Rapid assessment of home management of malaria among caregivers in parts of south eastern Nigeria

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Abstract

Background

This study was carried out to rapidly access the practice of home management of malaria by caregivers and community health workers in a rural part of South Eastern Nigeria between March and October, 2010.

Methods

Structured, pretested questionnaires, focus group discussions and oral interviews were used to collect data from 300 consenting individuals.

Results

Most of the participants/respondents were civil servants/teachers (44.3%). About 88.3% of them recognized malaria as an illness, 81.0% perceived it was transmitted by mosquito bites. Malaria diagnosis at home was mainly by noticing fever, headache, cough, and pains (86.0%). Most primary action was sought by going to hospitals/health centers (62.3%) and choroquine (46.7%) was the preferred antimalarial drug. Some of the factors hindering effective home management of malaria in the area included ignorance (13.0%); use of fake drugs (50%) and wrong diagnosis (19.1%).

Conclusion

This study shows that there is some awareness about malaria and its management in the study area. There is however need to improve and sustain the strategy, placing more emphasis on educating the people on current drug protocols to achieve better results in controlling and combating malaria especially at the local levels.

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Most cited references 19

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The burden of malaria in pregnancy in malaria-endemic areas.

R W Steketee, B Nahlen, M Parise … (2015)

Pregnant women in malarious areas may experience a variety of adverse consequences from malaria infection including maternal anemia, placental accumulation of parasites, low birth weight (LBW) from prematurity and intrauterine growth retardation (IUGR), fetal parasite exposure and congenital infection, and infant mortality (IM) linked to preterm-LBW and IUGR-LBW. We reviewed studies between 1985 and 2000 and summarized the malaria population attributable risk (PAR) that accounts for both the prevalence of the risk factors in the population and the magnitude of the associated risk for anemia, LBW, and IM. Consequences from anemia and human immunodeficiency virus infection in these studies were also considered. Population attributable risks were substantial: malaria was associated with anemia (PAR range = 3-15%), LBW (8-14%), preterm-LBW (8-36%), IUGR-LBW (13-70%), and IM (3-8%). Human immunodeficiency virus was associated with anemia (PAR range = 12-14%), LBW (11-38%), and direct transmission in 20-40% of newborns, with direct mortality consequences. Maternal anemia was associated with LBW (PAR range = 7-18%), and fetal anemia was associated with increased IM (PAR not available). We estimate that each year 75,000 to 200,000 infant deaths are associated with malaria infection in pregnancy. The failure to apply known effective antimalarial interventions through antenatal programs continues to contribute substantially to infant deaths globally.

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Treatment of childhood fevers and other illnesses in three rural Nigerian communities.

Phillip Agomo, W R Brieger, Bangmboye Afolabi … (2001)

The seeking of healthcare for childhood illnesses was studied in three rural Nigerian communities of approximately 10,000 population each. The aim was to provide a baseline understanding of illness behaviour on which to build a programme for the promotion of prepackaged chloroquine and cotrimoxazole for early and appropriate treatment of childhood fevers at the community level. A total of 3117 parents of children who had been ill during the 2 weeks prior to interview responded to questions about the nature of the illness and the actions taken. Local illness terms were elicited, and the most prevalent recent illness and the actions taken. Local illness terms were elicited, and the most prevalent recent illnesses were 'hot body' (43.9 per cent), malaria, known as iba (17.7 per cent), and cough (7.4 per cent). The most common form of first-line treatment was drugs from a patent medicine vendor or drug hawker (49.6 per cent). Only 3.6 per cent did nothing. Most who sought care (77.5 per cent) were satisfied with their first line of action, and did not seek further treatment. The average cost of an illness episode was less than US$2.00 with a median of US$1.00. Specifically, chloroquine tablets cost an average of US 29 cents per course. Analysis found a configuration of signs and symptoms associated with chloroquine use, to include perception of the child having malaria, high temperature and loss of appetite. The configuration positively associated with antibiotic use consisted of cough and difficult breathing. The ability of the child's care-givers, both parental and professional, to make these distinctions in medication use will provide the foundation for health education in the promotion of appropriate early treatment of childhood fevers in the three study sites.

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Malaria in the pregnant woman.

M Fried, James P. Duffy (2004)

Women become more susceptible to Plasmodium falciparum malaria during pregnancy, and the risk of disease and death is high for both the mother and her fetus. In low transmission areas, women of all parities are at risk for severe syndromes like cerebral malaria, and maternal and fetal mortality are high. In high transmission areas, where women are most susceptible during their first pregnancies, severe syndromes like cerebral malaria are uncommon, but severe maternal anemia and low birth weight are frequent sequelae and account for an enormous loss of life. P. falciparum-infected red cells sequester in the intervillous space of the placenta, where they adhere to chondroitin sulfate A but not to receptors like CD36 that commonly support adhesion of parasites infecting nonpregnant hosts. Poor pregnancy outcomes due to malaria are related to the macrophage-rich infiltrates and pro-inflammatory cytokines such as tumor necrosis factor-alpha that accumulate in the intervillous space. Women who acquire antibodies against chrondroitin sulfate A (CSA)-binding parasites are less likely to have placental malaria, and are more likely to deliver healthy babies. In areas of stable transmission, women acquire antibodies against CSA-binding parasites over successive pregnancies, explaining the high susceptibility to malaria during first pregnancy, and suggesting that a vaccine to prevent pregnancy malaria should target placental parasites. Prevention and treatment of malaria are essential components of antenatal care in endemic areas, but require special considerations during pregnancy. Recrudescence after drug treatment is more common during pregnancy, and the spread of drug-resistant parasites has eroded the usefulness of the few drugs known to be safe for the woman and her fetus. Determining the safety and effectiveness of newer antimalarials in pregnant women is an urgent priority. A vaccine that prevents pregnancy malaria due to P. falciparum could be delivered before first pregnancy, and would have an enormous impact on mother-child health in tropical areas.

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Author and article information

Journal

Journal ID (nlm-ta): Pan Afr Med J

Journal ID (publisher-id): PAMJ

Title: The Pan African Medical Journal

Publisher: The African Field Epidemiology Network

ISSN (Electronic): 1937-8688

Publication date (Electronic): 02 November 2011

Publication date Collection: 2011

Volume: 10

Electronic Location Identifier: 29

Affiliations

[1 ]Department of Public Health Technology, Federal University of Technology, Owerri, Nigeria

Author notes

[& ]Corresponding author: Uche Chukwuocha, Department of Public Health Technology, Federal University of Technology, Owerri, Nigeria

Article

Publisher ID: PAMJ-10-29

PMC ID: 3240927

PubMed ID: 22187611

SO-VID: f57cfb02-f728-4a20-85f9-c9dc67113a05

License:

The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Rapid assessment of home management of malaria among caregivers in parts of south eastern Nigeria

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Abstract

Background

Methods

Results

Conclusion

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Pan African Medical Journal

Most cited references 19

The burden of malaria in pregnancy in malaria-endemic areas.

Treatment of childhood fevers and other illnesses in three rural Nigerian communities.

Malaria in the pregnant woman.

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