UNDER UTILIZATION OF LONG LASTING INSECTICIDE TREATED NET IN THE PREVENTION OF MALARIA AMONG PREGNANT WOMEN IN OKE_ARO COMMUNITY

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Product Code: 00008860

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ABSTRACT

This project was conducted to investigate the underutilization of Long-last insecticide treated net in the prevention of Malaria among pregnant women in Oke-Aro community. A descriptive study design was use for this research to investigate the underutilization of long last insecticide treated net in the prevention of Malaria among mothers in Oke-Aro community. One hundred and ten (110) structured questionnaires were produced, out of which ten (10) were used for orally interviewed (non-literate respondents). And 100 copies were questionnaires distributed to the literates respondents). The data collected were analyzed and presented using tables and sample percentages. It was revealed that the (48%) of the respondents prefer to sleep under net while 32% said they did not like sleeping under net. The study also shows that 68% of the respondents agreed that antimalarial prophylaxis is not commonly use among pregnant mothers in the prevention of malaria due to the minor side effects like, vomiting, while 32% of the respondent disagreed with the statement. That; it was recommended that pregnant women should always sleep under the net at night even at day in case there is presence of mosquitoes. Also, government needs to also sensitize the community about seeking health care services often.

 

 

 

 

 

 

 

TABLE OF CONTENTS

Title                                                                                                                      Page

Certification                                                                                                             ii  

Dedication                                                                                                               iii

Acknowledge                                                                                                      iv-v

Abstract                                                                                                                  vi                                                

Table of contents                                                                                                vii-viii

List of tables                                                                                                           ix                                                                                               

CHAPTER ONE

1.1     Introduction                                                                                                         1-2

1.2     Background of the study                                                                            2-4

1.3     Statement of the problem                                                                           4

1.4     Aims of the study                                                                                       4

1.5     Objectives of the study                                                                              5

1.6     Significance of the study                                                                           6

1.7     Assumptions                                                                                              6

1.8     Definition of terms                                                                                     6-7

CHAPTER TWO

2.1     Literature review                                                                                      8

2.2     Malaria in pregnancy                                                                               8-10

2.3     Epidemiology                                                                                           10

2.4     Pathophysiology of malaria                                                                     11-12

2.5     Knowledge on malaria transmission and prevention                               12-13

2.6     Symptoms of malaria                                                                               13

2.7     Complications of malaria                                                                         14

2.8     Effectiveness of LLITNS in malaria prevention                                     14-16

2.9     Factors influencing use of ITNS                                                              16-17

2.10   Use of vector control measures                                                                18

2.11   Mosquito net ownership and use                                                             18

CHAPTER THREE

3.0     Research methodology                                                                             19

3.1     Study design                                                                                             19

3.2     Study area                                                                                                 19-20

3.3     Study population                                                                                      20

3.4     Sample size determination                                                                       20

3.5     Sampling technique                                                                                 20

3.6     Study instrument                                                                                      20

3.7     Data collection                                                                                         20

3.8     Data Analysis                                                                                           21

3.9     Ethical consideration                                                                                21

CHAPTER FOUR

4.0     Data presentation and analysis                                                                 22-33

CHAPTER FIVE

5.0     Summary, Discussion of findings, conclusion and recommendation

5.1     Summary                                                                                                 

5.2     Discussion of findings                                                                             34-35

5.3     Conclusion                                                                                               35

5.4     Recommendation                                                                                     36-37

REFERENCE                                                                                         37-40

APPENDIX                                                                                             41

 


 

LIST OF TABLES

Table 1: Age range of the respondents                                                               22

Table ii: Marital status of the respondents                                                         23

Table iii: Educational status of the respondents                                                23

Table iv: Occupation of the respondents                                                            24

Table v: Religion of the respondents                                                                 24

Table vi: Respondents understanding about long lasting insecticide treated net 25

Table vii: Respondents’ major causes of malaria                                              25

Table viii: Respondents’ that prefer sleeping under net                                    26

Table ix: The last time respondents treated for malaria                                     26

Table x: Respondents’ place of treatment                                                          27

Table xi: Respondents’ agreement on whether improper use of mosquito net among pregnant mothers can be due to the fear of the chemical’s side effect used in the treatment of the net                                                                                             27

