Supporting information files.

Malaria in pregnancy poses a high risk of poor maternal and neonatal outcomes and WHO recommends IPTp. However, its uptake has remained sub-optimal among mothers who attend antenatal care at private-not-for-profit health facilities. This study determined the level of and factors associated with uptake Intermittent preventive treatment of malaria for pregnant women (IPTp) at private-not-for-profit (PNFP) health facilities in Kasese District, Uganda. This was a cross-sectional study involving 396 postpartum mothers in the postnatal wards of 8 PNFP health facilities in Kasese district was conducted in September 2022. One hospital and 2 Health Centre IVs were purposively selected and 5 Health Centre IIIs selected randomly. Mothers were consecutively selected and interviewer administered semi-structured questionnaires were used to collect the data. Data were entered in epi-data version 3.1, cleaned and analyzed using STATA version 14. Data were adjusted for clustering & modified poison regression was used to determine associations of the factors and the outcome. From the analysis, level of optimal uptake of IPTp was 51.5% CI = (46.6–56.4). Being married (aPR = 1.35, 95% CI = 1.06–1.7, p = 0.014), attending ANC more than 4 Visits (aPR = 1.29, 95%CI = 1.09–1.54, p<0.001) positively influence optimal uptake while not taking IPTp at recommended time intervals (aPR = 0.49, 95%CI = 0.39–0.62 p<0.001) and mothers paying for IPTp drugs themselves (aPR = 0.74, 95%CI = 0.57–0.97, p = 0.031) negatively influence optimal uptake. This moderate uptake of IPTp among pregnant mothers suggests insufficient protection of pregnant mothers against malaria. Efforts to improve Antenatal care attendance, taking IPTp at recommended time intervals, not paying for ITPp drugs and encouraging marriages should be intensified.

妊娠期疟疾会对孕产妇及新生儿的不良结局带来极高风险，世界卫生组织（World Health Organization, WHO）推荐采用孕妇疟疾间歇性预防治疗（Intermittent Preventive Treatment of Malaria in Pregnancy, IPTp）。然而，在私立非营利性（Private-Not-For-Profit, PNFP）卫生机构接受产前保健（Antenatal Care, ANC）的产妇中，该干预措施的落实率仍未达到最优水平。
本研究旨在明确乌干达卡塞塞地区私立非营利性卫生机构中，孕妇疟疾间歇性预防治疗的落实现状及其相关影响因素。本研究于2022年9月开展，为横断面研究，共纳入卡塞塞地区8家私立非营利性卫生机构产后病房的396名产后产妇。研究采用目的抽样法选取1家医院及2家IV级卫生中心，并通过随机抽样法选取5家III级卫生中心。研究对象为连续纳入的产妇，由调查员采用半结构化问卷完成数据收集。
数据录入采用EpiData 3.1版本，经清理后使用STATA 14版本进行统计分析。分析过程中对聚类效应进行了校正，并采用修正泊松回归模型分析各影响因素与研究结局的关联。
分析结果显示，孕妇疟疾间歇性预防治疗的理想落实率为51.5%，95%置信区间（Confidence Interval, CI）为46.6%~56.4%。其中，已婚状态（调整后风险比[aPR]=1.35，95%CI=1.06~1.7，P=0.014）、产前保健就诊次数超过4次（aPR=1.29，95%CI=1.09~1.54，P<0.001）对理想落实率存在正向影响；未按推荐时间间隔接受孕妇疟疾间歇性预防治疗（aPR=0.49，95%CI=0.39~0.62，P<0.001）以及产妇自行支付治疗药物费用（aPR=0.74，95%CI=0.57~0.97，P=0.031）则对理想落实率存在负向影响。
本次研究中产妇的孕妇疟疾间歇性预防治疗落实率处于中等水平，提示当前对孕产妇的疟疾防护仍存在不足。后续应加大力度提升产前保健就诊率、督促产妇按推荐时间间隔接受治疗、免除产妇自行承担治疗药物费用，并强化婚姻相关支持举措。