CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Malaria remains a disease of public health concern in Nigeria and other parts of the world. Globally, malaria posses a threat to approximately 3.3 billion of the world’s population with around 250 million clinical cases annually and more than 1 million deaths mostly in children under 5yrs of age (WHO 2008). In Africa, malaria is the leading cause of under five mortality (20%) and constitute 10% of the continent’s overall disease burden accounting for 40% public health expenditure, 30-50% of inpatient admission and up to 50% of outpatient visit in areas with high malaria transmission (Toyin. S 2008).
Nigeria first org (2006) stated that the disease is responsible for 60% outpatient visit to health facilities in Nigeria, 30% childhood death, 25% of death in children under one year and 11% maternal death. It also stated that the financial loss due to malaria manually is estimated to be about 132 billion Naira in from of treatment cost, prevention, loss of man hours etc, yet it is a treatable and completely evitable disease. It has been found that the incidence of malaria is lower in urban than rural setting (Rocafeltrer 2008).
According to Akinleye (2009), reducing the burden of malaria is a major public health challenge and a priority for the Roll back malaria partnership and this can be achieved with good control and management practices. Except for South Africa, many countries in the continent do not have successful malaria control programmes due to among others, the magnitude of the problem compounded by lack of adequate health infrastructure as well as financial and human resources (Mabaso 2004). Malaria control practices have been examined in some rural population in Nigeria (Erhun 2005; Adeneye 2007) and result revealed non use of insecticide impregnated net which is the current international effort at malaria control.
Malaria control activities in Nigeria are planned and implemented through the primary health care system (FMOH 2005). However, the use of health centres as the first resort for malaria management has been shown to be low in Nigeria. A review of malaria treatment seeking behaviour in rural Southwestern Nigerian by Ajayi (2006) revealed that more than 80% malaria episode perceived treatment outside the existing government health care system. Brieger (2004) stated that these shortcomings encourage treatment of malaria at home with drugs bought from shops and herbal preparation and the treatment are usually incorrect or suboptimal. This practice increase morbidity and mortality in addition to contributing to possible emergence of drug resistance.
Yet prompt and effective treatment of malaria remains a crucial element for malaria control programmes. People who become ill with the disease need prompt and effective treatment to prevent the development of severe manifestation and death (WHO 2003).
In view of the negative economic and health impact of malaria, there is a need for the development of good preventive and control measures adoptable to the
communities hence this study is aimed at investigating the malaria control and management strategy that exist in Achi community.
STATEMENT OF PROBLEM
Malaria is a complex problem for which there is no “magic bullet” particularly in Nigeria where approximately 80-85% cases of death in the world due to malaria occur. Patterns of transmission and environmental and cultural factors all very so greatly that differences in prevalence and incidence occur even between neighboring villages. (Auerbacher 2002). The virulence of vector has thwarted some control efforts and emerging multi drug resistance strain appear to be inducing an increasing toll with a resulting impact on already over burdened health services and on productivity.
Enugu state has high transmission rate for malaria with incidence rate of 15% (MOH 2005) and Achi is a community in Enugu State. Good control and Management strategies is necessary in order to curtail this incidence thus the study is to determine the measures being used.
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