ABSTRACT
The malaria prevalence in Nigeria is high despite numerous interventions to date. The study examined malaria prevention, control and treatment practices among Tai Solarin University of Education staff and students resident in Ijagun Community. A cross sectional survey design was adopted. Data was collected from 286 students, 31 academic staff and 67 non-academic staff. Most respondents were between 18 and 22 years old. More than half of the respondents (57.8%) had either B.sc or HND educational qualification. The instrument for data collection was a closed-ended questionnaire. Ethical approval was obtained from Babcock University Health Research Ethics Committee (BUHREC). The data obtained from the study was coded and analysed using statistical package for social sciences (SPSS) version 21.0. Findings showed that respondents had knowledge mean score of 6.91 ± 2.05, attitudinal score of 12.96 ± 2.18 and perceptions mean score of 17.42 ± 3.66. In conclusion, poor treatment, prevention and control of malaria have been attributed to individual’s knowledge, attitude and perception. Public health intervention needs to be implemented in improving attitude and perception of non-educated individuals as evident from this study that educated individuals exhibit high level of perception and positive attitudinal disposition towards treatment, prevention and control of malaria. Education intervention aimed at improving knowledge of malaria transmission is very important in control of malaria as this is a predicting factor to behavioural change. There is need for a similar study to be conducted among non-educated individuals as result from this study may only be centered around educated personnel hence the varying result in comparison to other studies.
Keywords: Prevalence, Incidence, Prevention, Control, Practices and Treatment Practices of Malaria.
Word Count: 280
TABLE OF CONTENTS
ContentPage Title Pagei Certificationii Dedicationiii Acknowledgementsiv Abstractv Table of Contentsvi List of Tablesviii List of Figuresix Appendices x
CHAPTER ONE
INTRODUCTION
1.1Background to the Study Malaria is one of the most serious health problems facing the world. The World Health Organization (WHO) reported that over 300million cases of malaria arise a year with approximately 2-3million death resulting from complications (Roll Back Malaria, 2012). Malaria has continued to be a major threat to the world’s community posing its huge toll of morbidity and mortality in sub-Saharan Africa. There are several reasons why Africa bears an overwhelming proportion of the malaria burden. Most malaria infections in Africa, south of the Sahara are caused by Plasmodium falciparum. The malaria morbidity and mortality statistics in Nigeria has been an issue of great concern, Nigeria contributes 25% of the malaria burden in Africa and losses up to ₦12 billion annually in form of treatment costs, absenteeism at work and loss of productivity (Greenwood, Bojangk Whitty, & Targett, 2005). Malaria is a disease that is deadly but preventable, the most severe and life threatening form of Malaria is the prevalent parasitic endemic disease in Africa causing various problems such as increased morbidity and mortality which is preventable, treatable and curable, yet it remains one of the major health issues in Nigeria. Malaria is one of the major public health problems in Nigeria with an estimated 100 million malaria cases and over 300,000 deaths per year. It accounts for 60% of outpatients visit, 30% of hospitalizations among children under 5 years of age, and 11% maternal mortality (Nigeria malaria fact Sheet, 2011). The human and economic cost associated with declining quality of life, consultations, treatments, control, hospitalization and other events related to malaria are enormous and often lead to low productivity and lost of incomes. Malaria is unique among diseases because its roots lie so deep within human communities. The beliefs and practices of malaria Prevention are often related to culture and can influence the effectiveness of control strategies (Rodriguez, Penilla & Henry, 2003). The transmission is seasonal and unstable and case fatality is high due to lack of communal immunity. To make things worse, to date, there is no vaccine or no safe, effective and affordable drug for mass chemoprophylaxis against malaria. Globally, an estimated half of world populations are at risk of malaria (FMOH, 2005). However, the practice of malaria preventive measures has been related to the knowledge and belief of people. Within Nigeria, surveys of residents revealed a lack of knowledge and many misconceptions about the transmission and treatment of malaria, which could adversely affect malaria control measures and anti-malarial therapy. The 1998 Roll Back Malaria (RBM) initiative launched in Geneva by the United Nations Funds (UNICEF), the United Nations Development Programme (UNDP), the World Bank and the World Health Organization (WHO) is a people oriented programme that emphasizes community participation. The year 2011 Roll Back Malaria report (RBM, 2011) noted significant success in malaria control effort worldwide, with the anticipation of “near-zero malaria death in the next decade if the efforts are sustained”. As part of efforts towards achieving near-zero death for malaria in the next decade, National and State malaria control programmes for the development of plans and interventions in six states (recently extended to four more States), including Ogun State have contributed immensely to the achievements in malaria control targets in the focal states, with better results, compared with the achievement in other states. The transmission of malarial is related to socio-economic changes, such as population movement and increasing poverty and have been associated with an increase frequency of malaria epidemics on the African continent. The preliminary report of the February 2012 omnibus survey indicate that some states fared better than other states in the country which gives the impression of modest achievement through the malaria control indicators and targets. Despite the modest achievements in focal States and participatory approaches adopted the States programme reports indicate that there are sustainability challenges. This is evidenced by the fact that the initiative for planning process (such as the development of annual operational plan) and support to implement the plan is yet to be fully adopted and owned by government, there is little or no budget allocation from the government to malaria control. There is need for concerted efforts and commitment from government, partner and stakeholders not only to sustain the modest gains but to also continue to increase the scope and coverage of the intervention regarding access and demand of interventions and improving quality for malaria control products and services. A major strategy towards sustaining and surpassing the current gains in malaria control require advocacy, this is described as a process of influencing policy makers and leaders to show commitment, participate, and support developmental programmes (The Communication Initiatives Network, 2012). The priority advocacy issues identified in the State malaria include: institutional performance, support and access to resource, and visibility for malaria programme. At the policy and leadership levels, advocacy audiences include policy and decision makers, community leaders (traditional, religious and social) and programme managers of health service institutions and facilities collaborated with other RBM partner organizations to develop the drafts of generic advocacy packages on malaria control, while the advocacy activities targeted at LGAs authorities and media organizations at the state level. As part of the sustainability initiatives programme cycle, and beyond, it is most valuable to advocate directly to highest policy and decision makers in government for ownership of the planning process and for budget release to malaria control. An evidence based advocacy forum with policy makers / decision makers will provide avenue for achievement of the core elements of policy decision making namely: understanding the issues; evaluation of the issue to form personal stand; and weighing for action, based on evaluation of alternative strategies consider to be achieved (Nicole & James,2007).The forum will provides avenue to understand the issues through the presentation of policy issues, compare status of malaria control achievements and programming gaps in the State and across focal LGAs. In addition to government, a similar advocacy forum for mass media executives will serve as avenues to motivate the mass media executives to own and disseminate messages on the media in order to sustain the investment in using mass media for demand creation and generic marketing for malaria control. The advocacy forum will be supported by advocacy support materials to present hard data in a way that is meaningful to the priority audiences. School adolescents therefore constitute a formidable community entry point for the control of malaria under the people-oriented malaria control strategy-the RBM programme. It is important to look at malaria problems that grossly affect the morbidity and mortality rate in Ijagun community. Ijagun is a suburb of Ijebu-Ode. It is the host community of the first University of Education in Nigeria. It is a rural area with limited access to portable water and other modern amenities. The environment has lot of bushes with poor drainage system. The rate at which the staff and students report malaria infection at the school clinic is on the high side. Therefore, this study aims to investigate the prevention, control and treatment practices of malaria among Tai Solarin University of Education staff and students residing in Ijagun community in order to know the reasons for increase in prevalence of malaria in study area.
