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Format: MS WORD
| Chapters: 1-5
| Pages: 63
THE PREVALENCE OF MALARIA AMONG PREGNANT WOMEN ON ADMISSION IN IMO STATE SPECIALIST HOSPITAL OWERRI
ABSTRACT
A study was made to determine the prevalence of malaria infection among pregnant women on admission in Imo State specialist Hospital Owerri between July to August 2012. Blood samples were collected from the patients and a thick blood film made. The films were stained using parasitological standard procedures. Twenty-five (25) pregnant women in their 1st trimesters had the highest severe parasitaemia with 54.5%. And also primigravidae were also observed to have the highest infection rate with 87.5%. Similarly, the direct stained smear technique showed that 2,301 (80.1%) persons had malaria parasites while the Plasmodium falciparium (pf) antigen test showed that 1,801 (62.7%) persons were positive for malaria due to Plasmodium falciparium. Comparatively, the QBC and slide smear techniques were more effective for parasite detection than the pf antigen test. The age related prevalence showed that pregnant women within the age bracket 18 – 25 years had the highest prevalence (86.1%) of malaria infection, followed by those in the 36 – 40 (82.8%). The least prevalent age group was the 40 years and above group (74.7%) The overall mean infection according to zones showed that Owerri had the highest prevalence (83.9%), followed by Okigwe (72.1%) and Orlu (66.9%). Statistical analysis of the data showed a significant difference (p < 0.05) in the prevalence of plasmodiasis between the three zones of Imo State. Many pregnant women lost their jobs, some could not attend fully their businesses, some missed their religious activities due to malaria in pregnancy. Some women had low birth weight babies, some pre – term delivery etc due to malaria in pregnancy. This study has shown that malaria is a major public health challenge among pregnant women in Imo State Nigeria, leading to inestimable economic and social losses.
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Malaria is an infections disease caused by a parasite, plasmodium which infects red blood cells. Historical records suggest that malaria has infected human since the beginning of mankind. The name “mal aria” (Meaning bad air in Italian) was first used in English in 1740 by H. Walpole when describing the disease. The term was shortened to malaria in 20th century. Laveran; in 1880 was the first to identify parasites in human blood. In 1889, Ross discovered that mosquitoes transmit malaria.
Malaria continues to be a cause of great suffering in tropical and sub-tropical regions of the world (Brabin, 1989). Currently, it is endemic in about 100 countries affecting 4% of world’s population. Malaria has been eliminated or effectively suppressed in several parts of the world in past decade but is now undergoing resurgence (Gilles, 1987). It is returning to areas from which it had been eradicated as well as spreading into new areas such as central Asia and Eastern Europe. Despite global economic development people are dying from malaria now than 30 years ago.
1.2 Statement of the Problem
Malaria infection during pregnancy is a major public health problem in tropical and subtropical regions throughout the world and Nigeria in Particular. The burden of malaria infection during pregnancy is caused mainly by Plasmodium falciparum, the most common malaria species in Africa (WHO, 2010). Pregnant women and the unborn children are particularly vulnerable to malaria, which is a major cause of prenatal mortality, low birth weight, and maternal anaemia (Greenwood, 2007). Malaria during pregnancy compounds or provokes anaemia, which, when severe, increases the risk of maternal death (estimated at around 10,000 deaths annually), low birth weight (linked to around 100,000 annual infant deaths in Africa), pre-term delivery, congenital infection and reproductive loss of overwhelming morbidity and mortality (Fakeye, 2009). There have been a considerable number of reports about poor knowledge, attitudes, and practices among pregnant women relating to malaria and its control from different parts of Africa. The disease remains the world’s most important tropical health challenge. Access to medical care is limited in many malaria-endemic areas and where medical services exist, they commonly lack facilities for laboratory diagnosis, and treatment option. Thus this research work is made to find out the rate at which malaria affect pregnant women and their unborn children.
1.3 OBJECTIVES OF THE STUDY
The broad objective of this study is to examine the prevalence of malaria among pregnant women on admission in Imo State specialist hospital Owerri. Specifically the study seeks:
1. To examine the rate at which malaria is prevalent among residence of Imo State.
2. To find out the rate at which malaria affect pregnant women and their unborn children admitted to Specialist Hospitals .
3. To ascertain the symptoms of malaria present in pregnant women admitted to specialist hospitals.
4. To ascertain the intensity of malaria effect on pregnant women and their unborn children admitted to Specialist Hospitals .
