FACTORS ASSOCIATED WITH COVERAGE AND ACCEPTABILITY OF INDOOR RESIDUAL SPRAYING (IRS) FOR MALARIA PREVENTION IN NASSARAWA EGGON LGA OF NASSARAWA STATE, NIGERIA

FACTORS ASSOCIATED WITH COVERAGE AND ACCEPTABILITY OF INDOOR RESIDUAL SPRAYING (IRS) FOR MALARIA PREVENTION IN NASSARAWA EGGON LGA OF NASSARAWA STATE, NIGERIA

CHAPTER ONE: INTRODUCTION
1.1 Background
Malaria is caused by a parasite, Plasmodium. There are 5 species known to affect humans; P. Falciparum, P. ovale (sub-species P. ovale_curtisi, P. ovale_wallikeri) P. malariae, P. knowlesi and P. vivax. It is transmitted by the bite of female anopheles mosquito. It may also be transmitted vertically from a pregnant mother to the unborn child. The World Health Organization estimates 216 million cases of malaria occurred in 2010, 81% in the African region.Thirty countries in Sub-Saharan Africa account for 90% of global malaria deaths. Nigeria, Democratic Republic of Congo (DRC), Ethiopia, and Uganda account for nearly 50% of the global malaria deaths. Malaria is a public health problem in Nigeria. It has been eliminated in some countries but yet to be controlled in Nigeria. Malaria has been found to be endemic in Nigeria with 97% of the population at risk. The remaining 3% of the population live in the malaria free
highlands. This problem is responsible for 60% of outpatient visits and 30% of hospitalizations among children less than five years of age in Nigeria.Pregnant women are also affected by the disease. Malaria in pregnancy leads to several complications affecting both the pregnant mother and the unborn child. In Nigeria, 11% of maternal deaths are due to Malaria. In 2010, an estimated 655,000 people died of malaria – most were young children in sub-Saharan Africa.1An estimated 65% of Nigeria‟s population lives in poverty, and poverty is a major factor in malaria prevention and treatment.1 There is an estimated 100 million malaria cases with over 300,000 deaths per year in Nigeria.The general objective of Integrated Vector Management is the reduction of vector-borne disease particularly, malaria via the utilization of multiple control measures in a compatible manner. As its name implies, Indoor Residual Spraying (IRS) involves coating the walls and other surfaces of a house with a residual insecticide. A dilute solution of insecticide is sprayed on the inside walls of certain types of dwellings – those with walls made from porous materials such as mud or wood but not plastered concrete as in city dwellings. For several months, depending on the chemical composition and concentration, the insecticide will kill mosquitoes and other insects that come in contact with these surfaces. The effective period of most commonly used insecticides range from 4 to 6 months. The Mosquitoes are either killed or repelled by the spray. IRS however, does not directly prevent people from being bitten by mosquitoes but succeeds in preventing transmission of the disease by eliminating mosquitos usually while resting. Within the last decade, increasing numbers of partners and resources have rapidly increased malaria control efforts. This scale-up of interventions has led to decreased morbidity and mortality in a number of countries, and there are hopes that ultimately malaria can be eradicated. Inadequate coverage of IRS spraying gives little or no protection at all. It is therefore generally recommended that IRS should be provided where possible. Integrated Vector Management has been recommended by World health organization African regional office (WHO/AFRO) as the main vector control strategy in Nigeria. The concept of IVM is built on selected vector control strategies and it involves the targeted use of different vector control methods alone or in combination. This is to prevent or reduce vector populations and human- vector contact cost-effectively and in a sustainable manner. This is clearly in consonance with the Roll Back Malaria (RBM) multiple vector control strategies. In carrying out IVM, efforts are made to apply environmentally sound interventions in order to control vector populations. Most of the recent and historical reductions in malaria cases have been attributed to insecticide treated nets (ITNs), and IRS.Indoor residual insecticide spraying, while typically used for low malaria risk or epidemic prone regions has been further advocated for use in high and medium malaria transmission setting. In 2008, 44 countries employed IRS as a malaria control strategy. The World Health Organization (WHO) recommends IRS as one of three primary means of malaria control, the others being use of insecticide treated bed nets (ITNs) and prompt
treatment of confirmed cases with artemisinin-based combination therapies (ACTs).While previously the WHO had recommended IRS only in areas of sporadic malaria transmission, in 2006 it began recommending IRS in areas of endemic, stable transmission as well. For IRS to be effective, at least 80% of homes and barns in an area must be sprayed.

FACTORS ASSOCIATED WITH COVERAGE AND ACCEPTABILITY OF INDOOR RESIDUAL SPRAYING (IRS) FOR MALARIA PREVENTION IN NASSARAWA EGGON LGA OF NASSARAWA STATE, NIGERIA

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