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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