Social And Environmental Determinants Of Prevalence Of Malaria In Umudibia Nekede, Owerri West Local Government Area, Imo State
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This thesis is dedicated to the Almighty God, my husband and my children.
I wish to acknowledge the efforts of my supervisor, Prof. B. E. B. Nwoke for supervising this work. My special thanks go to Dr. A. A. Amaechi who painstakingly read through this work, made corrections and constructive criticisms, and for all his encouragements through thick and thin. I am sincerely grateful, Sir.
I am also grateful to my Head of Department, Assoc. Prof. C. M. U. Ajaero for all his encouragement. To my Head of Department Emeritus, Prof. C. N. Ukaga, I wish to say thank you for all your motherly advice and encouragement throughout this programme. My knowing has taken me to greater height. I would not fail to appreciate all my lecturers, Prof. Keke, Prof P. I. Onyeka, Dr. Mrs. Ogoamaka, Dr. Mrs. C. Ikpeama and Dr. Mrs. M. Ezike.
I am most indebted to my heartthrob, Mr. Chris Ononogbo for his consistent encouragement and support, both morally and financially; who gingered me on to work assiduously to make sure that this dream is actualized. To my lovely children, Chidera, Onyinyechi, Ugochi, Chinwendu, Chizaram and Chiziterem, am most grateful. To my siblings, I say thank you.
My thanks also goes to Nwakire Chibuike and all the other laboratory technicians for their wonderful assistance and co-operation. To all the families and individuals who agreed to serve as the subjects for this research, I am grateful. Mr. Emma Okpara, who took the pains of typesetting this work, I am grateful. Evang. Ifeanyi Okoroafor and L/R Chibueze, Iheanacho, thanks for all your prayers.
Above all, I am grateful to God Almighty who made it possible for me to withstand the rigors in the production of this work.
The present study on social and environmental determinants of prevalence of malaria was carried out in Umudibia Nekede, Owerri West local Government area of Imo state between May and September, 2017. Researched structured questionnaire and in-depth interview were used to get personal data of participants.
Blood samples were obtained from 400 consented participants from the four zones in Umudibia. mRDT and blood film examination using rapid Giemsa staining techniques were used to detect presence of malaria parasite. Only Plasmodium falciparum was sought for as the mRDT kit was only specific for the species.
The age group 1-10 years had the highest malaria prevalence of 28.6% while the age group 21-30 had the least prevalence of 18.8%. (Not yet complete).
Table Of Contents
- Content page
- Title page i
- Declaration ii
- Certification iii
- Approval page iv
- Dedication v
- Acknowledgements vi
- Abstract vii
- Table of contents viii
- List of figures
- List of plates
- List of Appendices
- 1.0 Introduction and Literature Review
- 1.1 Introduction
- 1.2 Aim and objectives of the study
- 1.3 Justification of the study
- 1.4 Literature review
- 1.5 History of malaria
- 1.6 Malaria Disease and burden
- 1.7 Mode of Transmission
- 1.8 Life cycle of malaria parasite
- 1.9 Vectors of malaria
- 1.10 Pathological aspect
- 1.11 Diagnosis
- 1.12 Control and prevention
- 2.0 materials and methods
- 2.1 Study area
- 2.2 Ethical consideration
- 2.3 Study population
- 2.4 Sample collection
- 3.0 Results
- 4.0 Discussions
- 4.1 Recommendations
- List of figures
Malaria has continued to be a major public health problem in the World today despite concerted efforts aimed at its control and elimination. The organism that causes the illness (Plasmodium) spends parts of its life cycle in the mosquito and the other in man (Gupta and Ghai, 2007). Malaria portends a serious present and future global concern. It is present in over one hundred countries worldwide and responsible for over 100 million clinical cases and an estimated 1-2 million deaths annually.
However, the burden of mortality and morbidity is worse in poor countries and amongst the most disadvantaged in these countries. The World Health Organization (WHO) suggests that Africa bear almost 90% of the global burden of malaria. Nigeria, due to its population of over 160 million people bears the largest share of the burden (300, 000 malaria related deaths annually, especially in children under 5 years). Nigeria with three other countries, suffer about 50% of global malaria mortality (WHO, 2012; 2010).