Table xii: Respondents’ agreement on whether antimalarial prophylaxis is not commonly use among pregnant mothers in the prevention of malaria due to the minor side effects like, vomiting.                                                                   28

Table xiii: Respondents’ agreement on whether traditional medicine can be one of the best malarial preventive measures when used effectively.                          28

Table xiv: Respondents’ use of mosquito treated net in the prevention of malaria 29

Table xv: Respondents’ use of local herbs in the prevention of malaria.        29

Table xvi: Respondents’ clearing of mosquito breeding places.                               30

Table xvii: Respondents’ times of taking antimalarial prophylaxis in prevention of malaria.                                   30

Table xviii: Respondents’ that make home garden with mosquito’s net.      31

Table xix: Respondents understanding about long lasting insecticide treated net 31

Table xx: Respondents’ major causes of malaria                     32

Table xxi: Respondents’ that prefer sleeping under net                    32

Table xxii: Respondents’ use of mosquito treated net in the prevention of malaria 33










CHAPTER ONE


INTRODUCTION 

Malaria is a mosquito-borne infectious disease that affects humans and other animals (Kane, 2015) Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches (Caraballo et al., 2014). In severe cases, it can cause jaundice, seizures, coma, or death. Symptoms usually begin ten to fifteen days after being bitten by an infected mosquito. If not properly treated, people may have recurrences of the disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria. Malaria is caused by single-celled microorganisms of the Plasmodium group. It is spread exclusively through bites of infected Anopheles mosquitoes. The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood. The parasites travel to the liver where they mature and reproduce. Five species of Plasmodium can infect and be spread by humans. Most deaths are caused by P. falciparum, whereas P. vivax, P. ovale, and P. malariae generally cause a milder form of malaria. The species P. knowlesi rarely causes disease in humans (Caraballo et al., 2014).

Insecticide-treated bed nets (ITNs) are a cornerstone of malaria prevention; multiple rigorous studies in sub-Saharan Africa have shown ITNs to be effective in preventing malaria morbidity when used consistently (Alonso et al., 2011).

 ITNs take advantage of the indoor feeding (endophagic) and indoor resting (endophilic) behaviours of some Anopheles mosquitoes and work by repelling and killing or decreasing the life span of mosquitoes, as well as providing a physical barrier between mosquitoes and users (Nevill et al., 2018). In Africa, the primary malaria vectors are from the Anopheles gambiae complex and the Anopheles funestus group, which predominantly bite indoors and when people are sleeping (Huho et al., 2013).


BACKGROUND OF THE STUDY

Malaria is one of the major public health problems with estimated 212 million malaria cases and 429, 000 malaria related death across the globe in 2016. In Africa, access to the tools needed for the prevention and treatment of malaria is still limited to millions of people in need (WHO, 2016). In Cameroon, the Ministry of Public Health through the National Malaria Control Program (NMCP) has put in place a number of strategies to fight this disease. This includes insecticide treated nets (ITNS), free treatment of uncomplicated malaria for children below 5 years of age using Artemisinin-based combination therapies (ACTs), and prompt management of confirmed cases with Artemisinin-based Combination Therapy, intermittent preventive treatment with sulphadoxine-pyrimethamine for pregnant women, environmental hygiene and in-door residual spraying (Fombang foundation, 2012) From 2002 the Cameroon government has conducted many campaigns for the free distribution of ordinary ITNs and long lasting insecticides treated ITNs all over the country (Tchinda et al., 2012). According to the Ministry of Public Health about two million ITNs were distributed between 2005 and 2008, over eight million distributed in 2011 and about twelve million in 2015 as a strategy to significantly reduce the morbidity and mortality burden of malaria in the country (Ngum et al., 2016).

Despite the government’s effort to scale up ITN distribution in Cameroon, full coverage and proper usage may be limited due to the lack of consistent distribution and other issues related to maintenance and replacement of nets, as well as local beliefs and poor understanding of the relationship between mosquitoes and malaria at the community level (Sibhatu,2012) In addition, studies have observed great disparities between ownership versus usage of ITNs. To acquire the anticipated benefits of ITNs, they should be properly and consistently used within households rather than merely owning them. WHO recommends that periodic household surveys should be done to determine whether the populations at risk have sufficient ITNs and whether they are using them properly (WHO,2011). Community and household factors such as discomfort, belief of low mosquito density, inconvenience installing the nets, residence, educational background, age and gender differences are among the frequently reported reasons for not using the acquired ITNs (Moiroux et al.,2012).

