Impact of mass media campaigns on knowledge of malaria prevention measures among pregnant mothers in Uganda: a propensity score-matched analysis.
Insecticide-treated nets
Malaria
Pregnancy
Pregnant women
Propensity score matching
Uganda
Journal
Malaria journal
ISSN: 1475-2875
Titre abrégé: Malar J
Pays: England
ID NLM: 101139802
Informations de publication
Date de publication:
24 Aug 2024
24 Aug 2024
Historique:
received:
26
03
2024
accepted:
17
08
2024
medline:
26
8
2024
pubmed:
26
8
2024
entrez:
24
8
2024
Statut:
epublish
Résumé
Uganda grapples with a considerable malaria burden, reporting prevalence rates of over 33% in some regions. To address this, the Uganda Ministry of Health employs audiovisual platforms for disseminating malaria prevention messages. However, the impact of these messages on pregnant women's knowledge of malaria prevention remains insufficiently explored. This paper therefore emphasizes the influence of audiovisual messages on the knowledge of malaria prevention measures among pregnant women in Uganda. Secondary data obtained from the Uganda Malaria Indicator Survey (MIS) 2018-2019 was used for this analysis. Women aged 15-49 were included in the study. A total of 8868 women were selected using a two-stage sample design. The two stages of selection included clusters and households. Women who were currently pregnant were included in the study, resulting in a weighted sample of 721 women. Propensity score-matched analysis was used to evaluate the impact of access to malaria messages on knowledge of prevention measures. The study revealed that 39% [95% CI 34.0-44.2] of pregnant women were exposed to malaria messages before the survey. Those exposed had a 17.2% higher knowledge [ATT = 0.172; 95% CI 0.035-0.310] of using mosquito nets for prevention compared to those unexposed. Among women exposed, radios accounted for most form of access to mass media campaigns [64.8, 95% CI 57.0-71.8] followed by interpersonal communication [45.0, 95% CI 37.6-52.6], community health workers [38.8, 95% CI 29.6-48.8], community events [21.4, 95% CI 15.8-28.3], and social mobilization [18.3, 95% CI 12.7-25.8]. Results highlight the importance of radios in spreading important malaria prevention messages to pregnant women. Being exposed to these messages is linked to increased awareness and knowledge about the proper use of insecticide-treated bed nets (ITNs) for preventing malaria. This finding underscores the importance of evaluating different channels for mass media campaigns to ensure the effective delivery of information about malaria prevention to the intended audiences.
Sections du résumé
BACKGROUND
BACKGROUND
Uganda grapples with a considerable malaria burden, reporting prevalence rates of over 33% in some regions. To address this, the Uganda Ministry of Health employs audiovisual platforms for disseminating malaria prevention messages. However, the impact of these messages on pregnant women's knowledge of malaria prevention remains insufficiently explored. This paper therefore emphasizes the influence of audiovisual messages on the knowledge of malaria prevention measures among pregnant women in Uganda.
METHODS
METHODS
Secondary data obtained from the Uganda Malaria Indicator Survey (MIS) 2018-2019 was used for this analysis. Women aged 15-49 were included in the study. A total of 8868 women were selected using a two-stage sample design. The two stages of selection included clusters and households. Women who were currently pregnant were included in the study, resulting in a weighted sample of 721 women. Propensity score-matched analysis was used to evaluate the impact of access to malaria messages on knowledge of prevention measures.
RESULTS
RESULTS
The study revealed that 39% [95% CI 34.0-44.2] of pregnant women were exposed to malaria messages before the survey. Those exposed had a 17.2% higher knowledge [ATT = 0.172; 95% CI 0.035-0.310] of using mosquito nets for prevention compared to those unexposed. Among women exposed, radios accounted for most form of access to mass media campaigns [64.8, 95% CI 57.0-71.8] followed by interpersonal communication [45.0, 95% CI 37.6-52.6], community health workers [38.8, 95% CI 29.6-48.8], community events [21.4, 95% CI 15.8-28.3], and social mobilization [18.3, 95% CI 12.7-25.8].
CONCLUSION
CONCLUSIONS
Results highlight the importance of radios in spreading important malaria prevention messages to pregnant women. Being exposed to these messages is linked to increased awareness and knowledge about the proper use of insecticide-treated bed nets (ITNs) for preventing malaria. This finding underscores the importance of evaluating different channels for mass media campaigns to ensure the effective delivery of information about malaria prevention to the intended audiences.
Identifiants
pubmed: 39182108
doi: 10.1186/s12936-024-05083-x
pii: 10.1186/s12936-024-05083-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
256Informations de copyright
© 2024. The Author(s).
