Abstract

Malaria is a major cause of illness and death especially among children under 5years old and pregnant women. It is estimated that more than one million children living in Africa especially in remote areas with poor access to health services die annually from direct and indirect effects of malaria. Fatally affected children often die within less than 72h after developing the symptoms. In Nigeria, malaria consistently ranks among the five most common causes of death in children. As a result of increased mortality and morbidity there is need for proper understanding of the epidemiology of the disease among the most at risk groups. The most prominent specie in the community is plasmodium falciparum (51.8%). Forty-three percent of the pupil positive for malaria had low parasitic diversity below 1000, 12.4% between 1000 and 10,000, 2.3% between 10,000 and 100,000 and 0.2% above 100,000. Malaria is a problem among children of 5-10 years old especially from age 5 years when their immunity from mothers start reducing. There is need to ensure that mothers protect their children from mosquito bite by ensuring that they sleep under ITN

CHAPTER ONE

INTRODUCTION

Malaria is one of the world’s most deadly diseases caused by an infection with single celled parasitic female anopheles mosquito.

This remains a burden especially in the sub Saharan Africa despite all the efforts put in by the various countries to control and eradicate the disease in these areas. Its problem has further contributed to low economic progress especially among countries that have been affected by the disease.

Background of the Study

Malaria is a major public health problem and cause of suffering and premature death in tropical and subtropical countries (Cheesbrough, 1998). Malaria is, a major cause of illness and death in children. It is estimated that more than one million children living in Africa die yearly from direct and indirect effects of malaria infection (Fawole & Onadeko, 2001). This preventable disease has reached epidemic proportions in many regions of the world and continues to spread unchecked (W.H.O., 1998). African children under ten years and pregnant women are most at risk of malaria. Fatally afflicted children often die less than 72 hours after developing symptoms. In those children who survive, malaria drains vital nutrients from them impairing their physical and intellectual development (W.H.O. ,1998). Malaria infections represent substantial social costs due to school absenteeism and reduced economic productivity. Malaria costs Africa up to US $12billion annually. A poor family living in malaria affected area may spend up to 25% or more of its annual income on prevention and treatment of malaria (W.H.O, 2000)Statement of the problem.

80% of malaria infections are caused by P. falciparum while up to 15% are caused by P malariae and less than 5% are caused by P ovale infections. Mixed infections with P falciparum are common (Federal Ministry of Health 1990, Orajaka, 1996). Mbanugo and Ejims (2000) in a study conducted in three hospitals and a Nursery School in Awka on prevalence of Plasmodium infections in children, discovered that out of 400 children, 233(58%) were positive and only Plasmodium falciparum were found. Among the positive cases 85.5% were observed in age group 2-3 while 33% was in 0-1 years indicating that the prevalence of Plasmodium infections among under 5 children is significantly affected by age. Sex in their findings did not affect prevalence rate. The major vectors of human malaria are Anopheles gambiae, Anopheles funestus, Anopheles arabiensis and Anopheles melas. A arabiensis is most dominant in the savannah areas and cities. A gambiae are found in highly dense forest areas, A funestus has an uneven distribution while A melas is a salt water species (Federal Ministry of Health, 1990). Anopheles mosquitoes can adapt to urban breeding sites over time eg, in India, Anopheles Stephensi has developed into urban species and is found in much higher numbers in many cities in India than in the surrounding country side (WHO,1988a). There is evidence that Anopheles mosquitoes are like wise becoming better adapted to the breeding site of Accra (Benneh et al, 1993).

