PREVALENCE OF MALARIA PARASITE IN CHILDREN 1 to 12 YEARS IN UNUBI, ANAMBRA STATE
This study was to determine the prevalence of malaria among children and malaria vectors in Unubi, Anambra state. The study was conducted between the month of July and August. Geimsa thick film and Rapid Diagnostic Test were used to detect malaria parasite in the blood. A total of 200 participants comprising of 86(43.0) males and 114(57.0) females selected from patients referred for malaria tests at health centres in Unubi Participants were aged 1-12 years. The prevalence of malaria in the study area was 27.0% for microscopy and 20.0% for rapid diagnostic test. Males were more infected with a prevalence rate of 15.0% (microscopy) and 9.5% (RDT) while females had a prevalence rate of 12.0% (Microscopy) and 10.5% (RDT). Malaria prevalence in relation to age in the study shows those children within the age of 4 years has the highest prevalence with the least prevalence been those within 8, 9 and 11 years of age. Based on these findings, the government and non-governmental agencies should sustain their efforts in the fight against malaria through an aggressive sensitisation campaign on the preventive measures. Provision of subsidised insecticide treated nets to the most vulnerable especially children and women in the rural communities will help reduce the prevalence for malaria diagnosis. The use of RDT should be encouraged where there is challenge of using microscopy.
TABLE OF CONTENTS
Title Page i
Approval Page iii
Table of Contents vii
List of Figures ix
List of Tables x
1.0 INTRODUCTION 1
CHAPTER TWO 7
LITERATURE REVIEW 7
2.1 Malaria in Children 4
2.1.1 Malaria Burden 7
2.2 Malaria Vectors 12
2.3 Confirmatory Test of Malaria 19
MATERIALS AND METHODS
3.1 Study Area 21
3.2 Design of Study 21
3.3 Sample Population and Size 22
3.4 Permission for the Study 22
3.5 Method of blood collection 22
3.5.1 Use of Rapid Diagnostic Test (RDT) 22
3.5.2 Parasitological method 24
3.5.3 Preparation of Thick Blood film 24
3.5.4 Staining of the Blood Films 24
3.5.5 Examination of blood film 24
3.6 Data Analysis 25
DISCUSSION, CONCLUSION AND RECOMMENDATIONS 30
Background of Study
Malaria is a mosquito-borne infectious disease affecting humans and other animals. It is caused by parasitic protozoans (a group of single-celled microorganisms) belonging to the genus Plasmodium type (WHO, 2014). The disease is most commonly transmitted by an infected female Anopheles mosquito. The mosquito bite introduces the parasites from the mosquito’s saliva into a person’s blood (WHO, 2014). The parasites travel to the liver where they mature and reproduce. Five species of Plasmodium can infect and spread by humans (Caraballo, 2014) namely, Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae and Plasmodium knowlesi.
Plasmodium infection can cause a wide variety of illnesses, ranging from asymptomatic infection over uncomplicated malaria to severe and complicated disease (Bousema et al., 2014; Galatas et al., 2016 and White, et al., 2014). Owing to the enormous morbidity and mortality of clinical malaria in young children, the epidemiology and consequences of asymptomatic infection in different settings and age-groups has received comparatively little attention. Increasingly, however, the underrated impact of asymptomatic and/or submicroscopic infections is now being recognized (Bousema et al., 2014; Galatas, et al., 2016 and Nankabirwa, 2013). Partial immunity against malaria develops during childhood in endemic regions as a result of repeated exposure. Increasing age has consequently been associated with low and submicroscopic parasite density as well as with asymptomatic infection, particularly among school-age children (Laishram, 2012; Okell, et al., 2015 and Walldorf ,2015). Most of these infections remain undiagnosed and untreated (Laishram, 2012; Walldorf, 2015), and—in the case of schoolchildren—are not subject of targeted interventions.
According to World Malaria Report 2016, there were 212 million new cases of malaria worldwide in 2015 (range 148–304 million). The WHO African Region accounted for most global cases of malaria (90%), followed by the South-East Asia Region (7%) and the Eastern Mediterranean Region (2%) (WHO, 2016). In 2015, there were an estimated 429 000 malaria deaths (range 235 000–639 000) worldwide. Most of these deaths occurred in the African Region (92%), followed by the South-East Asia Region (6%) and the Eastern Mediterranean Region (2%). Between 2010 and 2015. Children under five years of age are particularly susceptible to malaria illness, infection and death. In 2015, malaria killed an estimated 303 000 under-fives globally, including 292 000 in the African Region. Between 2010 and 2015, the malaria mortality rate among children under five fell by an estimated 35%. Nevertheless, malaria remains a major killer of under-fives, claiming the life of one child every two minutes.
Malaria is present in both rural and urban areas of the countries in sub Saharan Africa, though the risk is lower in urban cities (Keiser et al., 2014). Provost (2011) reported that by 2010, countries with the highest death rate per 100,000 populations are Coted’lvoire with 86.15, Angola 56.93 and Burkina Faso 50.66 all in Africa. This is attributed to consistent temperature, high humidity, significant amount of rainfall, along with stagnant waters in which mosquitoes larvae readily mature, providing them with the environment they need for continuous breeding and thick vegetation which prevail in African countries.
Oko et al. (2014) stated that majority of the cases were found in children less than five years old and pregnant women. Christopher et al. (2012) found out that 90% of malaria-related deaths occur in sub-Saharan Africa, with approximately 60% of deaths being young children under the age of five.
