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Background: Malaria remains a significant public health challenge, particularly for pregnant women and
their unborn children. The World Health Organization (WHO) recommends intermittent preventive
treatment with sulfadoxine-pyrimethamine (IPTp-SP) in endemic regions. However, data on adherence to
IPTp-SP among pregnant women attending antenatal care (ANC) in Ghana is limited. This study aimed
to assess malaria prevalence and IPTp-SP adherence among pregnant women in the Ashanti region of
Ghana.
Methodology: This cross-sectional study was conducted from February to June 2023, involving 210
pregnant women attending antenatal care at Aniniwah Medical Center in Emena, Ghana. Malaria was
diagnosed using a light microscope, following standard procedures for detecting Plasmodium species in
blood samples. Well-structured and validated questionnaires were administered to collect data on
sociodemographic and obstetric characteristics, as well as IPTp-SP uptake. Statistical analysis was
performed using SPSS version 25.0 and GraphPad Prism version 8.0, with a significance threshold set
at P < 0.05.
Results: Among the 210 pregnant women recruited, the majority (95, or 45.2%) were aged 20-29 years,
160 (76.2%) were married, 74 (35.2%) had tertiary education, and 156 (74.3%) identified as Christians.
The prevalence of malaria infection among the participants was 4.3%. Most (55.6%) of the infected
women were in their first trimester, compared to 22.2% in both the second and third trimesters. A
significant association was found between ANC contacts, IPTp-SP knowledge, and adherence to IPTp-SP
(p < 0.001). In the multivariate logistic regression model, having only one ANC contact [aOR = 12.362,
95% CI (1.383-110.490), p = 0.024] and lacking IPTp-SP knowledge [aOR = 5.060, 95% CI (1.158-
22.114), p = 0.031] were identified as independent predictors of malaria infection.
Conclusion: Adequate ANC contact is crucial for preventing malaria during pregnancy. The higher
incidence of malaria among women in their first trimester highlights the need to re-evaluate the timing
for initiating IPTp-SP. Increasing awareness of IPTp-SP may enhance adherence and improve maternal
and fetal health outcomes.