The last couple of decades, especially the 1950s onward, have witnessed unprecedented global interest and efforts towards eradication of malaria (Stratton et al., 2008). Programs such as the Roll Back Malaria Initiative (RBM) and the Multilateral Initiative on Malaria (MIM) have seen international donor organizations (public and private) spend millions of dollars on malaria eradication programs (Williams and Jones, 2004). Unfortunately, the results have not been completely positive. Today, despite decades of concerted global efforts, malaria related mortality is higher than half a century ago (WHO, 2010). Malaria has become the most important vector borne disease in Africa.
Today, scholars are arguing that the growing malaria epidemic in some African countries rest partly on the social, cultural and environmental factors peculiar to these countries that are often ignored in the design and implementation of malaria interventions (Jombo et al., 2010). There is a growing consensus that for interventions to succeed, they must focus on the fundamental causes of malaria by addressing the socio-cultural, behavioural and environmental dimensions of risks driving the malaria epidemic (WHO, 2012; 2010).
Many variables have been found to affect malaria transmission in addition to climatic changes. These are environmental modification (e.g., deforestation, increases in irrigation, blocked swamp drainage), population growth, limited access to health care systems, and lack of or unsuccessful malaria control measures (Patz and Lindsay, 1999). Most of the studies, however, do not take into account all of the factors that are related to malaria transmission.
Although malaria is one of the most climate-sensitive vector-borne diseases (Morse, 1995), several other factors have been identified as contributing to its emergence and spread. These include environmental and socio-economic change, deterioration of health care and food production systems, and the modification of microbial/vector adaptation (McMichael et al., 1998; Morse, 1995; Epstein, 1992).
1.2 Justification Of Study
Malaria is a serious problem in Africa where one in every five (20%) childhood deaths ids due to the effects of the disease (Sachs and Malaney, 2002). There were an estimated 216 million episodes of malaria in 2010, of which approximately 81% or 174 million cases were in African Region.
The control of malaria involves three living beings (man, mosquito and larva) and their environment. Man is highly mobile and able to facilitate the spread of the disease far and wide mosquitoes are moving and highly adaptable (Najera and Zaim, 2003). Eggs and larvae are highly adaptable to various environmental situations.
This interrelationship of the various living beings sustaining the burden of malaria can be described as malaria chain. Thus, malaria control involves measures that are deployed to disrupt the chain in order to reduce malaria burden to a point where it is not of public health importance. Makuola et al., 2014).
Effective malaria control must leverage on the various opportunities to interrupt the critical challenge of man, mosquito and larva. Since the year 2000, great progress has been made in tackling the disease, with massive campaigns to distribute insecticide-treated mosquito bed nets, to spraying homes with insecticide to kill adult mosquitoes and use of drugs for disease prevention and treatment (all targeted towards man as host and mosquitoes) have been the focus of malaria control efforts.
These strategies have helped reduce global malaria mortality by a quarter in the past decade. However, this success is now threatened by resistance to drugs and chemicals in the malaria parasite and its mosquito carriers, which could render insecticide treated bed nets, indoor residual spraying and widely available drugs less effective.
The environmental dimensions of malaria chain as regarding egg and larval reduction through larviciding is not very prominent in discussions on malaria control. In addition, the impact of environmental factors, while generally acknowledged, has not been properly researched in Nigeria, especially in the Eastern part of the country, and Imo state, in particular, as is evident in very few publications on this area.
The absence of such knowledge among the inhabitants of the study may have contributed to their inability to prevent malaria transmission and thus increase disease prevalence. This dearth of research in this area thus makes it imperative for further research to be made in order to create awareness. This will in turn help to reduce the incidence of infection on the part of the populace
1.3 Aims And Objectives Of The Study
The main aim of this study is to investigate the social and environmental determinants of malaria in Umudibia, Nekede, Owerri-West, L. G. A, Imo State.