Références
Dosoo DK, Chandramohan D, Atibilla D, Oppong FB, Ankrah L, Kayan K, et al. Epidemiology of malaria among pregnant women during their first antenatal clinic visit in the middle belt of Ghana: a cross sectional study. Malar J. 2020;19:381.
pubmed: 33097044
pmcid: 7585211
doi: 10.1186/s12936-020-03457-5
Mbonye AK, Buregyeya E, Rutebemberwa E, Clarke SE, Lal S, Hansen KS, et al. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda: implications for patient safety. Malar J. 2016;15:212.
pubmed: 27075477
pmcid: 4831190
doi: 10.1186/s12936-016-1245-2
Oladeinde BH, Omoregie R, Odia I, Oladeinde OB. Prevalence of malaria and anemia among pregnant women attending a traditional birth home in Benin City, Nigeria. Oman Med J. 2012;27:232–6.
pubmed: 22811774
pmcid: 3394357
doi: 10.5001/omj.2012.52
WHO. World malaria report 2019. Geneva: World Health Organization; 2019.
WHO. World malaria report 2020. Geneva: World Health Organization; 2020.
Colón-González FJ, Tompkins AM, Biondi R, Bizimana JP, Namanya DB, Salam A, et al. Assessing the effects of air temperature and rainfall on malaria incidence: an epidemiological study across Rwanda and Uganda. Geospat Health. 2016;11(Suppl 1):379.
pubmed: 27063731
Mangusho C, Mwebesa E, Izudi J, Aleni M, Dricile R, Ayiasi RM, et al. High prevalence of malaria in pregnancy among women attending antenatal care at a large referral hospital in northwestern Uganda: a cross-sectional study. PLoS ONE. 2023;18:e0283755.
pubmed: 37018283
pmcid: 10075480
doi: 10.1371/journal.pone.0283755
Namusoke F, Rasti N, Kironde F, Wahlgren M, Mirembe F. Malaria burden in pregnancy at Mulago National Referral Hospital in Kampala, Uganda. Malar Res Treat. 2010;2010:913857.
pubmed: 22347669
pmcid: 3277833
Kalyetsi R, Nafungo G, Muwanguzi E. Malaria infections among pregnant women attending antenatal clinic at Bududa hospital, eastern Uganda. J Protozool Res. 2019;29:44–50.
Okoyo C, Githinji E, Muia RW, Masaku J, Mwai J, Nyandieka L, et al. Assessment of malaria infection among pregnant women and children below five years of age attending rural health facilities of Kenya: a cross-sectional survey in two counties of Kenya. PLoS ONE. 2021;16:e0257276.
pubmed: 34529696
pmcid: 8445417
doi: 10.1371/journal.pone.0257276
Hill J, Hoyt J, van Eijk AM, Mello-Guyett LD, ter Kuile FO, Steketee R, et al. Factors affecting the delivery, access, and use of interventions to prevent malaria in pregnancy in sub-Saharan Africa: a systematic review and meta-analysis. PLoS Med. 2013;10:e1001488.
pubmed: 23935459
pmcid: 3720261
doi: 10.1371/journal.pmed.1001488
Djabanor J, Quansah E, Asante D. Effects of malaria in pregnancy (MiP) on pregnancy development and its outcome: a critical review. J Appl Biol Biotechnol. 2017;5:8–16.
Gontie GB, Wolde HF, Baraki AG. Prevalence and associated factors of malaria among pregnant women in Sherkole district, Benishangul Gumuz regional state, West Ethiopia. BMC Infect Dis. 2020;20:573.
pubmed: 32758164
pmcid: 7405459
doi: 10.1186/s12879-020-05289-9
Accrombessi M, Yovo E, Cottrell G, Agbota G, Gartner A, Martin-prevel Y, et al. Cohort profile: effect of malaria in early pregnancy on fetal growth in Benin (RECIPAL preconceptional cohort). BMJ Open. 2018;8:e019014.
pubmed: 29317419
pmcid: 5781192
doi: 10.1136/bmjopen-2017-019014
WHO. Malaria in pregnancy: guidelines for measuring key monitoring and evaluation indicators. Geneva: World Health Organization; 2007.
