TABLE OF CONTENT
Title page .. .. .. .. .. .. .. ii
Certification .. .. .. .. .. .. .. iii
Dedication .. .. .. .. .. .. .. iv
Acknowledgement .. .. .. .. .. .. v
Table of content .. .. .. .. .. .. vi
List of tables .. .. .. .. .. .. .. vii
List of figures .. .. .. .. .. .. .. viii
Abstract .. .. .. .. .. .. .. .. ix
Chapter One
Introduction .. .. .. .. .. .. .. 1
1.2Aims and objectives .. .. .. .. .. .3
Chapter Two
Literature Review .. .. .. .. .. .. 4
2.1 Geographical distribution of malaria .. .. 4
2.2 Epidemiology of malaria . . . 5
2.2. Environmental factors 5
2.2.2 Vectorial factors 6
2.2.3 Host factors 6
2.3 Studies on the prevalences of malaria 7
2.4 Transmission of malaria 12
2.5 Life cycle of malaria parasite 13
2.6 Pathogenesis and Pathology of malaria 16
2.7 Diagnosis of malaria 16
7
Chapter Three
3.0 Materials and Method .. .. .. .. .. . 21
3.1 Study areas .. .. .. .. .. .. 21
3.2 Study subject .. .. .. .. .. 21
3.3 procedure .. .. .. .. .. 22
3.4 Qualitative data collection .. .. .. .. 24
3.5 Analysis of results .. .. .. .. .. .. .. .. 24
Chapter Four
Results .. .. .. .. .. .. 25
Chapter Five
Discussion .. .. .. .. .. .. .. 30
Chapter Six
6.1 Summary and Recommendations .. .. .. 34
References .. .. .. .. .. .. .. 38
Questionnaire .. .. .. .. .. .. .. 52
Appendices .. .. .. .. .. .. .. 54
8
LIST OF TABLES
Table 1: Age prevalence of malaria – – – – – 25
Table 2: Sex prevalence of malaria – – – – – 25
Table 3: Help-seeking behaviour of the respondents – – 28
Table 4: Preventive measures adopted – – – – 28
Table 5: Methods of malaria treatments used – – – 28
Table 6: Educational background and method of treatment 29
LIST OF FIGURES
Figure 1: Geographic Distribution of Malaria – – – 4
Figure2: The Life Cycle of Malaria – – – – – 19
9
ABSTRACT
The study surveyed the prevalence of malaria as well as management practices
adpted in Ndiegoro community, Aba South L.G.A., Abia state between May and
August 2009. Blood samples of 300 individuals who attended local hospital were
examined using Giemsa stained thick and thin films, One hundred and fifty two
(152) persons (51%) were infected with Plasmodiumfalciparum . The age group 0-5
years ( 74.3%) had the highest prevalence, while the age group 36-45 years ( 40.0%)
recorded the lowest prevalence in the study. Males ( 58.7%) were statistically more
infected than females ( 43.3%) ( p< 0.05 ). Structured questionnaire were also
administered to obtain their management practices. On the help-seeking behavior
of the respondents more persons (63.4%) in the age group 0-15 years attend
laboratories for diagnosis more often than those in the age group 16> (36.6%). More
of the respondents resorted to patent chemist (27.6%) for treatment purposes. Visit
to hospitals for treatment was the least patronized (12.0%). Some of the
respondents combined more than one methods in their treatment for malaria. The
use of prophylactic drugs( 6.0%) and insecticide treated nets( 1.8%) were the least
preventive measures adopted by the respondents. This was due to the financial constaint
and non-awareness of them. Malaria still remained a public health problem in Nigeria and
data on its precise prevalence in some communities has remained unidentified.
CHAPTER 1
MALARIA
INTRODUCTION:
Malaria is a life-threatening disease of man caused by parasite of the genus
Plasmodium, which is transmitted from person to person, through the bite of
infected female Anopheles mosquitoes. It is a killer and debilitating disease and
remains a formidable health and socio-economic problem in the world (Nebeet al,
10
2002). Jaine and Michael (1990) described it as the leading cause of death in the
developing world. The World Health Report (2002) reported that about 90% of all
malaria deaths in the world today occur in Africa, South of the Sahara. And that
this is because majority of the infections in Africa are caused by Plasmodium
falciparum, the most dangerous of the four human malaria parasites. Anopheles
gambiae is the most effective malaria vector, the most widespread in Africa and
the most difficult to control. Global estimate on morbidity and mortality resulting
from malaria shows between 300-500 million clinical cases and between 1.5-2.7
million deaths attributed to malaria annually (Obi, 1997; Salako, 1997; WHO,
1998 and UNICEF, 2000), and an estimated one million people in Africa die from
malaria each year and most of these are children under 5 years old and women in
their first pregnancy (WHO, 2002; Sherman, 1998). NIH (2001) reported that the
number of deaths from malaria are on the increase due to insecticide resistance,
antimalarial resistance and environmental changes.
The four important species of the parasite that cause this disease are
Plasmodium falciparum.P. malariae, P ovaleand P. vivax. Various species of
the malaria parasites such as P.falciparum and P. malariaeare reported in Nigeria
(Eneanya, 1998; Matur, et al, 2001). Anopheles gambiae, An. funestus and An.
arabiensis have been implicated for malaria transmission in Nigeria with major
impacts (Umaru et al, 1997). Scientific investigations revealed many pathological
effects of malaria on man which include varying degrees of anaemia, splenic
enlargement and various syndromes resulting from physiological and pathological
involvements of certain organs like the brain, liver and the kidneys (Adams and
Macgraith, 1985). Chukwuraet al (2003) described P. falciparummalaria as the
11
most prevalent and virulent in Nigeria, capable of causing mental apathy,
weakness and generally slowing down economic development; accounting for up
to 98% of severe cases with significant mortality and morbidity (WHO, 2000).
Malaria has been observed to keep people away from school or work thereby
affecting;
(i) The amount they learn at school
(ii) The quantity of food they are able to grow and
(iii) The money they can earn (WHO, 1991). Salako (1996) and Cooker et al,
(2001) reported that malaria accounts for over (600) six hundred deaths
daily in Nigeria, especially in children less than five years of age in the
rural, peri-urban and urban settlements; with high index of child mortality
from the disease.
Mbanugo and Ejims (2000) also reported that malaria is holoendemic in many
countries and directly responsible for up to 10-25% of the infant mortality. Poor
knowledge, attitude and practice (KAP) by our people in handling malaria seems
to compound the issue of this disease in our various communities, particularly in
AbiaState. Studies in Nsukka, Enugu state by Briegeret al (1997) and in a coastal
area of Lagos state by Nebeet al (2002) confirmed that the perception of malaria
by the inhabitants were not helpful. Many believe that malaria is caused by such
factors as excessive heat, malnutrition, eating too much palm oil and other
superstitious considerations. This poor malaria perception stimulated the present
study ‘A study to determine the prevalence of malaria infection among members
of Ndiegoro community, Aba South L.G.A., Abia State., attending hospital and to
ascertain their management practices’. The outcome of the study is hopefully
12
expected to disclose some strategies for eliminating or reducing to the barest
minimum this health problem of man and enhancement of his health, generally.
1.2 AIMS AND OBJECTIVES OF THE STUDY
The aims and objectives of this study are;
To determine the prevalence of malaria in the study area andto
document the management practices by the people in the community.
(ii) Specific Objectives:
These are:
To determine the prevalence of malaria with regards to age and sex
To identify the Plasmodium species prevalent in the study area
To document the help-seeking behavior of the people
To document the preventive measures adopted by the people
To document the treatment methods by the people
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