The signs and symptoms of malaria illness vary widely. Symptoms of uncomplicated malaria episode include fever, chills, sweats, headache, nausea, vomiting, body ache, and malaise, whereas symptoms of severe clinical episode are organ dependent. Abnormal behavior, seizures, coma, or impairment of consciousness is observed in cerebral malaria. Anemia, jaundice, and hemoglobinuria result from massive destruction of red blood cells. Other severe symptoms include acute respiratory distress, low blood pressure, acute kidney failure, metabolic acidosis, and hypoglycemia. Conventional diagnosis is based on examination of thin and thick blood films stained with Giemsa's or Field's stain. The antigen-based dipstick tests known as “Rapid Diagnostic Tests” (RDTs) offer a useful alternative to microscopy in situations where reliable microscopic diagnosis is not available. PCR-based diagnostic tests for human malarias are more applicable to large-scale surveys than to clinical diagnosis. In addition to the human cost, the economic burden of malaria is vast. It is estimated that malaria costs African countries more than US $12 billion every year in direct losses (Morgan, 2018). This figure includes the costs of healthcare, absenteeism, days lost in education, decreased productivity due to brain damage from cerebral malaria, and loss of investment and tourism.  Certain countries that managed to completely eliminate malaria in recent times have had more rapid economic growth than their neighbors (Gallup et al.,2001).

STATEMENT OF THE PROBLEM

Malaria has been an endemic disease in Africa especially in Nigeria and it has been claiming the lives of many people including pregnant women. Malaria in pregnancy occur due to the bite of infected female anopheles’ mosquitoes. Long last insecticide treated net is used for the prevention of mosquito bite. Yet many pregnant mothers do not make use of it, despite the fact that it is giving out for free. So, this project aimed to investigate the irregular use of Long last insecticide treated net in the prevention of malaria in Oke-Aro community, Akure.

AIM OF THE STUDY

The aim of this study is to investigate the irregular use of Long last insecticide treated net in the prevention of Malaria in Oke-Aro community, Akure.

OBJECTIVES OF THE STUDY

The objectives of this study are to;

v Investigate the level of irregular use of Long last insecticide treated net in Oke-Aro Community

v Examine causes of the attitudes towards the use of Long-lasting insecticide treated net in the study area

v Sensitise the pregnant and lactating mothers on the benefit of efficacy or use tasty investigative

SIGNIFICANCE OF THE STUDY

This study will help to correct the wrong attitudes towards Long lasting insecticide treated net. It will also help to reduce the incidence of Malaria thereby reduce mortality rate as a result of Malaria. This study will also help to increase the knowledge of the respondents about the importance of Long-lasting insecticide treated net. This study will also serve as base line knowledge for other researchers.

ASSUMPTIONS

v People assumed that Long lasting insecticide treated net is their right some therefore abuse it.

v Some people prefer sleeping without using Long lasting insecticide treated net claiming that it will interrupt their sleeping.

v Some people prefer to used it for catching fish rather than using it for its main purpose.

DEFINITION OF TERMS

Acidosis: an excessively acid condition of the body fluids or tissues.

 

Anemia: a condition in which there is a deficiency of red cells or of hemoglobin in the blood, resulting in pallor and weariness.

 

Anopheles mosquito: Is a mosquito of a genus which is particularly common in warmer countries and includes the mosquitoes that transmit the malarial parasite to humans.

Endophagic mosquito: is a mosquito that feeds indoors.

 

Fever: is an abnormally high body temperature, usually accompanied by shivering, headache, and in severe instances, delirium.

Hemoglobinuria: The abnormal presence of hemoglobin in the urine 

Hypoglycemic: is the deficiency of glucose in the bloodstream.

Jaundice: A medical condition with yellowing of the skin or whites of the eyes, arising from excess of the pigment bilirubin and typically caused by obstruction of the bile duct, by liver disease, or by excessive breakdown of red blood cells.

Nausea: is a feeling of sickness with an inclination to vomit.

 

Seizure: is a sudden, uncontrolled electrical disturbance in the brain.


 

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