5. To determine the complication associated with malaria in Pregnant Women.
1.4 Research Questions
1. What is the rate at which malaria is prevalent among residence of Imo State?
2. What is the rate at which malaria affect pregnant women and their unborn children admitted to Specialist Hospitals?
3. What are the symptoms of malaria present in pregnant women admitted to specialist hospitals?
4. What is the intensity level of malaria effect on pregnant women and their unborn children admitted to Specialist Hospitals?
5. What are the complication associated with malaria in Pregnant Women admitted to Specialist hospitals?
1.5 Justification of the Study
The findings from this study would be useful to the following; pregnant women, ministries of health, parastatals, health sectors, policy makers Health practitioners would benefit from this study; as it would help them in caring adequately and planning well for pregnant women attending antenatal clinic when treating them for malaria. This study would be of great importance to ministries of health by informing them on the importance of this study is to address the issue concerning the attitude towards the use of traditional herbal medicine for the treatment of malaria among pregnant women attending antenatal care and to organize enlightenment programmes aimed at enhancing the attitudes of pregnant women towards frequent antenatal clinics. This study will help policy makers to formulate relevant policies on malaria prevention while making informed decisions on the steps to follow in increasing antenatal care attendance levels among pregnant women attending Teaching Hospital in Imo State This study would be useful to government and parastatals by educating them on the need to provide concerted health education intervention to improve the attitude and knowledge of pregnant women regarding poor health seeking behavior and adequate strategies for malaria prevention especially with the use of insecticide, treated Net, adequate funding, etc. necessary for controlling and reducing incidence of malaria in the general public.
1.6 Scope of the Study
The broad objective of this study is to examine the prevalence of malaria among pregnant women on admission in Imo State specialist hospital Owerri. The study will also ascertain the symptoms of malaria present in pregnant women admitted to specialist hospitals. It will ascertain the intensity of malaria effect on pregnant women and their unborn children admitted to Specialist Hospitals.It will determine the complication associated with malaria in Pregnant Women.
1.7 Limitation of the study
Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint was the scanty literature on the subject owing to the nature of the discourse thus the researcher incurred more financial expenses and much time was required in sourcing for the relevant materials, literature, or information and in the process of data collection, which is why the researcher resorted to a limited choice of sample size. Additionally, the researcher will simultaneously engage in this study with other academic work. More so, the choice of the sample size was limited as few respondent ofPregnant Women in Specialist Hospital Owerri were selected to answer the research instrument hence cannot be generalize to other hospitals. However, despite the constraintencountered during theresearch, all factors were downplayed in other to give the best and make the research successful.
ABSTRACT
A study was made to determine the prevalence of malaria infection among pregnant women on admission in Imo State specialist Hospital Owerri between July to August 2012. Blood samples were collected from the patients and a thick blood film made. The films were stained using parasitological standard procedures. Twenty-five (25) pregnant women in their 1st trimesters had the highest severe parasitaemia with 54.5%. And also primigravidae were also observed to have the highest infection rate with 87.5%. Similarly, the direct stained smear technique showed that 2,301 (80.1%) persons had malaria parasites while the Plasmodium falciparium (pf) antigen test showed that 1,801 (62.7%) persons were positive for malaria due to Plasmodium falciparium. Comparatively, the QBC and slide smear techniques were more effective for parasite detection than the pf antigen test. The age related prevalence showed that pregnant women within the age bracket 18 – 25 years had the highest prevalence (86.1%) of malaria infection, followed by those in the 36 – 40 (82.8%). The least prevalent age group was the 40 years and above group (74.7%) The overall mean infection according to zones showed that Owerri had the highest prevalence (83.9%), followed by Okigwe (72.1%) and Orlu (66.9%). Statistical analysis of the data showed a significant difference (p < 0.05) in the prevalence of plasmodiasis between the three zones of Imo State. Many pregnant women lost their jobs, some could not attend fully their businesses, some missed their religious activities due to malaria in pregnancy. Some women had low birth weight babies, some pre – term delivery etc due to malaria in pregnancy. This study has shown that malaria is a major public health challenge among pregnant women in Imo State Nigeria, leading to inestimable economic and social losses.
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Malaria is an infections disease caused by a parasite, plasmodium which infects red blood cells. Historical records suggest that malaria has infected human since the beginning of mankind. The name “mal aria” (Meaning bad air in Italian) was first used in English in 1740 by H. Walpole when describing the disease. The term was shortened to malaria in 20th century. Laveran; in 1880 was the first to identify parasites in human blood. In 1889, Ross discovered that mosquitoes transmit malaria.