1.3.2 Specific Objectives Are;
- To ascertain the overall malaria prevalence/status in the study area.
- To determine the relationship between socio-demographic characteristics and malaria status in the area.
- To ascertain the relationship between social and environmental factors and malaria status in the area.
- To determine the relationship between housing characteristics and malaria status.
- To ascertain the relationship between malaria status, environmental factors and level of awareness.
1.4 Research Questions
- What is the overall malaria prevalence/status in the study area?
- What is the relationship between the socio-demographic characteristics and malaria status in the study area?
- What is the relationship between social and environmental factors and malaria status in the area?
- What is the relationship between housing characteristics and malaria status in the area?
- What is the relationship between malaria status, environmental factors and level of awareness?
1.5 Research Hypothesis
- H0: There is no significant relationship in the overall malaria prevalence/status in the study area.
Ha: There is significant relationship in the overall malaria prevalence/status in the study area.
- H0: There is no significant relationship between demographic characteristics and malaria prevalence in Umudibia, Nekede.
H0: There is significant relationship between demographic characteristics and malaria prevalence in Umudibia Nekede
- H0: There is no significant relationship between social and environmental factors and malaria status in the area.
Ha: There is significant relationship between social and environmental determinants and malaria status in the area.
- H0: There is no significant relationship between housing characteristics and malaria status in the area.
Ha: There is significant relationship between housing characteristics and malaria status in the area.
- H0: There is no significant relationship between malaria status, environmental factors and level of awareness.
H4: There is significant relationship between malaria status, environmental factors and the level of awareness.
1.6 Literature Review
Malaria is a mosquito-borne infectious disease of humans caused by eukaryotic protists of the genus Plasmodium (Phylum Apicomplexa). In humans, malaria is largely caused by P. falciparum, P. malariae, P. ovale, and P. vivax. Fong et al., (1971) and Singh et al., (2004) noted a fifth species, Plasmodium knowlesi, a zoonosis that causes malaria in macaques but can also infect human. Plasmodium falciparum is the most common cause of infection and is responsible for about 80% of all malaria cases, and is responsible for about 90% of the deaths from malaria (Mendis et al, 2001). Malaria caused by Plasmodium vivax, Plasmodium ovale and Plasmodium malariae is generally a milder disease that is rarely fatal.
These four major species causing human malaria differ morphologically, immunologically, in geographical distribution relapse pattern and in drug response.
- Plasmodium vivax, which is synonymous with Haemamoeba vivax, is the cause of vivax or benign tertian malaria. It is the most common malaria is more common in the Americas and Asia than in the tropical region.
- Plasmodium ovale is the cause of ovale malaria or ovale tertian. It is the least common malaria parasite of man and restricted to West Africa, principally on the West coast. Ovale malaria produces a mild illness.
- Plasmodium malariae is the cause of malariae or quartan malaria. It is found in isolated places scattered across the globe such as tropical Africa, Burma, Sir Lanka, and some parts of India. Though it cause severe fever, quartan malaria is usually not life threatening.
- Plasmodium falciparum is the cause of malignant sub-tertian or falciparum malaria. The specific name “falciparum” was derived by Welch from “falx” (sickle or crescent) and “parere” (P. falciparum is the cause of the most severe, often fatal form of the disease. It remains almost unchallenged as one of the greatest killers of human race over most part of tropical Africa and elsewhere in the tropics. In the past, Plasmodium falciparum used to be common in the southern United States of America and along the Mediterranean shores but now it is rare in these areas following malaria eradication programmes. (Beaver et al., 1984).
Malaria is widespread in tropical and subtropical regions, including much of Sub-Saharan Africa, Asia and the Americas. The disease results from the multiplication of malaria parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases progressing to coma, and death. Each year, Philips (2010) reported that there are more than 225 million cases of malaria, killing around 781,000 people each year.
The majority of deaths according to Snow (2005) are young children in sub-Saharan Africa. Ninety percent of malaria-related deaths occur in sub-Saharan Africa. Malaria is commonly associated with poverty, and can indeed be a cause of poverty (Institute for the Study of Labor, 2008), as well a major hindrance to economic development.
