Intermittent Preventive Treatment among Pregnant Women Attending a Tertiary Healthcare Facility in Jos, North Central Nigeria: Adherence Patterns and Preliminary Assessment of Associated Factors

Abstract

Adherence to intermittent preventive treatment with Sulphadoxine-Pyrimethamine (IPTp-SP) for malaria prevention in pregnancy remains a challenge in Nigeria. This retrospective cross-sectional study investigated IPTp-SP adherence patterns among pregnant women attending antenatal clinics at a tertiary healthcare facility in Jos, North Central Nigeria, from January 2022 to December 2024. A preliminary assessment of sociodemographic factors associated with IPTp-SP adherence was also conducted using univariate analysis, with statistical significance set at p<0.05. Most participants were aged 21-30 years (50.0%), resided in urban and peri-urban areas (80.0%), and were multigravida (40.0%). Overall, 60.1% initiated IPTp-SP in the second trimester, while 60.0% received at least two doses. Adherence was assessed based on the time of IPTp-SP initiation, the number of doses received, and intake intervals. Across these three criteria, IPTp-SP adherence was consistently and significantly associated with occupation (χ²=34.89, p<0.001; χ²=14.38, p<0.01; χ²=28.51, p<0.001) and residence (χ²=19.93, p<0.001; χ²=25.79, p<0.001; χ²=10.81, p<0.01). Additionally, the time of IPTp-SP initiation was significantly associated with the timing of antenatal registration (χ²=9.18, p<0.01). In a subset of participants, 73.9% of second-trimester initiators and 30.4% of third-trimester initiators tested negative for malaria parasitemia, suggesting that earlier initiation of IPTp-SP enhances the reduction of maternal malaria burden. Targeted interventions addressing access barriers and promoting early antenatal enrollment and adherence to IPTp-SP guidelines are critical for improving malaria prevention and maternal health outcomes in North Central Nigeria.