Malaria continues to be a cause of great suffering in tropical and sub-tropical regions of the world (Brabin, 1989). Currently, it is endemic in about 100 countries affecting 4% of world’s population. Malaria has been eliminated or effectively suppressed in several parts of the world in past decade but is now undergoing resurgence (Gilles, 1987). It is returning to areas from which it had been eradicated as well as spreading into new areas such as central Asia and Eastern Europe. Despite global economic development people are dying from malaria now than 30 years ago.
1.2 Statement of the Problem
Malaria infection during pregnancy is a major public health problem in tropical and subtropical regions throughout the world and Nigeria in Particular. The burden of malaria infection during pregnancy is caused mainly by Plasmodium falciparum, the most common malaria species in Africa (WHO, 2010). Pregnant women and the unborn children are particularly vulnerable to malaria, which is a major cause of prenatal mortality, low birth weight, and maternal anaemia (Greenwood, 2007). Malaria during pregnancy compounds or provokes anaemia, which, when severe, increases the risk of maternal death (estimated at around 10,000 deaths annually), low birth weight (linked to around 100,000 annual infant deaths in Africa), pre-term delivery, congenital infection and reproductive loss of overwhelming morbidity and mortality (Fakeye, 2009). There have been a considerable number of reports about poor knowledge, attitudes, and practices among pregnant women relating to malaria and its control from different parts of Africa. The disease remains the world’s most important tropical health challenge. Access to medical care is limited in many malaria-endemic areas and where medical services exist, they commonly lack facilities for laboratory diagnosis, and treatment option. Thus this research work is made to find out the rate at which malaria affect pregnant women and their unborn children.
1.3 OBJECTIVES OF THE STUDY
The broad objective of this study is to examine the prevalence of malaria among pregnant women on admission in Imo State specialist hospital Owerri. Specifically the study seeks:
1. To examine the rate at which malaria is prevalent among residence of Imo State.
2. To find out the rate at which malaria affect pregnant women and their unborn children admitted to Specialist Hospitals .
3. To ascertain the symptoms of malaria present in pregnant women admitted to specialist hospitals.
4. To ascertain the intensity of malaria effect on pregnant women and their unborn children admitted to Specialist Hospitals .
5. To determine the complication associated with malaria in Pregnant Women.
1.4 Research Questions
1. What is the rate at which malaria is prevalent among residence of Imo State?
2. What is the rate at which malaria affect pregnant women and their unborn children admitted to Specialist Hospitals?
3. What are the symptoms of malaria present in pregnant women admitted to specialist hospitals?
4. What is the intensity level of malaria effect on pregnant women and their unborn children admitted to Specialist Hospitals?
5. What are the complication associated with malaria in Pregnant Women admitted to Specialist hospitals?
1.5 Justification of the Study
The findings from this study would be useful to the following; pregnant women, ministries of health, parastatals, health sectors, policy makers Health practitioners would benefit from this study; as it would help them in caring adequately and planning well for pregnant women attending antenatal clinic when treating them for malaria. This study would be of great importance to ministries of health by informing them on the importance of this study is to address the issue concerning the attitude towards the use of traditional herbal medicine for the treatment of malaria among pregnant women attending antenatal care and to organize enlightenment programmes aimed at enhancing the attitudes of pregnant women towards frequent antenatal clinics. This study will help policy makers to formulate relevant policies on malaria prevention while making informed decisions on the steps to follow in increasing antenatal care attendance levels among pregnant women attending Teaching Hospital in Imo State This study would be useful to government and parastatals by educating them on the need to provide concerted health education intervention to improve the attitude and knowledge of pregnant women regarding poor health seeking behavior and adequate strategies for malaria prevention especially with the use of insecticide, treated Net, adequate funding, etc. necessary for controlling and reducing incidence of malaria in the general public.
1.6 Scope of the Study
The broad objective of this study is to examine the prevalence of malaria among pregnant women on admission in Imo State specialist hospital Owerri. The study will also ascertain the symptoms of malaria present in pregnant women admitted to specialist hospitals. It will ascertain the intensity of malaria effect on pregnant women and their unborn children admitted to Specialist Hospitals.It will determine the complication associated with malaria in Pregnant Women.
1.7 Limitation of the study
Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint was the scanty literature on the subject owing to the nature of the discourse thus the researcher incurred more financial expenses and much time was required in sourcing for the relevant materials, literature, or information and in the process of data collection, which is why the researcher resorted to a limited choice of sample size. Additionally, the researcher will simultaneously engage in this study with other academic work. More so, the choice of the sample size was limited as few respondent ofPregnant Women in Specialist Hospital Owerri were selected to answer the research instrument hence cannot be generalize to other hospitals. However, despite the constraintencountered during theresearch, all factors were downplayed in other to give the best and make the research successful.
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