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How to nail it on the head during your project defence
You are through with writing that project. Now what?
You have found yourself at that point where you have to defend what you have written. Of course you have to stand in front of your supervisor and other literary personalities to prove that you know what you wrote in your project paper. Unfortunately, the more you think about it, the more it looks like you are about to face a legion. It is not a war. But the emotion of dread welling up inside of you makes it look like one. So now you are asking yourself questions.
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You really want to nail it, but you need to come to terms with exactly how to get everything in perfect control. Especially your emotions of fear that seem to make a wreck of you every time you think about public speaking.
So here is the deal. I want to help you avoid that feeling that would ruin your precious moment if you dare to let it. And we are going to do it together.
I am going to highlight some very important tips to help you get in control for you to be comfortable enough to move from that feeling of DREAD to CONFIDENT; and making an awesome Impression for that great rating your supervisors should be giving to you so freely.
Consider these tips as you prepare for your defence. We will be taking them one after the other so here we go.
Watch Your Body Language And Keep It Confident:
Can you tell that a person is falling apart if they look confident? … If I can second guess you rightly, am sure you answered no to that question. Remind yourself that you need to come out that way. Now this might seem like a huge big deal when you are dealing with the foreboding. Maintaining a poise of confidence is very important. So find your most comfortable position, sitting or standing and draw up your body. You must exude confidence. It is something you need to do for yourself. People can only see what you allow your body language to show. So you must endeavour to put that out. Remember the story of David and Goliath? … At the end of your defence day, you want to be David.
Dress In Your Most Comfortable And Impressive:
Am sure this one is a no brainer. However I must highlight that you choose comfortable pieces. You don’t want to look so good and yet look like you were forced to wear something that does not belong to you. It’s great to ensure that as impressive as your clothes are on you, that they are also very comfortable.
Speak With Authority:
Going hand to hand with that aura of confidence is your most powerful asset:your words. If you look that confident, your words must not come out like whimpers. To be able to pull this off, you definitely need to speak as deliberately as possible in expressing yourself. Let them also hear what they see.
Use, Your Gestures:
I have often found this to come to my rescue in dealing with shyness and conveying my confidence. Usually it gives you an edge to also drive home your point. You must, however, ensure that you do not over use it. It doesn’t mean that your hands should be flying all over the place. That would be absolutely unnecessary. If you do this well, after a while you will realize that you are not as self-conscious as you used to be at the very start. For most situations, it would have completely disappeared altogether; leaving a really confident you talking.
Have A Good Opening And Closing Line:
Make sure you have perfected a good opening line. You should also be armed with a good closing line too. Try and rehearse it to a friend. If for the first time you presented it, your friend does not say “wow, that’s beautiful” or something like that; just know you need to keep refining it until you get the perfect line. Both opening and closing lines will go a long way in how impressed your panel gets to rate you high.
Make Sure You Know Your Work:
Certainly you should understand how important it is to know your own work from start to finish. Not having in-depth knowledge of your own work is tantamount to a suicide mission. Why should you kill yourself?
When all is said and done, this is what you came to defend in the first place. You should know your work from A to Z.
Prepare For The Questions:
Now this part is truly essential. You must be sure you do not floor all the good work you did on your presentation by not answering correctly. You must pay attention to the questions you are asked to be sure you will give the right answer. Many people get it wrong at this stage and spoil their good presentation. When you do not understand any question do endeavour to ask the person to expatiate what they mean before you answer.
These tips are by no means exhaustive, but applying these tips will give you some necessary advantage you need for a great outcome. Of course that outcome would mean that you eventually earn all your points on this project.
The structure of a good project work
Undergraduate projects in Nigeria is a prerequisite for graduation amongst Nigerian tertiary students who will which to obtain bachelors degree in their respective courses of study such as accounting, banking and finance, business administration and a host of others. Writing an undergraduate project in Nigeria for final year students entails a lot both financially and otherwise. Being able to develop any final year project depends on getting a researchable topic whether it is Accounting Undergraduate project topics, Banking and Finance research topics or banking and finance project topics and materials and it all requires diligent hard work of students who are willing to develop best undergraduate projects in Nigeria and graduate in flying colors.
