Determinants of uptake of deworming medication during pregnancy in Tanzania: insights from 2022 demographic and health survey

坦桑尼亚孕期服用驱虫药的决定因素:来自2022年人口与健康调查的启示

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Abstract

BACKGROUND: Anemia during pregnancy increases delivery risks, with untreated parasitic infections being a major cause. In Tanzania, evidence on deworming uptake among pregnant women aged 15-49 is limited. This study assessed national uptake and determinants of deworming medication use in this group. METHODS: We analyzed secondary data from the 2022 Tanzania Demographic and Health Survey (TDHS-2022), using the Pregnancy Outcome and Care for Pregnancies (NR) file. The study population consisted of pregnant women aged 15-49 years who had a live birth or stillbirth in the three years preceding the survey. A total of 4,401 women were included (unweighted n = 4,387; weighted n = 4,401). The outcome was uptake of deworming medication during pregnancy, defined using DHS variable m60 (yes = 1, no = 0). Survey-adjusted logistic regression was used to identify determinants, and results are presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). RESULTS: The uptake of deworming medication among pregnant women in Tanzania was 61.9% (95%CI: 59.7-64.0). Multivariable logistic regression analysis revealed several significant determinants. Women aged 25-34 years (aOR: 1.36, 95%CI: 1.13-1.63), residing in the Southern zone (aOR: 1.62, 95%CI: 1.26-2.09), currently employed (aOR: 1.26, 95%CI: 1.08-1.49), and those from wealthier households (aOR: 1.38, 95%CI: 1.05-1.82) had higher odds of taking deworming medication. Insurance coverage (aOR: 1.58, 95%CI: 1.00-2.50), having seven or more children under five years (aOR: 2.80, 95%CI: 1.26-6.23), attending four or more ANC visits (aOR: 1.36, 95%CI: 1.05-1.77), and accessing mass media at least once a week (aOR: 1.40, 95%CI: 1.15-1.72) were also associated with increased uptake. Conversely, women in rural areas had lower odds of taking deworming medication (aOR: 0.75, 95%CI: 0.59-0.95) compared to their urban counterparts. CONCLUSIONS: In Tanzania, deworming medication uptake among pregnant women remains suboptimal. Determinants of higher uptake included age 25-34 years, southern residence, employment, wealth, insurance coverage, high parity, attending at least four ANC visits, and regular media exposure, while rural residence was associated with lower uptake. ANC programmes should prioritize equitable access and implement tailored strategies to improve coverage, particularly among rural and underserved women.

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