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Status of Malaria and Utilization of Insecticide Treated Bed Nets Among Rural People in Wachuge Villages, Meta Woreda, East Hararge Zone, Oromia Region, Ethiopia

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Status of Malaria and Utilization of Insecticide Treated Bed Nets Among Rural People in Wachuge Villages, Meta Woreda, East Hararge Zone, Oromia Region, Ethiopia STATUS OF MALARIA AND UTILIZATION OF INSECTICIDE TREATED BED NETS AMONG RURAL PEOPLE IN WACHUGE VILLAGES, META WOREDA, EAST HARARGE ZONE, OROMIA REGION, ETHIOPIA M. Sc. Thesis By Belete Wondimu August 2016 Haramaya University Status of Malaria and Utilization of Insecticide Treated Bed Nets Among Rural People in Wachuge Villages, Meta Woreda, East Hararge Zonal Administration, Oromia, Ethiopia A Thesis Submitted to the Department of Biology School of Graduate Studies HARAMAYA UNIVERSITY In Partial Fulfilment of the Requirements for the Degree of Master of Science in Biology By Belete Wondimu August 2016 Haramaya University ii APPROVAL SHEET OF THESIS HARAMAYA UNIVERSITY SCHOOL OF GRADUATE STUDIES As Thesis Research advisor, I hereby certify that I have read and evaluated this thesis prepared, under my guidance, by Belete Wondimu, entitled “Status of Malaria and Utilization of Insecticide Treated Bed Nets Among Rural People in Wachuge Villages, Meta Woreda, East Hararge Zonal Administration, Oromia, Ethiopia”. I recommend that it can be submitted as fulfilling of the thesis requirement. Dr, Sissay Menkir _________________ _______________ Major Advisor Signature Date Dr. Sewnet Mengistu ___________ _______________ Co-advisor Signature Date As member of the Board of Examiners of the MSc Thesis Open Defence Examination, we certify that we have read, evaluated the thesis prepared by Belete Wondimu and examined the candidate. We recommended that the thesis be accepted as fulfilling the Thesis requirement for the Degree of Master of Science in Biology. ______________________ _________________ _______________ Chairperson Signature Date ______________________ _________________ _______________ Internal Examiner Signature Date ______________________ _________________ _______________ External Examiner Signature Date iii DEDICATION I dedicate this thesis manuscript to my Sister Mindaye Wondimu and my Wife Mintiwab Tamirat, for nursing me with affection and love and for their dedicated partnership in the success of my life. iv STATEMENT OF AUTHOR First, I declare that this thesis is the result of my own work and that all sources or materials used for this thesis have been duly acknowledged. This thesis is submitted in partial fulfilment of the requirements for an MSc degree at Haramaya University and to be made available at the University’s Library under the rules of the Library. I confidently declare that this thesis has not been submitted to any other institution anywhere for the award of any academic degree, diploma or certificate. Brief quotations from this thesis are allowable without special permission, provided that accurate acknowledgement of source is made. Requests for permission for extended quotation from or reproduction of this manuscript in whole or in part may be granted by Dean of the School of Graduate Studies when in his or her judgment the proposed use of the material is in the interests of scholarship. In all other instances, however, permission must be obtained from the author. Name: Belete Wondimu Signature: ____________________ Place: Haramaya University Date of submission: August 16 v BIOGRAPHICAL SKETCH The author was born June 1973 in East Hararge zone. He was attended his elementary school at Aberagizaw Elementary and Junior Secondary school of Deder and secondary education at Deder senior Secondary School, East Hararge Zone. In 2001, he was graduated from Haramaya University with B.Ed. degree in Biology in summer service program. After graduation, he was working as a high school biology teacher in Chelenko high school until he joined the School of Graduate Studies at Haramaya University in July 2012. He has been working at Chelenko preparatory school for the last three years. vi ACKNOWLEDGEMENTS First and foremost, I would like to express my deepest gratitude to my advisors Dr. Sissay Menkir and Dr. Sewnet Mengistu for their unreserved guidance and encouragement at all steps of this study. Their kind approach, constructive comments, share of experience and smooth treatment are among which I appreciate. Secondly, I am grateful to all members of Meta Woreda Health Office and Meta Woreda Malaria Prevention and Control Bureau (MWMPCB) for their support, Chelenko Hospital staff, Wachuge Health Centre and the data collectors who were always with me with no boredom these all the time while I kept on pressing on them to work hard. I would be glad to thank all friends especially Mr. Dawit Tilahun from Meta Woreda education bureau and Ato Seyfudin Ahmed Wachuge Kebele chairman for their genuine moral support and AtoTegene