Malaria Parasitaemia and the use of ITNs for malaria control amongst under-5 year old children in Calabar, Nigeria.
Authors:
Anthony Achizie Iwuafor,
Chukwudi Charles Egwuatu,
Agwu Ulu Nnachi
Malaria remains a major cause of febrile illness in Nigeria. In Nigeria, Plasmodium falciparum is the dominant malaria parasite while female Anopheles gambiae and Anopheles funestus group are dominant vector species. An estimated 3.3 billion people were at risk of malaria in 2010, 655 000 malaria death occurred of which 91% occurred in Africa and 86% of the deaths involved under-5 children. It has caused huge economic loss, loss of man-hours, and school absenteeism. The Nigerian government came up with interventions to reduce malaria burden, with focus on the use of Insecticide treated nets. This study is set to determine the knowledge, perceptions about malaria and practice of insecticide-treated nets (ITNs) of caregivers of under-five year old children. Each caregiver attending the clinic with any under-five child was interviewed using structured questionnaires. The questionnaire elicited information on the background characteristics of the respondents, knowledge of malaria symptoms, causes of malaria, treatment seeking behavior and preventive measures. Capillary blood obtained from under-5 year children by finger prick was tested for malaria parasites by Rapid diagnostic test and by microscopy.
A parasitaemia prevalence of 32.2% (by Rapid diagnostic test kit [RDT]) or 40.1% (by microscopy) was obtained in the study. Fifty five-point four (55.4%) of the febrile patients had malaria parasitaemia (by RDT) or 61.2% (by microscopy). Fifty five point six (55.6%) of the caregivers acknowledged the use of nets on doors and windows for malaria prevention and control, 51.5% mentioned sleeping under mosquito net while 51.1% acknowledged the use of insecticide sprays. Seventy one-point five (71.5%) of the households possessed at least one mosquito net while only 25.4% of the under-5 children slept under any net the night before the survey.
No statistically significant reduction in malaria parasitaemia was observed with the use of mosquito nets among the under-5 children. Almost all the respondents (97.8%) identified mosquito bite as the cause of malaria. Fever was identified by the majority of the respondents (92.2%) as the commonest symptom of malaria. Among the under-5 children that had fever 2 weeks prior to the study, 47.7% sought for treatment first at the government hospitals, 28.4% self-treated their children at home, while 10.1% resorted to patent medicine vendor. The findings of the study showed high prevalence of parasitaemia, fever was significantly associated with malaria parasitaemia. Mosquito net utilization among the under-fives was low despite high net ownership rate by households. The respondents demonstrated good knowledge of the cause and symptoms of uncomplicated malaria, but not symptoms/signs of severe malaria. Majority of the caregivers would prefer taking their under-fives with febrile illness to government hospital first, some others would start self-medicating at home first, while only few would want to consult a patent medicine dealer first.
Public health education should focus on enlightening the caregivers on signs/symptoms of uncomplicated and complicated malaria, and encourage use of ITNs especially among the under-fives.
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