FEVER AS A PREDICTOR FOR MALARIA INFECTION AMONG INDIVIDUALS ATTENDING KOFAI PHCC IN  ARDO-KOLA LGA TARABA STATE

ABSTRACT

This study was carried out on fever as a predictor for malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State. To achieve this 4 research questions were formulated. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of selected staff and patients in kofai phcc, Ardo-Kola LGA Taraba State. In determining the sample size, the researcher conveniently selected 77 residents while 60 were returned and validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using standard deviation. The result of the findings reveals that the major causes of malaria among adults in Nigeria include; Mosquito bites, Temperature and precipitation, Malaria vectors, Pollutants, Blood Transfusion and Immune System Deficiency.

In regard to the findings, the study recommends that Non-governmental organizations (NGO) should fully participate in enlightenment campaign in the locality and cleaning of roads, gutters and drainages should be encouraged to stop the spread of malaria. Further more, adults should endeavor to use insecticides in their houses to prevent the bite of mosquitoes.

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF STUDY

Malaria is a life threatening parasitic disease transmitted by female Anopheles mosquitoes. In Nigeria, malaria is responsible for around 60% of the out-patient visits to health facilities, 30% of childhood death, 25% of death in children under one year and 11% of maternal deaths (National Population Commission, 2008; Noland et al., 2014). Similarly, about 70% of pregnant women suffer from malaria, which contributes to maternal anemia, low birth weight, still births, abortions and other pregnancy-related complications (Federal Ministry of Health Abuja, 2005).

Presently, malaria remains one of the worst menaces of tropical countries of the world. It is a killer and debilitating disease that affects the physical and economic well-being of people living in endemic areas of Africa (WHO, 2008). Pregnant women are among those in the higher risk group (Okwa, 2003). Recent global estimate shows that there are between 300 – 500million clinical cases of malaria and between 1.50 – 2.70million deaths attributed to malaria annually (Greenwood, 2005). Pregnant women are at immense risk of malaria due to natural immune depression in pregnancy (Fievet, 2008). Hence, it is one of the most important health issues affecting pregnant women as it has a risk of jeopardizing the life of the woman or the fetus (WHO, 2010).

Malaria has been the focus of multiple declarations, and a range of targets have been set since the beginning of the millennium (WHO, 2015). In Africa`s malaria endemic countries, an average of 30% of all outpatient clinic visits are for malaria (Roll Back Malaria, 2008). In these same countries, between 20% and 50% of all hospital admissions are a consequence of malaria (Roll Back Malaria Partnership, 2013). With high case-fatality rates due to late presentation, inadequate management, and unavailability or stock-outs of effective drugs, malaria is also a major contributor to deaths among hospital inpatients in Africa (Roll Back Malaria Partnership, 2013). People are at increased risk both of becoming infected with malaria and of becoming infected more frequently (Roll Back Malaria Partnership, 2013). Families live in dwellings that offer little protection against mosquitoes and are reluctant towards affording insecticide-treated nets etc (Roll Back Malaria, 2011).

The population at high risk of malaria incidence in Nigeria is estimated at 135,552,389 (WHO, 2015). The countrys’ confirmed and suspected cases of Malaria incidence as at 2015, stood at 19,555,575 people (WHO, 2015), with adults accounting for over 28% of the victims. Among vector borne diseases, the malaria is influenced by seasonal or spatial changes in the environment (Messina et al., 2011). Environmental factors such as the presence of bushes and stagnant water around homes, rainfall, low altitude and high temperatures favor the breeding of malaria vectors, as well as parasite reproduction within them (Messina et al., 2011). Malaria has, therefore, been defined as an environmental disease (Hay et al., 2000). The key to addressing the challenge of reducing malaria parasite prevalence is an integrated approach that combines preventative measures, such as Insecticide Treated bed Nets (ITNs), Indoor Residual Spraying (IRS), improved access to effective anti-malarial drugs (Kokwaro, 2009), as well as proper environmental management. Climate has been established as an important determinant in the distribution of vectors and pathogens (Odetoyinbo, 1969). Tropical areas including Nigeria have the best combination of adequate rainfall, temperature and humidity allowing for breeding and survival of anopheles mosquitoes (Efe and Ojoh, 2013). An increase in rainfall and temperature enhances mosquito development and improved breeding sites leading to incidence of malaria (Vincent and Sunday, 2015). Rainfall provides the breeding sites for mosquitoes and increases relative humidity necessary for mosquito survival, leading to increase in the number of mosquitoes biting an individual per unit time (Lindsay and Martens, 1998). An adult mosquito`s chance of survivorship is determined by the ambient temperature, humidity and rainfall. Warmer ambient temperatures shorten the duration of the extrinsic cycle, thus increasing the chances of transmission (Jackson and Yang, 2010). Malaria pandemic alone has caught the attention of both the local authorities and international agencies. Several measures have been adopted to reduce the rate of morbidity due to malaria. It is believed that climatic parameters had changed significantly over the past two/three decades (Akinbobola and Oluleye, 2010). Hence, a deeper knowledge of environmental variables, conducive to mosquito vector life cycle, is important to target control interventions most importantly among adults. Modeling environmental variables are very valuable in defining foci of malaria transmission. The development of spatial analytical techniques has created an avenue to evaluate environmental variables that are generated by remote sensing satellite sensors and captured by Geographic Information Systems (GIS) for spatial and temporal environmental analysis (Tanser and Le Sueur, 2002; Thomas et al., 2002). For an effective malaria management especially, the knowledge of adults on how and where climatic and environmental conditions favouring the development and spread of malaria vector can be of great benefit to health management agencies, thus enabling containment and treatment efforts to be focused where most needed.

