This research work was carried out to investigate the factors influencing the prevalence of malaria among children of 1-5years in Odode community, Idanre local government, Ondo state. A descriptive study design was used. The data for this study was gotten through sampling techniques with the distribution of questionnaires to selected mothers and care givers. One Hundred and Fifty (150) questionnaires were distributed; One Hundred and Thirty (130) questionnaires were recovered and analyzed. After the analysis of this work, it was seen that the use of LLINs and Daraprim, Sulfadoxine / pyrimathamine are very effective in the prevention of malaria and reduce the factors that influence the prevalence of malaria which majority of the respondent are aware of. At the end of the project, recommendation were made to mothers, health workers and government on the prevention and management of factors that influence the prevalence of malaria, a threat to public health.
CHAPTER ONE
INTRODUCTION
Malaria is an acute febrile illness caused by plasmodium parasites, which are spread to people through the bites of infected female anopheles mosquitoes. (WHO, 2021). Malaria is a human disease that is caused by sporozoan parasites (genus plasmodium) in the red blood cells, is transmitted by the bite of anopheline mosquitoes, and is characterized by periodic attacks of chill and fever (Merriam-webster dictionary).
Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female anopheles mosquitoes. It is preventable and curable (WHO,2020).
Malaria is caused by infection with sporozoa of the germs plasmodium, transmitted by the bite of an infected female anopheles mosquito. Four species of plasmodium are responsible for malaria infection, viz: P. Falciparum, P. Malarie, P. Ovale, P. Vivax (Oladipo,2012).
Malaria is responsible for mortality in almost one third (1/3rd) of children under 5years and associated with one tenth (1/10th) of maternal deaths in Nigeria (Dessai et.al. 2017). About 300,000 children die of malaria annually while an estimated 4,500pregnant women are lost on account of malaria (Salawu et,al.,2016).
Malaria remains an important cause of morbidity and mortality in Nigeria. Nigeria accounts for 32% of the global estimate of 655,000malaria deaths annually in 2010(WMR, 2012) with an estimated population of 160million.Nigeria has a large population at risk of malaria. However, children under 5 years of age and pregnant women are the most vulnerable to illness and death from malaria infection in Nigeria (National Malaria Strategic Plan 2014-2020).
The clinical diagnosis of malaria is usually based on the patients’ signs and symptoms which include:
Fever
Headache
Nausea and vomiting
Anorexia(loss of appetite )
Rigor
Muscle pains
General joint and body pain (Ilegbusi, 2020).
The above symptoms are also associated with other disease which makes early diagnosis difficult leading to delay in the commencement of treatment but with the Rapid Diagnostic Test (RDT), diagnosis and treatment of malaria even in the remotest part of the world is easy.
Also in the management of malaria, the State government gave financial support in the mass distribution of Long Lasting Insecticidal Treated Nets (LLINs). Likewise, the introduction of Abiye-safe-mother-hood initiative where free antimalaria drugs (ACTs) were given to children under 5years of age to replace the use of chloroquine in the health system (Adeleye,2016).
Over the last 2decades, expanded access to WHO- recommended malaria prevention tools and strategies – including effective vector control and the use of preventive anti malaria drugs- has had a major impact in reducing the global burden of the disease (WHO,2022).
The types of medication and length of treatment may vary, depending on:
The type of plasmodium that caused malaria
How severe the symptoms are
Where the person caught malaria
If they took anti malarial drugs before
If the person is pregnant.
Additionally, people who develop complications may need a combination of medications (Peter, 2022).
A clinical diagnosis of malaria is still challenging because of the non specific nature of the signs and symptoms, which overlaps considerably with other common disease, as well as potentially life-threatening diseases e.g. common viral or bacterial infections, and other febrile illnesses.
The overlapping of malaria symptoms with other tropical diseases impairs diagnostic specificity, which can promote the indiscriminate use of anti-malarias and compromise the quality of care for patients with non- malarial fever in endemic areas (Korean, 2009).
The world health organization coordinated the production of guidelines for the management of severe and complicated malaria in 1990 and again in 2000, which also contain strict definitions of severe malaria, useful for standardizing clinical research.