Kebede Y, Abebe L, Alemayehu G, Sudhakar M. School-based social and behavior change communication (SBCC) advances community exposure to malaria messages, acceptance, and preventive practices in Ethiopia: a pre- posttest study. PLoS ONE. 2020;15:e0235189.
pubmed: 32584891
pmcid: 7316301
doi: 10.1371/journal.pone.0235189
Uganda National Malaria Control Division (NMCD), Uganda Bureau of Statistics (UBOS). Uganda Malaria Indicator Survey 2018–19. Kampala, Uganda, 2020. https://www.dhsprogram.com/pubs/pdf/MIS34/MIS34.pdf
Yaya S, Uthman OA, Amouzou A, Bishwajit G. Mass media exposure and its impact on malaria prevention behaviour among adult women in sub-Saharan Africa: results from malaria indicator surveys. Glob Health Res Policy. 2018;3:20.
pubmed: 29998191
pmcid: 6030754
doi: 10.1186/s41256-018-0075-x
Okethwangu D, Opigo J, Atugonza S, Kizza CT, Nabatanzi M, Biribawa C, et al. Factors associated with uptake of optimal doses of intermittent preventive treatment for malaria among pregnant women in Uganda: analysis of data from the Uganda Demographic and Health Survey, 2016. Malar J. 2019;18:250.
pubmed: 31349829
pmcid: 6660695
doi: 10.1186/s12936-019-2883-y
Kawuki J, Donkor E, Gatasi G, Nuwabaine L. Mosquito bed net use and associated factors among pregnant women in Rwanda: a nationwide survey. Res Square. 2022;60:130.
Amankwah S, Anto F. Factors associated with uptake of intermittent preventive treatment of malaria in pregnancy: a cross-sectional study in private health facilities in Tema Metropolis, Ghana. J Trop Med. 2019;2019:9278432.
pubmed: 31467566
pmcid: 6699305
doi: 10.1155/2019/9278432
Nadew J, Obsa MS, Alemayehu A, Haji Y. Utilization of insecticide treated nets among pregnant women in sodo zuria woreda Southern Ethiopia. Front Trop Dis. 2022;3:926893.
doi: 10.3389/fitd.2022.926893
Yitayew AE, Enyew HD, Goshu YA. Utilization and associated factors of insecticide treated bed net among pregnant women attending antenatal clinic of Addis Zemen Hospital, North-Western Ethiopia: an institutional based study. Malar Res Treat. 2018;2018:3647184.
pubmed: 30675334
pmcid: 6323465
Hlongwana KW, Mavundza EJ, Mohapi EP, Kruger P, Urbach J, Mukaratirwa S, et al. Vector-control personnel’s knowledge, perceptions and practices towards insecticides used for indoor residual spraying in Limpopo Province, South Africa. Parasit Vectors. 2013;6:118.
pubmed: 23618516
pmcid: 3639850
doi: 10.1186/1756-3305-6-118
Mazigo HD, Obasy E, Mauka W, Manyiri P, Zinga M, Kweka EJ, et al. Knowledge, attitudes, and practices about malaria and its control in rural Northwest Tanzania. Malar Res Treat. 2010;2010:794261.
pubmed: 22332023
pmcid: 3275933
Kofuor E, Darteh M, Dickson KS, Ahinkorah BO, Owusu BA, Okyere J, et al. Factors influencing the uptake of intermittent preventive treatment among pregnant women in sub-Saharan Africa: a multilevel analysis. Arch Public Health. 2021;79:182.
doi: 10.1186/s13690-021-00707-z
Ediau M, Babirye JN, Tumwesigye NM, Matovu JKB, Machingaidze S, Okui O, et al. Community knowledge and perceptions about indoor residual spraying for malaria prevention in Soroti district, Uganda: a cross-sectional study. Malar J. 2013;12:170.
pubmed: 23705591
pmcid: 3679793
doi: 10.1186/1475-2875-12-170
WHO. Bridging the funding gap to defeat malaria in Africa. Geneva: World Health Organization; 2023.
WHO. Malaria. Geneva: World Health Organization; 2023.
Ameyaw EK. Uptake of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) in Uganda: a national survey. Malar J. 2022;21:285.
pubmed: 36207727
pmcid: 9547429
doi: 10.1186/s12936-022-04299-z
Wafula ST, Mendoza H, Nalugya A, Musoke D, Waiswa P. Determinants of uptake of malaria preventive interventions among pregnant women in eastern Uganda. Malar J. 2021;20:5.
pubmed: 33390153
pmcid: 7780677
doi: 10.1186/s12936-020-03558-1
Martin MK, Venantius KB, Patricia N, Bernard K, Keith B, Allen K, et al. Correlates of uptake of optimal doses of sulfadoxine-pyrimethamine for prevention of malaria during pregnancy in East-Central Uganda. Malar J. 2020;19:153.
