mosquito breeding sites can prevent malaria [aOR = 1.85, Crl = 1.75–1.98] were associated with higher odds of ITN use. ITN use attributable to regional and community level random effects was 39.1% and 45.2%, respectively. Conclusion The study has illustrated that ITN policies and interventions in Uganda need to be sensitive to community and region level factors that affect usage. Also, strategies to enhance women’s knowledge on malaria prevention is indispensable in improving ITN use.
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    Uptake of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) in Uganda: a national survey
    (BioMed Central Ltd, 2022-10) Ameyaw, Edward Kwabena
    Abstract Background: In spite of the missed opportunities of sulfadoxine-pyrimethamine (IPTp-SP) in Uganda, scanty literature exist on malaria in pregnancy. To date, empirical national study utilizing the 2018-19 Uganda Malaria Indicator Survey to explore predictors of attaining three or more doses of IPTp-SP in the country is non-existent. This study investigated the factors afecting uptake of three or more IPTp-SP doses as recommended by the World Health Organization. Methods: Data from the 2018–2019 Uganda Malaria Indicator Survey (2018-19 UMIS) was analysed. Adequate uptake of intermittent preventive therapy with IPTp-SP was the dependent variable for this study. Weighted frequencies and percentages were used to present the proportion of women who had adequate IPTp-SP uptake or otherwise with respect to the independent variables. A three-level multilevel logistic regression was ftted. The Bayesian Deviance Information Criterion (DIC) was used in determining the goodness of ft of all the models. Results: Less than half of the surveyed women had three or more IPTp-SP doses during their last pregnancies (45.3%). Women aged 15–19 had less odds of receiving at least three IPTp-SP doses compared to those aged 45–49 [aOR=0.42, Crl=0.33–0.98]. Poor women [aOR=0.80, Crl=0.78–0.91] were less likely to have three or more doses of IPTp-SP relative to rich women. Most disadvantaged regions were aligned with less likelihood of three or more IPTpSP uptake [aOR=0.59, CI=0.48–0.78] compared to least disadvantaged regions. The variation in uptake of three or more IPTp-SP doses was substantial at the community level [σ2=1. 86; Crl=11.12–2.18] than regional level [σ2=1.13; Crl=1.06–1.20]. About 18% and 47% disparity in IPTp-SP uptake are linked to region and community level factors respectively. Conclusion: IPTp-SP interventions need to refect broader community and region level factors in order to wane the high malaria prevalence in Uganda. Contextually responsive behavioural change communication interventions are required to invoke women’s passion to achieve the recommended dosage. Keywords: Malaria, Pregnancy, Public health, Maternal health, Uganda