Are rural pregnant women disadvantaged in accessing intermittent preventive treatment in pregnancy in Ebonyi State, Nigeria?

INTRODUCTION: Adequate intermittent preventive treatment (IPTp) uptake (≥3 doses) routinely delivered at antenatal clinics is effective in preventing malaria during pregnancy. Whereas, low IPTp uptake (24.0%) had been reported among pregnant women in Ebonyi State, there is paucity of studies comparing the uptake and its predictors in the urban and rural areas of Ebonyi State. We determined IPTp uptake and its predictors in the urban and rural areas of Ebonyi State. METHODS: We conducted a cross-sectional comparative study among 864 reproductive age women selected using multistage sampling. Using a structured interviewer-administered questionnaire, we collected data on respondent's socio-demographic characteristics and IPTp uptake. Uptake was adjudged adequate if ≥3 doses were taken, otherwise inadequate. We estimated the proportion of women with adequate IPTp uptake and determined the factors associated with adequate uptake in rural and urban areas using chi square and multiple logistic regression at 5% level of significance. RESULTS: The mean ages of respondents in the urban and rural areas were 28.5±4.6 and 27.4±5.0 years respectively. Adequate IPTp uptake was 82.5% and 60.8% in the urban and rural respectively (p<0.001). In the urban area, women whose husbands had attained ≥ secondary education (aOR:2.9; 95%CI:1.2-7.4; p = 0.02) and those who paid for sulfadoxine/pyrimethamime (aOR:0.2; 95%CI: 0.1-0.6; p = 0.01) were 2.9 times more likely and 5 times less likely to take adequate IPTp respectively compared to respondents whose husbands had attained ≤ primary education and those who had sulfadoxine/pyrimethamine free. In the rural area, women who had attended ANC <4 times (aOR:0.4; 95%CI: 0.3-0.7; p<0.001) were 2.5 times less likely to take adequate IPTp compared to women that had attended ANC ≥4 times. CONCLUSION: Uptake of IPTp was more in the urban than rural areas of Ebonyi State. Interventions that reinforce the importance of health professionals carrying out actions aimed at pregnant women and their partners (spousal) in order to guide them on preventive actions against malaria and other diseases are recommended in Ebonyi State.

Knowledge and preventive practice to COVID-19 among household heads in Enugu metropolis, South-East Nigeria.

INTRODUCTION: the coronavirus disease COVID-19 pandemic has affected the way we live. The use of non-pharmaceutical interventions (NPI) has been reported to be effective in controlling similar respiratory diseases outbreak in the past and is being used as one of the mainstays of control of the pandemic. We therefore assessed the knowledge and practice of preventive measures against COVID-19 among adults in Enugu metropolis during the outbreak in the State. METHODS: we conducted a descriptive cross-sectional study among 320 adults who were recruited through a multistage sampling technique. We used semi-structured interviewer-administered questionnaire to collect information on the knowledge and preventive practices against COVID-19. The data were analyzed using the IBM-SPSS version 25. RESULTS: the mean age of the participants was 41.6±12.5 years. There were 168 (52.5%) male, 69.7% had attained tertiary education and 57.8% were self-employed. Overall, 256 (80.0%) of the respondents had good knowledge about COVID-19. Only 133 (41.6%) had good practice of preventive measures among respondents. The more commonly practiced NPIs among the respondents were use of alcohol hand sanitizer (86.6%), physical distancing (85.6%), washing of hands with soap and water (81.6%) and disinfecting frequently touched surfaces (80.9%). The NPIs the respondents practiced poorly were use of face mask (33.8%) and avoidance of crowded areas (47.2%). Having good knowledge (aOR: 3.2; 95% CI: 1.65 - 6.05) and attaining secondary education or less (aOR: 2; 95%CI: 10-3.13) were the only predictors of good practice of preventive measures. CONCLUSION: the highly educated segment of the population needs to be targeted with appropriate messages to improve their adoption of the right preventive measures against COVID-19.