A typical Undergraduate project in Nigerian tertiary institutions can be said to be divided into five or six chapters depending on the format of the school and course of study which are
The introduction of an undergraduate project states the main research problem and research argument. What precisely the study is all about and why it is important. It looks at the originality of the research work and how it will fill the gap in other studies. Justification for a research undergraduate topic should not be lengthy before it has been explicitly stated.
Below are the contents in chapter one of an undergraduate research project which includes;
- Background of the study,
- Statement of the problem,
- Objectives or aims of the study,
- The research questions,
- Research hypothesis,
- Significance of the study,
- Scope of the study,
- Limitations of the study and
- Operational definition of terms.
2. Literature review
Literature review of any undergraduate research work, be it business administration project topics or Economics project topics just to mention a few is very critical to securing a high grade in one’s project work. The literature review of a research process uncovers what other writers have written about the student’s topic. A student’s undergraduate research work should include a discussion or review of what is known about the subject and how that knowledge was acquired. The review could conclude with a brief summary of the literature and its implications. The contents of the literature review are the theoretical review, conceptual framework, empirical review and summary of literature review.
3. Research Methodology
This section includes a description of the research methods used in the undergraduate research work such as the sample size, data collection methods, measurement instruments, research data analysis procedures and the population from which the sample was selected. This section also describes the method used in selecting the sample or samples, validation and reliability of the instruments used in the research work. There are different research statistical techniques used in undergraduate research work such as SPSS, e-views etc.
4. Results & Discussion
This section presents and discusses the data analysis results used in an undergraduate research work, the results of each analysis is being summarized, tabulated, and then discussed for each research question. Then for each research hypothesis, the statistical test of significance selected and applied to the data is briefly described, followed by a statement indicating whether the hypothesis was supported or not supported. In presenting the result analyses/summary in an undergraduate project tables and figures and or graph are used to add clarity to the presentation.
5. Summary, Conclusions And Recommendations
This section summarizes the findings of the study in an easy to understand manner. It also explains the practical implications of those findings, and points to recommended directions for future research in that area.
This is where every source cited in the undergraduate research work is being included. Every undergraduate research work must be properly referenced for its authenticity.
Choosing A Good Project / Research Topic
Students in Nigerian universities these days wish to choose a very simple project topic/material. There is no issue choosing a simple project topic; the only problem is your ability to choose a good project or research topic that your supervisor will easily approve for you.
Most project supervisors really want to see how good his or her project student understands his or her surrounding through the kind of topic he or she chooses for their project work.
There are some project topic that are not reject-able; for instance in Nigeria of today; what do you think is the major issue on ground now?
If a project student can choose or craft a topic on the effect of dollar increment on the economy of Nigeria. Such project topic will be very interesting to write on.
Now what are the qualities of a good project topic?
- The materials for the project topic must be easily assessable.
- The project topic itself must be meaningful.
- The variables must be able to give a clear aim of the project topic.
What do I mean by variable?
Well I am deriving my point from the area of ; the variables here are those main words in the project topic.
Like the above project topic; the effect of dollar increment on the economy of Nigeria. You can see the main variables that really define this project topic are:dollar, increment and economy.
Before you present your topic to your project supervisor, first of all understand your project topic, and then secondly try to do some research for your topic to see if at least you can get up to 60% of what you need to write the complete project.
I said that above because you might have a very nice topic that the materials are not available online and there are no books as regard the topic; in this case the project topic becomes difficult for you even though the topic is catchy.
What do I mean by your topic being assessable?
Well what I mean is very simple and easy to understand. Simply pick your project topic, type it on google and see if you will have at least a good background for the topic you are writing on.
If you can have a good background for your project topic and you can understand the problem associated with the project topic, then I believe the aim of the project is not far-fetched.