PREVALENCE OF MALARIA PARASITE IN CHILDREN 1 to 12 YEARS IN UNUBI, ANAMBRA STATE
This study was to determine the prevalence of malaria among children and malaria vectors in Unubi, Anambra state. The study was conducted between the month of July and August. Geimsa thick film and Rapid Diagnostic Test were used to detect malaria parasite in the blood. A total of 200 participants comprising of 86(43.0) males and 114(57.0) females selected from patients referred for malaria tests at health centres in Unubi Participants were aged 1-12 years. The prevalence of malaria in the study area was 27.0% for microscopy and 20.0% for rapid diagnostic test. Males were more infected with a prevalence rate of 15.0% (microscopy) and 9.5% (RDT) while females had a prevalence rate of 12.0% (Microscopy) and 10.5% (RDT). Malaria prevalence in relation to age in the study shows those children within the age of 4 years has the highest prevalence with the least prevalence been those within 8, 9 and 11 years of age. Based on these findings, the government and non-governmental agencies should sustain their efforts in the fight against malaria through an aggressive sensitisation campaign on the preventive measures. Provision of subsidised insecticide treated nets to the most vulnerable especially children and women in the rural communities will help reduce the prevalence for malaria diagnosis. The use of RDT should be encouraged where there is challenge of using microscopy.
TABLE OF CONTENTS
Title Page i
Approval Page iii
Table of Contents vii
List of Figures ix
List of Tables x
1.0 INTRODUCTION 1
CHAPTER TWO 7
LITERATURE REVIEW 7
2.1 Malaria in Children 4
2.1.1 Malaria Burden 7
2.2 Malaria Vectors 12
2.3 Confirmatory Test of Malaria 19
MATERIALS AND METHODS
3.1 Study Area 21
3.2 Design of Study 21
3.3 Sample Population and Size 22
3.4 Permission for the Study 22
3.5 Method of blood collection 22
3.5.1 Use of Rapid Diagnostic Test (RDT) 22
3.5.2 Parasitological method 24
3.5.3 Preparation of Thick Blood film 24
3.5.4 Staining of the Blood Films 24
3.5.5 Examination of blood film 24
3.6 Data Analysis 25
DISCUSSION, CONCLUSION AND RECOMMENDATIONS 30
LIST OF FIGURES
1 The RDT Kit 23
LIST OF TABLES
1 Age more susceptible to Malaria 27
2 Gender more Susceptible to Malaria 26
Malaria is a mosquito-borne infectious disease affecting humans and other animals. It is caused by parasitic protozoans (a group of single-celled microorganisms) belonging to the genus Plasmodium type (WHO, 2014). The disease is most commonly transmitted by an infected female Anopheles mosquito. The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood (WHO, 2014). The parasites travel to the liver where they mature and reproduce. Five species of Plasmodium can infect and spread by humans (Caraballo, 2014) namely, Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae and Plasmodium knowlesi.
Plasmodium infection can cause a wide variety of illnesses, ranging from asymptomatic infection over uncomplicated malaria to severe and complicated disease (Bousema et al., 2014; Galatas et al., 2016 and White, et al., 2014). Owing to the enormous morbidity and mortality of clinical malaria in young children, the epidemiology and consequences of asymptomatic infection in different settings and age-groups has received comparatively little attention. Increasingly, however, the underrated impact of asymptomatic and/or submicroscopic infections is now being recognized (Bousema et al., 2014; Galatas, et al., 2016 and Nankabirwa, 2013). Partial immunity against malaria develops during childhood in endemic regions as a result of repeated exposure. Increasing age has consequently been associated with low and submicroscopic parasite density as well as with asymptomatic infection, particularly among school-age children (Laishram, 2012; Okell, et al., 2015 and Walldorf ,2015). Most of these infections remain undiagnosed and untreated (Laishram, 2012; Walldorf, 2015), and—in the case of schoolchildren—are not subject of targeted interventions.
According to World Malaria Report 2016, there were 212 million new cases of malaria worldwide in 2015 (range 148–304 million). The WHO African Region accounted for most global cases of malaria (90%), followed by the South-East Asia Region (7%) and the Eastern Mediterranean Region (2%) (WHO, 2016). In 2015, there were an estimated 429 000 malaria deaths (range 235 000–639 000) worldwide. Most of these deaths occurred in the African Region (92%), followed by the South-East Asia Region (6%) and the Eastern Mediterranean Region (2%). Between 2010 and 2015. Children under five years of age are particularly susceptible to malaria illness, infection and death. In 2015, malaria killed an estimated 303 000 under-fives globally, including 292 000 in the African Region. Between 2010 and 2015, the malaria mortality rate among children under five fell by an estimated 35%. Nevertheless, malaria remains a major killer of under-fives, claiming the life of one child every two minutes.
Malaria is present in both rural and urban areas of the countries in sub Saharan Africa, though the risk is lower in urban cities (Keiser et al., 2014). Provost (2011) reported that by 2010, countries with the highest death rate per 100,000 populations are Coted’lvoire with 86.15, Angola 56.93 and Burkina Faso 50.66 all in Africa. This is attributed to consistent temperature, high humidity, significant amount of rainfall, along with stagnant waters in which mosquitoes larvae readily mature, providing them with the environment they need for continuous breeding and thick vegetation which prevail in African countries.
Oko et al. (2014) stated that majority of the cases were found in children less than five years old and pregnant women. Christopher et al. (2012) found out that 90% of malaria-related deaths occur in sub-Saharan Africa, with approximately 60% of deaths being young children under the age of five.
The prevalence, intensity and regularity of malaria differ from location to location depending on factors such as rainfall patterns and proximity of human dwelling places to vector breeding sites among others (Onyido et al, 2011). Anopheles gambiae, the principal transmitter of malaria in Nigeria is closely associated with sunlit water collections close to human dwellings while Anopheles funestus another important malaria vector tends to breed more in cool, clear, shaded, permanent water bodies in rural areas relatively undisturbed by man (Onyido et al, 2011). Several studies on the pattern of malaria in Nigeria have been carried out but these were mostly concentrated in urban and sub-urban communities than in rural communities. Hence the rationale to work in Unubi, a rural community
The general objective of this study was to determine the prevalence of malaria among children and malaria vectors in Unubi, Anambra state The specific objectives include;
1. To determine the prevalence of malaria parasite in children 1-12 years in Unubi
2. To compare the use of RDT and microscopy in the determination of malaria parasite. in children 1-12 years in Unubi.