Knowledge, Attitude and Practices to Malaria in Pregnancy and Use of Sulfadoxine-pyrimethamine among Pregnant Women in Osun State, Nigeria

Background: Malaria in pregnancy is a major public health challenge in Nigeria, causing maternal anemia, low birth weight, and poor neonatal outcomes. Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and antenatal care (ANC) are key preventive strategies. Understanding women’s awareness and use of SP is essential for improving coverage and outcomes. Methods: A cross-sectional facility-based survey was conducted in three secondary-level hospitals in Osun State. Pregnant women aged 18–49 years who had received at least one dose of SP and consented were included. Using systematic sampling, 250 participants were recruited and interviewed with structured questionnaires by trained assistants. Data were collected via KoboCollect and analyzed descriptively using SPSS v23. Likert responses were grouped into positive, neutral, and negative categories, with significance set at p<0.05. Results: Awareness of malaria risks was high, with 94.0 % agreeing that malaria in pregnancy can cause anemia and 98.6 % recognizing its potential severity for mother and fetus. Regarding personal susceptibility, 88.4 % perceived themselves at risk. The utility of SP for malaria prevention was acknowledged by 96.0 %, although only 69.6 % were aware of potential adverse reactions. Positive attitudes toward ANC attendance were widespread, with 98.0 % expressing agreement on its benefits. These findings indicate high awareness but highlight gaps in understanding SP safety and optimal utilization. Conclusion: Pregnant women attending ANC in Osun State showed good awareness of malaria prevention and SP. However, gaps in knowledge of adverse reactions and proper IPTp-SP dosing highlight the need for targeted health education to improve coverage and maternal–fetal outcomes.