healthmedicinet

Study area

The study was carried out in the Buea Health District (BHD) that comprises of both
rural and urban communities. It has seven health areas with a total of 21 recognised
health facilities of which Six were purposively selected: Mount Mary Hospital, Buea
Road HC, Regional Hospital Buea, Solidarity Health Foundation, Molyko HC, Mile 16
IHC, to have a spatial distribution of the health facilities.

Study design and population

The study was a cross sectional hospital-based survey that contacted 410 pregnant
women. However, 292 pregnant women met the inclusion criteria. That is being in their
second or third trimester of pregnancy. There was no case of refusal. The survey was
carried out from April to July 2014. The Cochran formula (Z ² x p (1-p)/d2 Where z?=?1.96 for 95 % CI; p?=?ITN and IPT usage rate of 25 % and 90 %
respectively; d?=?precision) was used to estimate the minimum sample size assuming that, the proportion of pregnant
women using ITN and IPT was 25 % and 90 % based on 10] and 11] respectively, with a 95 % confidence interval and a 5 % precision.

Data collection

A closed ended structured questionnaire was designed and administered in English.
However, for all illiterate women, questions were translated and the participants
were interviewed in “Pidgin” (Creole). The questionnaire sought to obtain demographic
data and data on IPTp-SP and ITN use. Before the study started the questionnaire was
pre-tested out of the study site and upon analysis,,the results were promising and
questions in which participants had difficulties understanding were rephrased before
the final study. Hospital records of participants were used to confirm IPTp-SP use
and the dosage. The Roll Back Malaria(RBM) partnership indicator for ITN use which
is based on the proportion of pregnant women who slept under an ITN the previous night
12] was equally used to determine ITN use. The term ITN in this study was referred to
nets that had been treated with insecticide and needed ongoing treatment. Or long
lasting insecticide nets which are currently the most frequently distributed types
of net in Africa 12]. The term free distribution net in this study refers to the door to door distribution
as well as free nets received from the hospital. A sample size of 288 or 139 had been
estimated to provide the desired outcome at 5 % precision, 95 % confidence level and
an estimated usage rate for ITN of 25 % 10] and 90 % 11] for IPT.

Ethical considerations

The study was approved by the Institutional Review Board of the Faculty of Health
Sciences of the University of Buea. And an administrative authorisation was obtained
from the Regional Delegation of Public Health, South West region and the District
Medical Officer of Buea. Consent was sought from the different health facilities selected
for the study. Informed consent was obtained from the women prior to their interview
at the clinic.

Data analysis

A template of the questionnaire was prepared using Epi Info version 3.4.3 statistical
software and the data entered and subsequently exported to the Statistical Package
for the Social Sciences SPSS version 20 (SPSS, Inc., Chicago, IL, USA) and analyzed.
A descriptive statistical analysis was carried out on the use of ITN and IPT. Differences
in proportions were analyzed using Chi square (?²
) tests. Multivariate analysis was done for all significant values obtained from bivariate
analysis to get the best-fit model using unconditional multiple logistic regression.
A P-value??0.05 was considered a statistically significant association.