pubmed: 32295601
pmcid: 7161174
doi: 10.1186/s12936-020-03230-8
National Malaria Control Division (NMCD) & Uganda Bureau of Statistics (UBOS). 2018–19 Uganda Malaria Indicator Survey ( UMIS ) - Atlas of Key Indicators. 2018. https://dhsprogram.com/pubs/pdf/ATR21/ATR21.pdf
Ridgeway G, Kovalchik SA, Griffin BA, Kabeto MU. Propensity score analysis with survey weighted data. J Causal Inference. 2015;3:237–49.
pubmed: 29430383
pmcid: 5802372
doi: 10.1515/jci-2014-0039
Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983;70:41–55.
doi: 10.1093/biomet/70.1.41
Xi SG, Carolina N, Hill C, Chen Q. Propensity score analysis: recent debate and discussion. J Soc Social Work Res. 2020;11:463–82.
doi: 10.1086/711393
Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivar Behav Res. 2011;46:399–424.
doi: 10.1080/00273171.2011.568786
Guo S, Fraser MW. Propensity score analysis: statistical methods and applications. Washington DC: Sage; 2015.
Ali MS, Prieto-alhambra D, Lopes LC, Ramos D, Bispo N, Ichihara MY, et al. Propensity score methods in health technology assessment: principles, extended applications, and recent advances. Front Pharmacol. 2019;10:973.
pubmed: 31619986
pmcid: 6760465
doi: 10.3389/fphar.2019.00973
Morgan CJ. Reducing bias using propensity score matching. J Nucl Cardiol. 2017;25:404–6.
pubmed: 28776312
doi: 10.1007/s12350-017-1012-y
Littnerova S, Jarkovsky J, Parenica J, Pavlik T. Why to use propensity score in observational studies? Case study based on data from the Czech clinical database AHEAD 2006–2009. Cor Vasa. 2013;55:e383–90. https://doi.org/10.1016/j.crvasa.2013.04.001 .
doi: 10.1016/j.crvasa.2013.04.001
Qin R, Titler MG, Shever LL, Kim T. Estimating effects of nursing intervention via propensity score analysis. Nurs Res. 2008;57:444–52.
pubmed: 19018219
pmcid: 2778306
doi: 10.1097/NNR.0b013e31818c66f6
Okoli GN, Sanders RD, Myles P. Demystifying propensity scores. Br J Anaesth. 2014;112:13–5.
pubmed: 24318697
pmcid: 3854550
doi: 10.1093/bja/aet290
Haukoos JS, Lewis RJ. The propensity score. J Am Med Assoc. 2016;314:1637–8.
doi: 10.1001/jama.2015.13480
Yaya S, Gunawardena N, Bishwajit G. Association between intimate partner violence and utilization of facility delivery services in Nigeria: a propensity score matching analysis. BMC Public Health. 2019;19:1131.
pubmed: 31420028
pmcid: 6697943
doi: 10.1186/s12889-019-7470-1
Chen L, Liu F, Wang B, Wang K. Subxiphoid vs transthoracic approach thoracoscopic surgery for spontaneous pneumothorax: a propensity score-matched analysis. BMC Surg. 2019;19:46.
pubmed: 31035996
pmcid: 6489176
doi: 10.1186/s12893-019-0503-y
Baser O. Too much ado about propensity score models? Comparing methods of propensity score matching. Value Health. 2006;9:377–85.
pubmed: 17076868
doi: 10.1111/j.1524-4733.2006.00130.x
Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometriks. 2018;70:41–55.
doi: 10.1093/biomet/70.1.41
Mwebesa E, Kagaayi J, Ssebagereka A, Nakafeero M, Ssenkusu JM, Guwatudde D, et al. Effect of four or more antenatal care visits on facility delivery and early postnatal care services utilization in Uganda : a propensity score matched analysis. BMC Pregnancy Childbirth. 2022;22:7.
pubmed: 34979981
pmcid: 8722208
doi: 10.1186/s12884-021-04354-8
Garrido MM, Kelley AS, Paris J, Roza K, Meier DE, Morrison RS, et al. Methods for constructing and assessing propensity scores. Health Serv Res. 2014. https://doi.org/10.1111/1475-6773.12182 .
doi: 10.1111/1475-6773.12182
pubmed: 24779867
pmcid: 4213057
Austin PC, Small DS. The use of bootstrapping when using propensity-score matching without replacement: a simulation study. Stat Med. 2014;33:4306–19.
pubmed: 25087884
pmcid: 4260115
doi: 10.1002/sim.6276
US-PMI. Uganda Progresses in Malaria Fight. 2012. https://www.pmi.gov/uganda-progresses-in-malaria-fight/
Epstein A, Maiteki-Sebuguzi C, Namuganga JF, Nankabirwa JI, Gonahasa S, Opigo J, et al. Resurgence of malaria in Uganda despite sustained indoor residual spraying and repeated long lasting insecticidal net distributions. PLoS Glob Public Health. 2022;2:e0000676.