Transmission of malaria is intense and stable in Nigeria because the intensity of attack remains constant throughout the year or from year to year. The degree of endemicity of malaria measured is based on the spleen rate in children aged 2-9 years as published by W.H.O. (1951) in their order of severity. Hypoendemic malaria occurs when spleen rate in children is less than 10%. Mesoendemic malaria occurs when spleen rate in children is 11- 50%. Hyperendemic malaria occurs when spleen rate is 75% in children and > 25% in adults. Holoendemic malaria occurs when spleen rate is >75% in children but very low in adults. In Nigeria, malaria is holoendemic in the rural areas and mesoendemic in the urban areas. In the southern part of the country the transmission rate is approximately uniform throughout the year. In the far North there is a marked difference between the high transmission rate in the short wet season and low transmission rate in the long dry season (Lucas & Gilles, 1998)

Statement of the problem

The government’s long term objective is to ensure total eradication of malaria in all the endemic areas of the country and as such a lot of effort through funding has been sourced both internally and externally towards the above cause. A lot of sensitization and prevention measures of malaria such as education of individuals and families to sleep under insecticide treated nets, vector control through spraying (IRS), eliminating breeding places, and reducing infections through prophylaxis and treatment with ACTs. The government has also through the years 2009 -2015 conducted several programs including integrated community case management (ICCM), integrated management of childhood illness (IMCI) and training of VHTs to offer curative malaria treatment at community level. (Danielle Roberts, Glenda Mathews). Despite all these efforts malaria cases continues to remain high and one of the leading causes of ill-health and deaths in Nigeria. As a result of this trend therefore, malaria infection has led to a high number of referrals due to complicated malaria which has resulted into complications like cerebral malaria, hypoglycemia, jaundice, severe anemia leading to increased number of in-patient admissions and deaths. The infection has also led to malnutrition, growth retardation, reduced school attendances and dropouts among the children. Malaria infection has also led to low economic growth as a lot is spent on treatment of the disease and this has left the people poor and economically devastated. It also contributes to low productivity as parents spend most of the time attending to the sick children

 Objectives of the study

The general objective of this study is on the determine Prevalence of malaria parasite among children age 5-10 in Uturu.

Specific objectives

1. To determine the prevalence of malaria among children below 10 years in Uturu
2. To identify the care giver factors associated with prevalence of malaria among children below 10 years in Uturu
3. To assess the environmental factors contributing to the prevalence of malaria amongst children below 10 years in Uturu
4. To find out the house hold factors associated with prevalence of malaria amongst children children below 10 years in Uturu

            Research question

1. What is the prevalence of malaria among children below 10 years in Uturu?
2. How does the care giver factor affect the prevalence of malaria prevalence in children less than 10 years in Uturu?
3. What are the environmental factors associated with malaria prevalence in children below 10 years in Uturu?
4. What house hold factors are associated with malaria prevalence in children below 10 years in Uturu?

Significance of the study/justification

Despite the availability of malaria control measures the morbidity and mortality in children under ten years is still unacceptably high. This study therefore was to help to identify the factors associated with malaria prevalence. The study will help the concerned authorities to plan and sensitize the community about the above factors and put in place strategies to help reduce on the number of malaria cases in the community. This will reduce on overcrowding in the health units and referrals due to complicated malaria; this will cause a reduction of inpatient admissions and mortality rates in children below ten years. It will be an essential component in the effectiveness of malaria control and elimination in the already existing strategies that are being scaled up hence re- align the effectiveness in the malaria control measures. This study is also as a requirement for the fulfillment of my bachelor’s degree which will also help in the future literature review by other researchers.

Scope of the study

The study was carried out in Uturu in the months of august 2021. The study aimed at determining the Prevalence of malaria parasite among children age 5-10 in Uturu. Health workers were also included in the study for statistical information about malaria prevalence

Operational Definitions

 Prevalence is the total number of cases of a disease that are present in a particular Population at a given period.

Malaria is a life threatening disease caused by a bite of an infected female anopheles mosquito.

Parasitaemia is the number of malaria parasites contained in the blood.

Malaria prevalence is the proportion of people who are infected with malaria infection at a given point of time.

Children below ten years- these are the most vulnerable group for malaria infection.

Caregiver – refers to someone who takes responsibility for those children below the age of ten years.

Household– a unit that consist of one or more people who live in the same dwelling and also share meals and consist of a single family or other group of people.

Environment – the circumstances, objects, conditions by which one surrounded.