1.2 STATEMENT OF THE PROBLEM

Malaria is caused by Plasmodium falciparum, and the mosquitoes Anopheles gambiae, Anopheles funestus, Anopheles arabiensis, and Anopheles moucheti are the major vectors that cause year-round transmission; artemether-lumefantrine (AL) or artesunate + amodiaquine (AS + AQ) is the treatment regime adopted in 2004. Notably, malaria is one of the most severe global public health problems worldwide, particularly in Africa, where Nigeria has the greatest number of malaria cases.

Major risk factors enhancing malaria prevalence and transmission among adults in Nigeria include demographic factors, environmental factors, and socioeconomic factors. Demographic factors include age and gender, while environmental factors include the presence or absence of bushes and forests which enhance mosquito breeding. Meanwhile, climatic factors include temperature, humidity, and rainfall that may support rapid growth and development of mosquito vectors.

For a better management and cure of malaria, the signs and symptoms of malaria need to be known among individuals. In most cases, the occurrence of fever serves as a sign that one is down with malaria. But does having fever always mean that one is down with malaria? This study seeks to find that out.

1.3 OBJECTIVES OF THE STUDY

The primary objective of this study is to examine fever as a predictor for malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State. Specifically, this study will;

1. Examine the signs and symptoms of malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State

2. Determine the extent in which fever serves as a predictor for malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State

3. Examine the causes of malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State

4. Examine if fever serves as a predictor of other infections among individuals attending kofai phcc in Ardo-Kola LGA Taraba State.

1.4 RESEARCH QUESTIONS

1. What are the signs and symptoms of malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State?

2. To what extent does fever serve as a predictor for malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State?

3. What are he causes of malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State?

4. Does fever serve as a predictor of other infections among individuals attending kofai phcc in Ardo-Kola LGA Taraba State?

1.5 SIGNIFICANCE OF THE STUDY

The study will be mostly useful to all adults in Nigeria as well as the general public as it will expose and enlighten them on the basic and general knowledge of malaria, its causes, and the role of fever as a predictor for malaria infection. More so, this study will add to the body of existing literature on the topic of concern, thus, will be useful to researchers, medical and none medical students, and other intellectuals who may wish to carry put a study on a related topic.

1.6 SCOPE OF THE STUDY

This study will be focused on fever as a predictor for malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State. Specifically, it will be focused on examining the signs and symptoms of malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State, determining the extent in which fever serves as a predictor for malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State, examining the causes of malaria infection among individuals attending kofai phcc in Ardo-Kola LGA Taraba State and examining if fever serves as a predictor of other infections among individuals attending kofai phcc in Ardo-Kola LGA Taraba State.

1.7 LIMITATIONS OF THE STUDY

There was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed. More so, the findings of this study only reflects the perception of the respondents, who were staff of the selected hospitals in the study area, hence, the findings may not portray the true situation when measured against others perception.

1.8 DEFINITION OF TERMS

Malaria: Malaria is a serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans.

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

Predictor: a person or thing that predicts that something will happen in the future or will be a consequence of something.