Project Materials

PREVALENCE OF MALARIA PARASITE INFECTIONS AMONG SCHOOL AGED CHILDREN IN RURAL AREAS

Chapter one

INTRODUCTION

1.1 Background of the Study

Malaria control rarely targets school-aged children, despite the fact that their Plasmodium infection rates frequently exceed those of younger children. It is also possible that present progress in lowering transmission would result in an increase in the prevalence of clinical malaria in school-aged children in previously highly endemic areas in the future, as immunity acquisition is delayed.

Malaria in schoolchildren has garnered increased scientific attention over the last decade, with a rising body of knowledge on the harmful effects of asymptomatic infection on health and education, as well as the deleterious effects of clinical attacks in this population.

Nonetheless, there is a lack of research on the best control techniques for schoolchildren and how they may change across malaria transmission contexts. 20 21 Intermittent preventive therapy in schools has previously been found to reduce malaria infections and anaemia while improving sustained attention in an area of high perennial transmission in western Kenya12, but it has not been tested in areas of seasonal transmission.

Seasonal malaria chemoprevention in the Sahel region, when expanded to target children up to the age of ten, is related with considerable improvement in malaria and anaemia in all ages. 13 22 However, the effects on cognition and learning have not been investigated.

We conducted a cluster-randomized trial in a highly seasonal malaria area in southern Mali to investigate the impact of a comprehensive malaria control strategy in schools

which combined vector control using long-lasting insecticidal nets (LLINs) supported by teacher-led participatory malaria prevention education and mass treatment to clear residual parasitaemia (termed intermittent parasite clearance in schools (IPCs)), in reducing malaria infections and anaemia.

Malaria is one of the most climate-sensitive vector-borne diseases, causing public health concerns. It accounts for 110 million clinical cases per year1.

Malaria affects about half of the Nigerian population, and the condition accounts for the majority of outpatient visits to health institutions, according to the National Malaria Programme.

According to the Federal Ministry of Health in Nigeria, malaria treatment and prevention costs approximately N132 billion. Malaria affects over 90% of Nigeria’s 167 million population and continues to be a serious public health challenge2. Chioma Amajoh, national coordinator of the National Malaria Control Programme, told Business Day during the 2012 World Malaria Day celebrations in Lagos, Nigeria, that malaria has put huge strain on Nigeria’s already overburdened health-care system.

Malaria is claimed to account for over 66% of all clinic visits and 30% of hospital admissions in Nigeria, imposing a significant strain on the country’s families, communities, health-care system, and workforce2.

Malaria causes 350 to 500 person infections and nearly 1.3 million fatalities each year, primarily in the tropics. Sub-Saharan Africa accounts for 85% of the fatalities3.

Malaria is the leading cause of death each year, accounting for 1% of all deaths4. Every year, more than 100 million cases of malaria are reported, with one million deaths5. I

n Nigeria, malaria is holoendemic6. According to Oparaocha, malaria not only causes sickness and mortality in millions of individuals in endemic communities, but it also weakens their resilience to other diseases7.

Useful man-hours are lost, resulting in low production, financial loss, social and economic distress, and absenteeism among schoolchildren owing to malaria, which leads to poor academic performance and a low educational standard8.

According to the data presented above, more than half of Nigeria’s population is impoverished, malnourished, has a low income, and dies from malaria. The poor are trapped in a vicious cycle: they are sick because they are poor; they get poorer as a result of their illness, and sicker as a result of their poverty9.

Malaria sickness exerts the greatest socioeconomic impact on the rural population, which relies on farming for a living.

Malaria infection is widely spread in warmer regions of the world, particularly in the tropics, where the vectors of malaria are located. 8. Malaria, caused by protozoan parasites of the genus Plasmodium, continues to affect the most youngsters, accounting for around one million episodes.

Nigerian infectious human parasites infect and kill a greater proportion of people than any other single infectious disease. Human malaria is caused by five species of the Plasmodium genus: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi.

They pass from person to person by the bites of Anopheles mosquitos, which are haematophagous anthropophilic females. These adult female Anopheles mosquitoes are hence referred to be malaria carriers or parasites.

Ezugbo et al. described malaria’s clinical symptoms as fever, headache, chills, fatigue, nausea, and chest and abdominal pain6. They went on to say that malignant malaria causes spleen, kidney, and liver enlargement.

1.2 Statement of the Problem

Stagnant water has been recognised as a risk factor for malaria transmission. Nigeria is endemic due to Nigerians’ failure to comply with malaria prevention measures such as sleeping under insecticide-treated nets (ITNs), correctly administering Artemisinin-based Combination Therapy (ACTs), intermittent malaria preventive treatment during pregnancy, and proper environmental sanitation2.

Chioma Amajoh also stated that factors impeding significant success in the fight against malaria include insufficient funding, poor utilisation of available health care services, a weak supply chain system, an inadequate strategic information network, and various infrastructural challenges.