Comparison Between Microscopy And Rapid Diagnostic Test Among Children Of 0-5 Years At Gusau, Nigeria

Project and Seminar Material for Parasitology And Entomology

Comparison Between Microscopy And Rapid Diagnostic Test Among Children Of 0-5 Years At Gusau, Nigeria


Abstract


It is noted globally over 95 countries and territories have on going malaria transmission with an estimated 3.2 billion people who are at risk of getting infected. The WHO indicates that 214 million people are infected with malaria worldwide and of these 438,000cases result in deaths. Children below five years are the most susceptible to malaria illness which accounts for estimated deaths of 303,000 before reaching age five globally and 292,000 occur in the African region (WHO world malaria report 2016).

To determining the prevalence of malaria and the associated risk factors among children below 5 years in Gusau HC III, Gusau town council in Gusau.

The study was a quantitative and cross section survey which involved a sample size of 243 care takers of 243 children below the age of five who attended Gusau HCIII. A convenient sampling method allowed data to be collected about malaria prevalence and the associated factors simultaneously in the months of August and September 2017.

Results:

The prevalence of malaria was high 118(48.6%) and the factors that were significant with malaria prevalence included; house hold source of light (x2= 8.560, P=0.036), care taker knowledge of signs and symptoms (loss of appetite) x2=4.023, P=0.045) and environmental factor about presence of garbage heaps (x2=4.322, P=0.038).
Prevalence of malaria was high and it was influenced by house hold source of light, knowledge and signs and symptoms of malaria and garbage heaps around the homes.

This study recommended that caretakers should not stop at having knowledge about malaria prevention transmission, but should have a positive attitude on the implement of the preventive measures. Health unit workers, community health workers and VHTs together with stakeholders should put in more effort to ensure that information about malaria is communicated to the caretakers in languages best under stood and should mainly target the vulnerable households in the community. The town council authorities and local leaders need to work with community to ensure proper garbage disposal. The Town council health team has to liaise with the district health team to strengthen the health system on prevention and control of malaria through sustainable messages like posters on malaria, TV messages and programs on malaria. Lobby for electricity in all the households of the town council.


Chapter One


Introduction

1.1 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.


1.2 Background of the Study

World health organization defines malaria as a life threatening parasitic disease caused by a bite of an infected female anopheles mosquito. (WHO) ( malaria fact sheet updated December, 2016). Malaria can kill within 24 hours of onset of symptoms and whereas it affects all people the most affected are children under five years of age.

Malaria has been and continues to be if not checked and controlled the number one parasitic killer disease globally that affects children mainly less than five years due to their low immunity. Malaria is an entirely preventable and treatable mosquito borne illness. (WHO – world malaria day, 2016).

Globally, over 95 countries and territories have on going malaria transmission with estimation of 3.2 billion people at a risk of getting infected. The world health organization (WHO) indicates that 214 million people are infected with malaria world wide and 438.000 cases result in deaths. Children under five are particularly susceptible to malaria illness which kills an estimate of 303.000 before their age of five years globally including 292.000 in the African region. (WHO world malaria report 2016).

According to WHO the malaria prevalence depends on the possible environmental factors related to parasite, vector, the human host and the environment. The transmission is also observed more in places where the life span of the mosquito is longer favoring the parasite to develop completely in a mosquito increasing the transmission and therefore high prevalence of malaria. The climate conditions such as rainfall patterns, temperature and humidity also affect the number and survival of mosquitoes and in many places transmission is seasonal and high always in rainy seasons and immediately after the rainy season. More transmissions and epidemics can occur in people who have little or no immunity to malaria. (WHO world malaria report 2017).

Sub Saharan- Africa continues to carry a high portion on global malaria burden with 90% of malaria cases and 92% of malaria deaths, children being particularly vulnerable accounting for 70% of all the malaria deaths. Malaria remains a major cause of morbidity in children in sub Saharan Africa under the age of 5 years and one child die after every 2 minutes (WHO world malaria report 2015).

As one of the most serious and complex public health problem, malaria is identified as the disease most likely to be affected by climate change and this allows the spread to newer areas together with the prevailing socio-economic conditions. The mean temperature is highly associated with malaria prevalence in Nigeria. (Niringiye and O.G Douglaston 2010).

In Nigeria malaria is still a major public health problem associated with slow economic development and poverty and is the most frequently reported disease at both public and private health facilities in Nigeria. It accounts 30 – 50% of the outpatient visits at health facilities and 15 -20% of in patients or hospital admissions. Malaria accounts for 27.7% of deaths amongst children under the age of five. (MOH, NMCP 2014 – 2020).

Nigeria ranked third in the total number of malaria cases in sub Saharan Africa (WHO Malaria report 2015). Malaria is the leading cause of morbidity in Nigeria with 90 -95%of the population at risk and contributing approximately 13% of the under-five mortality (Daniel Roberts and Glenda Mathews 2016).

