Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS

11.2 USE OF ANTIMALARIAL DRUGS DURING PREGNANCYMalaria during pregnancy is extremely common among women who live in countries that aremalaria-endemic. Pregnant women in these areas are semi-immune to malaria and often have a lowprevalence of peripheral parasitaemia but have a high prevalence of placental infection (Steketee etal., 2001). Malaria placental infection is a major contributor to low birth weight, infant mortality,maternal anaemia, spontaneous abortion, and stillbirth. Studies have shown that IPT with two-dosesof SP protect pregnant women from maternal anaemia, malaria placental infection, and reduce theincidence of low birth weight (Steketee et al., 2001). As a protective measure, it is recommended thatall pregnant women in Tanzania receive at least two doses of IPT with SP during the second and thirdtrimesters of pregnancy.Regarding the pregnancy leading to their last live birth, women in the 2007-08 THMIS wereasked whether they took any antimalarial medications during the pregnancy, and if so, what drugswere taken. Women were also asked whether the drugs they received were part of an antenatal carevisit. It should be noted that obtaining information about drugs can be difficult because somerespondents may not know or remember the name or the type of drug that they received.Table 11.4 shows the percentage of women who had a live birth in the two years precedingthe survey who took any antimalarial drug, and the percentage who took IPT during pregnancy. Thefourth and fifth columns in Table 11.4 assess the extent to which women took SP for IPT.Overall, 60 percent of pregnant women took an antimalarial drug during pregnancy (59percent in Mainland and 78 percent in Zanzibar). The data suggest that IPT use of SP is integratedinto routine antenatal care; 57 percent of pregnant women in Mainland Tanzania and 74 percent inZanzibar reported having taken at least one dose of SP (IPT-1) during an ANC visit. However, only30 percent of pregnant women in Mainland and 52 percent in Zanzibar received two or more doses ofSP (IPT-2). These figures show an increase since the 2004-05 TDHS, when 22 percent of pregnantwomen in Mainland and 14 percent in Zanzibar received two or more doses of SP.There are significant differences in the percentage of women who received complete IPT(IPT-2) by background characteristics. Women in urban areas are more likely (42 percent) to receiveIPT-2 than women in rural areas (28 percent). The same pattern was observed in the 2004-05 TDHS(29 and 20 percent, respectively).In only five regions in Mainland Tanzania do more than 40 percent of pregnant womenreceive IPT-2. These regions are Dar es Salaam (58 percent), Lindi (41 percent), Morogoro (44percent), Singida (45 percent) and Tanga (42 percent). Mwanza and Shinyanga have the lowestproportions of women who received IPT-2 (16 and 17 percent, respectively). In Zanzibar, IPT-2 isreceived by 54 percent of pregnant women in Pemba and 50 percent in Unguja.Women in households in the higher wealth quintiles and those with higher levels of educationare more likely to receive IPT-2 than women in households in the lower wealth quintiles or who havelittle or no education.138 | Malaria