pubmed: 36962736
pmcid: 10022262
doi: 10.1371/journal.pgph.0000676
Adjah ESO, Panayiotou AG. Impact of malaria related messages on insecticide-treated net (ITN) use for malaria prevention in Ghana. Malar J. 2014;13:123.
doi: 10.1186/1475-2875-13-123
Flatie BT. Knowledge, attitude, and practice towards malaria among people attending Mekaneeyesus Primary Hospital, South Gondar, Northwestern Ethiopia: a cross-sectional study. J Parasitol Res. 2021;2021:5580715.
pubmed: 34976405
pmcid: 8718288
doi: 10.1155/2021/5580715
Apo SB, Kwankye SO, Badasu DM. Exposure to malaria prevention messages and insecticide treated bednet usage among children under five years in Ghana. Eur Sci J. 2015;11:290–305.
Pinto LDS, Arroz JAH, Martins RO, Hartz Z, Negrao N, Muchanga V, et al. Malaria prevention knowledge, attitudes, and practices in Zambezia Province, Mozambique. Malar J. 2021;20:293.
doi: 10.1186/s12936-021-03825-9
Zalisk K, Herrera S, Inyang U, Mohammed AB, Uhomoibhi P. Caregiver exposure to malaria social and behaviour change messages can improve bed net use among children in an endemic country: secondary analysis of the 2015 Nigeria Malaria Indicator Survey. Malar J. 2019;18:121.
pubmed: 30954073
pmcid: 6451249
doi: 10.1186/s12936-019-2750-x
Nkoka O, Chuang T-W, Chen Y-H. Influence of maternal exposure to malaria social and behavioral change messages and effectiveness of communication media on bed net use and malaria infection in Malawi. Health Educ Behav. 2021;48:179–89.
pubmed: 33095066
doi: 10.1177/1090198120964201
Sonibare OO, Bello IS, Olowookere SA, Shabi O, Makinde NO. Effect of malaria preventive education on the use of long-lasting insecticidal nets among pregnant females in a Teaching Hospital in Osun State, south-west Nigeria. Parasite Epidemiol Control. 2020;11:e00182.
pubmed: 33005773
pmcid: 7519353
doi: 10.1016/j.parepi.2020.e00182
Flueckiger RM, Thierno DM, Colaço R, Bangoura L, Reithinger R, Fitch ER, et al. Using short message service alerts to increase antenatal care and malaria prevention : findings from implementation research pilot in Guinea. Am J Trop Med Hyg. 2019;101:806–8.
pubmed: 31392951
pmcid: 6779205
doi: 10.4269/ajtmh.19-0202
Bowen HL. Impact of a mass media campaign on bed net use in Cameroon. Malar J. 2013;13:36.
doi: 10.1186/1475-2875-12-36
Boulay M, Lynch M, Koenker H. Comparing two approaches for estimating the causal effect of behaviour-change communication messages promoting insecticide-treated bed nets: an analysis of the 2010 Zambia malaria indicator survey. Malar J. 2014;13:342.
pubmed: 25174278
pmcid: 4161873
doi: 10.1186/1475-2875-13-342
WHO. Community deployment of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine: a field guide. Geneva: World Health Organization; 2024.
WHO. Policy brief for the implementation of intermittent preventive treatment of malaria in pregnancy. WHO Golbal Malaria Programme. 2014. http://whqlibdoc.who.int/hq/2001/WHO_RHR_01.30.pdf
Bosdriesz JR, Stel VS, van Diepen M, Meuleman Y, Dekker FW, Zoccali C, et al. Evidence-based medicine—when observational studies are better than randomized controlled trials. Nephrology. 2020;25:737–43.
pubmed: 32542836
doi: 10.1111/nep.13742
Gilmartin-Thomas JFM, Liew D, Hopper I. Observational studies and their utility for practice. Aust Prescr. 2018;41:82–5.
pubmed: 29922003
pmcid: 6003013
doi: 10.18773/austprescr.2018.017
Moneer O, Daly G, Skydel JJ, Nyhan K, Lurie P, Ross JS, et al. Agreement of treatment effects from observational studies and randomized controlled trials evaluating hydroxychloroquine, lopinavir-ritonavir, or dexamethasone for covid-19: meta-epidemiological study. BMJ. 2022;377:e069400.
pubmed: 35537738
doi: 10.1136/bmj-2021-069400