More recently, in 2006, WHO published evidence based guidelines for the treatment of malaria, which includes extensive advice on the management of severe malaria as well as clinically useful distillation of the WHO severe malaria definitions. Unfortunately, the clinical evidence base on which to base guidelines is small, as most of the clinical trials on severe malaria management have been either negative, under powered or both. (Nicholas, 2007).
On the 14th April, 2021, Nigeria launched the implementation of the Global fund 2021-2023 malaria grant towards support to the elimination of the disease and for building resilient sustainable system for health across the country (WHO, 2021).
BACKGROUND OF THE STUDY
According to WHO latest world malaria report, there were an estimated 241million malaria cases and 627,000 malaria deaths worldwide in 2020. This presents about 14million more cases in 2020 compared to 2019, and 69,000more deaths (WHO,2021).
Malaria is an endemic in Nigeria with all year transmission and 97% of the population at risk. Plasmodium falciparum is the predominant parasite species. Mainly transmitted by anopheles ss. An funestus and An. arabiensis. prior to 2010, available data was insufficient to clearly micro stratify the country’s malaria epidemiological profile. However, the 2010 Nigeria indicators survey (NMIS), revealed that malaria parasite prevalence is still high with an average parasite prevalence of 42% among children of under 5years of age with zonal variations ranging from 27.6% in the south-east to 50.3% in the south-west zone.
The new causes of death methodology was applied to 32countries in sub-saharan Africa that shoulder about 93% of all malaria death globally (WHO,2021).
Nigeria is known for high prevalence of malaria and it is a leading cause of morbidity and mortality in the country. Available records shows that at least 50% of the population suffers from at least one episode of malaria each year and malaria account over 45% of all outpatient visits. The disease account for 25% of infant mortality and 30% of childhood mortality in Nigeria. Therefore, it imposes great burden on the country in terms of pain and trauma suffered by its victims as well as loss in outputs and cost of treatment (Jimoh et.al., 2007).
Nigerians spend over 300billlion annually on malaria treatment (Olatunji,2 020). Children aged under 5years are the most vulnerable group affected by malaria in 2018, they accounted for 67% (272,000) of all malaria death worldwide (WHO, 2019). Over the years, increase in population, rainfall fluctuation and urban heat cum, high thermal discomfort that has been experience recently and other factors have contributed to the increase in malaria morbidity. Malaria cases increased from 24,092 ( of which male and female) accounted for 12,477 and 30,413 respectively to 11,615 and 31,708 respectively in the year 2002 and 2008 in Ondo state (Ayeni,2011). While in Odode Idanre, the study location 85% of the outpatient clients are often diagnosed with malaria culled from the outpatient register.
STATEMENT OF THE PROBLEM
Despite the current trend in Arthemsin Combined Therapy, use of LLINs etc in the prevention, management and control of malaria, it was observed during my community urban posting, that cases of malaria are still on the increase. Thus the need to look into the factor influencing the prevalence of malaria among children of 1-5years a vis malaria.
OBJECTIVES OF THE STUDY
To identify the factors influencing the prevalence of malaria among children of 1-5years in Odode Idanre
To intensify effort in health educating parents and caregivers on the factors of the current trend in the prevention, management and control of malaria especially among the under-five (5) years.
SIGNIFICANCE OF THE STUDY
This study is set to investigate the factors influencing the prevalence of malaria among children of 1-5years.
ASSUMPTIONS
It is often assumed that malaria is caused by stress and not mosquito bite
People believe that walking in sun is the causes of malaria
Chloroquine is still better and more effective than ACT
People believe that paracetamol do cure malaria permanently.
DEFINITION OF TERMS
Malaria: A serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans
Factors: A circumstance that contributes to a result
Influence: The capacity to have an effect or the effect itself
Prevalence: The total number of people in a population who have the disease (both new and old cases) at a given point in time.
Child: A young human being below the age of puberty or below the legal age of majority
Disease: This is an abnormal deviation from normal state of health of an individual.
Infection: This is the invasion and multiplication of micro organism such as bacteria, viruses and parasite that are not normally present within the body.
Parasite: An organism that lives on or in another organism deriving benefit from the without contributing any benefit to the host but harming it.
Mortality: The death rate of a population
Morbidity: The condition of suffering from a disease or medical condition
Endemic: The constant presence of case of a disease or infection agent within a given community or area.
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