Children under five years are most vulnerable to malaria infection as their immunity is not yet developed to fight any disease. (CDC- Global health division for parasitic diseases and malaria, 2012). Statistics from the ministry of health show that malaria is still the leading cause of death in Nigeria accounting for 27% of deaths and that Nigeria has the world’s highest malaria incidence with a rate of 478 cases per 1.000 populations per year. Acceding

In Gusauwere the study area is located, malaria is the most common cause of death in children and the district suffers the highest malaria burden in the country. This creates a reason to find out the prevalence of malaria and the associated factors in children below the age of five years.(malaria consortium, Mbale malaria control project).


1.3 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. According to the records available in Gusau health office, the trend for the last three years indicated that malaria prevalence was at 17,216, in 2014, 17322 in 2015, and 12790 in 2016 both outpatient and inpatient of which 242 deaths were registered.

In Gusau alone 7437 cases were registered in the same period of 3 years. The overall trend indicates that malaria is still a threat in the district and Gusau being one among the affected areas still has a high number of malaria cases being reported in the outpatient department. This therefore verifies that there could be several reasons or factors contributing to the high prevalence of malaria in Gusau health center despite all the efforts that the government has put in place to reduce on the infections.

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.


1.4 Objectives

1.4.1 General Objective

To determine the prevalence of malaria and the associated factors among children under the age of five who attend OPD of Gusau health center 111, Gusau Town council in Gusau during the period of August and September. 2017.

1.4 2. Specific Objectives
  1. To determine the prevalence of malaria among children below five years who attend OPD of Gusau health center III in Gusau town council in Gusau in the months of August and September, 2017.
  2. To identify the care giver factors associated with prevalence of malaria among children below five years who attend OPD of Gusau health center III in Gusau Town council in Gusau in the months of August and September, 2017.
  3. To assess the environmental factors contributing to the prevalence of malaria amongst children below five years who attend OPD of Gusau health center III in Gusau town council in Gusau in the months of August and September, 2017.
  4. To find out the house hold factors associated with prevalence of malaria amongst children below age five who attend OPD of Gusau health center III in Gusau town council in Gusau in the months of August and September, 2017.

1.5 Research Question

  1. What is the prevalence of malaria among children below five years who attend the OPD of Gusau health center III in Gusau town council Gusau?
  2. How does the care giver factor affect the prevalence of malaria prevalence in children less than five years who attend out patients department of Gusau health center III Gusau Town council in Gusau?
  3. What are the environmental factors associated with malaria prevalence in children less than five years who attend in outpatient department of Gusau health center III in Gusau Town council Gusau.
  4. What house hold factors are associated with malaria prevalence in children below five years who attend out patients department of Gusau health center III in Gusau Town council in Gusau?

1.6 Significance of the Study / Justification

Despite the availability of malaria control measures the morbidity and mortality in children under five 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 five 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.


1.7 Scope of the Study

The study was carried out in Gusau health center III situated in Gusau town council. The study aimed at determining the prevalence of malaria and the associated factors which included care taker factors household factors and environmental factors among children below five years who attended in the OPD of Gusau health center III together with their care givers. Health workers were also included in the study for statistical information about malaria prevalence in Gusau health center III


Chapter Six


Conclusions and Recommendations:

6.0 Conclusions

  1. The prevalence of malaria among children below age five was very high with as almost half of the sample size of children were tested positive with a proportion (48.6), negative (51.4).
  2. Knowing that malaria causes loss of energy and loss of appetite were the only caretaker factors that influenced prevalence of malaria.
  3. Source of light was the only household’s factors that significantly influenced prevalence of malaria among children below five years.
  4. Similarly occurrence of malaria among children below five years was significantly influenced by presence or absence of garbage heaps in the home environment.

6.1 Recommendations

The following recommendations can help control high malaria prevalence in among children below five years of age attending Gusau HCIII.

Re-enforcement of communication strategies and information dissemination to change individual and community behavior and attitudes towards the control and prevention of malaria and insist that they should not only have knowledge of the transmission and control but put in practice or implement the acquired knowledge practically both individually and as a community at large. This should be delivered by well and appropriate trained community health workers, VHTs, health unit staffs in the local languages that are most understood and mainly to vulnerable households

Efforts should be made for these care takers to know and understand every sign and symptoms of malaria especially those that significantly contributed to the high prevalence of malaria for example loss of appetite and loss of energy which are serous signs of severe malaria.

The town council administrators should find a way of how to dispose garbage to avoid heaps around the households and also find and strategize a way of involving the entire town council community and the surrounding communities on how to avoid garbage in their households as this is another suitable breeding site for mosquitoes.

The town council authorities should liaise with the district officials to lobby for electrify as a better source of light in the house as variant source of light was seen to be significantly influencing malaria prevalence in children below age of five years.


Comparison Between Microscopy And Rapid Diagnostic Test Among Children Of 0-5 Years At Gusau, Nigeria


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