Impact of knowledge, attitudes, practices, and perceptions on the effectiveness of intermittent preventive treatment with sulfadoxine-pyrimethamine among pregnant women in the Dschang Health District, Cameroon

Malaria during pregnancy is a significant public health concern in countries with limited resources, such as Cameroon. The effectiveness of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) may be influenced by behavioral, cognitive, and contextual factors. This study examined the impact of pregnant women’s knowledge, attitudes, practices, and perceptions on the effectiveness of IPTp-SP in the Dschang Health District in Cameroon. An analytical, retrospective, cross-sectional study was conducted among 249 pregnant women who received at least three doses of IPTp-SP between January and December 2021 at two major healthcare facilities. Data were collected using a structured questionnaire. Statistical analyses included chi-square tests, Spearman’s correlation, and multivariate logistic regression. The mean age of the participants was 26.75±5.08 years. Despite receiving three or more IPTp-SP doses, the incidence of malaria during pregnancy remained high at 37.35%. Factors independently associated with malaria occurrence were irregular use of long-lasting insecticidal nets (LLINs; p=0.001), lower malaria knowledge scores (p=0.009), and low parity. Primiparous and secundigravidae women were the most affected (p=0.012). Frequent LLIN use significantly reduced the risk of infection (adjusted odds ratio [AOR]=2.75; 95% confidence interval [CI]: 1.51-5.00). Behavioral factors, particularly consistent LLIN use and adequate malaria knowledge, play a key role in improving IPTp-SP effectiveness. Strengthening counseling during antenatal care could improve malaria prevention among pregnant women.