The prevalence, intensity and regularity of malaria differ from location to location depending on factors such as rainfall patterns and proximity of human dwelling places to vector breeding sites among others (Onyido et al, 2011). Anopheles gambiae, the principal transmitter of malaria in Nigeria is closely associated with sunlit water collections close to human dwellings while Anopheles funestus another important malaria vector tends to breed more in cool, clear, shaded, permanent water bodies in rural areas relatively undisturbed by man (Onyido et al, 2011). Several studies on the pattern of malaria in Nigeria have been carried out but these were mostly concentrated in urban and sub-urban communities than in rural communities. Hence the rationale to work in Unubi, a rural community
Malaria is a potentially deadly disease characterized by cyclical bouts of fever with muscle stiffness, shaking and sweating (WHO, 2000). Macleod (1998) also stated that malaria is a parasitic infection transmitted to humans through the bites of an infected female Anopheles mosquito. The name “malaria” is derived from the Italian words Mal (bad) and aria (air). It arose originally because the citizens of Rome thought that the disease was contracted by breathing the bad air of the Pontine Marshes (Garnham, 1966). Hornby (2007) defined malaria (ague, marsh fever, periodic fever, paludism) as an infectious disease due to the presence of parasitic Protozoa of the genus Plasmodium (P. falciparum, P. malariae, P. ovale or P. vivax) within the red blood cells. The disease is confined to tropical and subtropical areas. Malaria is one of the most prevalent diseases of the world. Current estimates predict over two hundred million cases annually. The number of clinical cases exceeds 150 million with approximately 2.3 million deaths, most of these victims are infants and young children. Over half of the worlds population lives in malarious areas (WHO, 2000; Okeke et al., 2006). About 90% of all malaria deaths in the world today occur in Africa South of the Sahara. This is because the majority of infections is caused by Plasmodium falciparum, the most dangerous of the four malaria parasites. It is also because the most effective malaria vectors, the mosquito Anopheles gambiae is the most widespread in Africa and most difficult to control (WHO, 2000). Severe malaria is not readily distinguishable from other severe diseases such as typhoid, pneumonia, and meningitis which require very different therapy (WHO 2000). Toure et al. (2004) also estimated that between 300 and 500 million people are at risk. Irrespective of various malaria control programmes of WHO, UNICEF, Government of various nations, malaria had remained the most infectious and prevalent disease of the world. Various misconceptions in addition to drug resistance, insecticide resistance, misdiagnosis, ignorance and poverty are responsible for the failure of control programmes on malaria (Breman, 2001). The French Physician, Charles Louis Alphonse Laveran first identified the parasite under the microscope in 1880. Ronald Ross and Giovanni Grassi recognized the mosquito as malaria vector in 1897 (Good, 2001). However, despite enormous and diverse efforts to control this disease, malaria is among the top three most deadly communicable diseases and the most deadly tropical parasitic disease today (Sachs and Malaney, 2002). Worldwide, great and varied efforts are being made to learn about this disease and to determine how to control it. This is a formidable task. The official malaria eradication programme, run by world Heath Organization (WHO), was cancelled in the late 1960s because of growing difficulty given that the complex and persistent nature of this disease became increasingly obvious. A management strategy today includes the development of vaccines and chemotherapeutic agents, vector control, insecticides, education, bed nets and insecticide treated nets. Resistance to drugs by both the mosquito and the parasite is a growing obstacle in the battle against malaria. Combination therapy has been shown to increase the efficacy of combining drugs (Toure et al., 2004). Although the above efforts have been successful to varying degrees, approximately 500 million clinical cases of malaria are reported each year and mortality estimates range between 0.7 and 2.7 million. Most of these deaths are young children in sub-Saharan Africa, where malaria mortality is the highest, 90% of reported malaria – related deaths are children under the age of five (Gardner, 2002). However, the actual figure of illness, morbidity and mortality may be very different from those cited above. Accuracy is impeded by the fact that most malaria deaths occur at home, many cases are misdiagnosed and functional microscopes are not available to most clinics in the area (Greenwood and Mutabingwa, 2002). Unfortunately the disease burden is on the rise.
STATEMENT OF PROBLEM
Malaria is one of the world’s top killer diseases, especially for the young children. Malaria has remained a major threat to public health and economic development in the tropical and subtropical regions of the world. Attempts to control or completely eradicate the disease have failed massively as a result of well-known resistance to drugs for the malaria parasite and to insecticides for the vector and the situation has become life-threatening. Though there is collaborative energy both at the international, national and individual level to fight the disease by developing vaccines and new drugs, no-one has produced any permanent result yet. In the field of science, education about understanding the disease has recorded a tremendous progress.
OBJECTIVES OF STUDY
1.To determine the prevalence of malaria among children in Esan north east local government area
2.To determine knowledge on prevention of malaria among parents\guardian in Unubi, Anambra state
3.To determine knowledge on control of malaria among parents in Unubi, Anambra state
- To proffer solutions to the prevalence of mosquito in the study area
- What is the prevalence of malaria among children in Unubi, Anambra state
- What is knowledge on prevention of malaria among parents\guardian in Unubi, Anambra state
3.What is knowledge on control of malaria among parents in Unubi, Anambra state
- What is solutions to the prevalence of mosquito in the study area
The study will be useful to community dwellers on knowledge on the prevention and control of malaria in the area
The study will also be of great importance to government on various ways to assist residents in rurals area on the provison of insectide for the prevention of malaria in Unubi, Anambra state SCOPE OF STUDY
The study was majorly aim at studying the prevalence of malaria among children in Unubi local government area, Anambra state.