Bekele Wachuge Health Centre laboratory technicians for their kind assistance during blood sample collection and formation of smears. This study could not have been possible without the cooperation of the study participants, health management staff and other government employees (D.A and Teachers), all inhabitants of the study villages are warmly acknowledged for their kind cooperation and genuine participation in blood sample provision. vii LIST OF ABBREVIATIONS AND ACRONYMS ACIPH Addis Continental Institute of Public Health API Annual Parasite Incidence CDC Centre for Disease Control CSA Central Statistics Agency DHS Demographic and Health Survey FMOH Federal Ministry of Health GHE Global Health Education GMP Global Malaria Program HBI Human Blood Index IRS Indoor Residual Spraying ITN Insecticide Treated Net LLIN Long Lasting Insecticide Net MWMPCB Meta Woreda Malaria Prevention and Control Bureau MFS Malaria Fact Sheet MIS Malaria Indicator Survey MOP Malaria Operational Plan NIAID National Institute of Allergy and Infectious Diseases NMG National Malaria Guide NSP National Strategic Plan RBC Red Blood Cell RBM Roll Back Malaria RDT Rapid Disease Test TCC The Carter Centre SSA Sub-Saharan African WMR World Malaria Report viii TABLE OF CONTENTS STATEMENT OF AUTHOR V BIOGRAPHICAL SKETCH VI ACKNOWLEDGEMENTS VII LIST OF FIGURS XII ABSTRACT XIV 1. INTRODUCTION 1 2. LITRATURE REVIEW 6 2.1. The Malaria Parasite 6 2.2. Life Cycle of Plasmodium Species 7 2.3. Clinical Manifestation of Malaria 9 2.4. Malaria Vector 10 2.5. Global Epidemiology of Malaria 11 2.6. Epidemiology and Distribution of Malaria in Ethiopia 13 2.7. Factors Affecting the Epidemiology of Malaria 16 2.8. Prevention and Control Strategies of Malaria 17 2.9. Insecticide Treated Bed Net (ITN) 18 2.10. Knowledge about the Use of Insecticide Treated Bed Net 19 3. MATERIALS AND METHODS 21 3.1. Description of Study Area 21 3.2. The Study Design 21 3.3. Study Population 22 3.4. The Sample Size Determination and Sampling Procedure 22 3.5. Sampling Technique 22 3.6. Methods of Data Collection 23 3.6.1. Questionnaire Survey 23 3.6.2. Blood Sample Collection and Preparation of Blood Films 23 3.6.3. Laboratory Examination of Malaria Parasites 24 3.6.4. Malaria Health Records Collection 24 3.7. Data Quality Controls 24 3.8. Data Analysis 25 ix 3.9. Ethical Considerations 25 4. RESULTS AND DISCUSSION 26 4.1. Socio-Demographic Characteristics of Study Participants 26 4.2. Study Participants’ Knowledge about Malaria Infection, Transmission and Vector 27 4.2.1. Study Participants’ Malaria Prevention Methods and Treatment Seeking 30 4.3. Knowledge about and Utilization of ITNs among Study Participants 32 4.3.1. Study Participants’ Knowledge about ITNs and ITNs Possession 32 4.3.2. ITNs Utilization and Condition Related to the Study Participants’ ITNs Utilization 34 4.3.3. Study participants’ Knowledge about Utilization of ITN 36 4.4. Association between some Selected Socio-Demographic Characteristics, Malaria Knowledge and the Study Participants’ Knowledge about ITN Utilization 38 4.5. Prevalence of Malaria Infections among Study Participants 40 4.6. Trends and Patterns of Malaria Infections in Wachuge Rural Villages from Year 2010- 2014 in Health Centre 43 4.7. Associations of some Socio-Demographic Characteristics with Malaria Incidence among Study Participants 44 4.8. The Association of Malaria Infection with Study Participants’ Selected Knowledge about Malaria 46 5. SUMMARY, CONCLUSIONS AND RECOMENDATION 49 5.1. Summary 49 5.2. Conclusions 52 5.3. Recommendations 53 6. REFERENCES 54 7. APPENDICES 61 Appendix I Consent Form (English Version) 61 Appendix II Consent form-Oromic Version 62 Appendix III Questionnaire (English Version) 63 Appendix iv Afan Oromo Version Questionnaire 67 APPENDIEX V Tables 71 x LIST OF TABLES TABLE PAGE 1. Some Basic Socio- Demographic Characteristics of Study Participants (N=403) in Wachuge Rural Villages, East Hararge, Oromia, Ethiopia, During May-June 2015. 27 2. Study Participants’ Knowledge about Malaria, Transmission and Vector of Malaria (N=403) in Wachuge Rural Villages, East Hararge, Oromia, Ethiopia, During May-June 2015 29 3. Malaria Prevention and Treatment Seeking of Study Participants (N=403) in Wachuge Rural Villages, East Hararge, Oromia, Ethiopia, During May-June 2015. 31 4. ITN Owning, Knowledge and Conditions Related to Study Participants’ITNs (N=403) in Wachuge Rural Villages, East Hararge, Oromia, Ethiopia, During May-June 2015 34 5. Study Participants Experience and Frequency of ITNs Utilization (N=403) in Wachuge Rural Villages, East Hararge, Oromia, Ethiopia, During May-June 2015 36 6. Association Between some Socio-Demographic Characteristics and Knowledge about Malaria with Knowledge about ITN Utilization, (N=305) in Wachuge Rural Villages, East Hararge, Oromia, Ethiopia, During May-June 2015 40 7. Prevalence of Plasmodium Species Infection by Age and Sex (N=403) in Wachuge Rural Villages, Meta
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