Studies on the Prevalence, Knowledge, and Practices Toward Malaria in Owerri West Local Government Area of Imo State, Nigeria. Ajero, C.M.U, Ukaga,C.N. , Uzochukwu,U.C and Chigbo,U N Department of Animal and Environmental Biology, Imo State University, P. M. B. 2000, Owerri, Imo State, Nigeria 2348033587707, E-mail: [email protected] Abstract The present study was designed to assess malaria prevalence in cluster households, knowledge, and practices of people towards malaria, as well as the extent of coverage of Government’s distribution of Long Lasting Insecticide Treated Nets (LLITN) using cluster samples in Owerri West L.G.A. of Imo State Nigeria. Ethical clearance for the study was obtained from the University Research Ethics Committee, Local Government Health authorities as well as from the heads of respective households used in the study. Malaria parasitemia was determined using rapid diagnostic test kit ((ICT COMBO, Core Diagnostic, U.K). Other data was collected using pre- tested questionnaires from the adults in each household sampled. Analysis of 16 household clusters revealed 25.7% prevalence of malaria. More males (27.5%) than females (24.3%) subjects investigated had malaria infection. Teenagers (10-19yrs) had the highest malaria prevalence rate and were followed by Children aged 0-9years. A significantly higher percentage (79.8%; p<0.05) of the households knew that mosquito bites transmit malaria. Other factors linked to malaria included drinking of dirty water (12.4%) and eating too much oil (8.9%). Fifty-eight percent of the households knew that insecticide treated nets can be used to prevent mosquito bite, while 3.4% of them reported to use such nets. Only 6.7% of the households had Long Lasting Insecticide Nets distributed by the State government. A highly significant percent (80.9%) (p<0.05) of the households did not have the LLIN. These results suggest that the cluster method could indeed serve to estimate the prevalence of malaria with reasonable precision and may also be used to demonstrate as well as predict the reduction in prevalence of malaria and most common diseases. The cluster method in addition, could be used to enhance awareness campaigns on malaria control especially with regards to the improvement in the distribution and actual utilization of the Long Lasting Insecticide Treated Nets in the study area. Keywords: Cluster sampling, Malaria, Prevalence, Knowledge, Practices, Long lasting Insecticide Treated Nets ________________________________________________________________________________ 1.0 Introduction Despite the continued progress made so far population experiencing at least one episode towards meeting the Millennium Development of malaria each year (2,3). goals on malaria control, the mortality and Previous reports of malaria burden in Imo debilitating effect of malaria in Nigeria and State and in Nigeria at large were those done other sub-Saharan African countries has using selected groups. These groups among continued to be of serious concern. According others include pregnant women attending to the World Malaria Report (1), there were an antenatal, normadic migrants, school children, estimated 216 million episodes of malaria and coastal dwellers, and out patients(4,5,6,7,8). 655,000 malaria deaths in 2010. Of these No documented report has been made on the numbers, approximately 174 million (81%) application of cluster survey in investigating and 600,000 (91%) of cases and deaths, malaria in Owerri West L. G. A. of Imo State, respectively were in the African Region (1). Nigeria. Cluster survey technique have been Malaria is holoendemic in Nigeria with developed and used to determine vaccine greater intensity during the wet season than coverage of populations. It has also been the dry season, and with fifty percent of the applied in the detection of poliomyelitis and West African Journal of Industrial & Academic Research Vol.14 No.1 June 2015 91 neonatal tetanus (9,10). This paper is the was carried out using Rapid Diagnostic Test report of a study on the application of cluster kit (ICT COMBO, Core Diagnostic, U.K) for sampling method in estimating malaria burden detection of Plasmodium falciparum and pan as well as the knowledge and practices of the malaria antigen Pf/Pan for non-falciparum study population towards malaria in parts of species. eastern Nigeria. Heads of households, the caregivers as well as all adults aged 18 years and above in each 2.0 Materials and Methods house hold were interviewed using designed 2.1 Study Area: pre-tested questionnaires on Knowledge, and Owerri West Local Government Area of Practices towards malaria as well as on the Imo State, south-eastern Nigeria located coverage of distribution of LLIN by the State between latitude 50311 and 60271 and Ministry of Health. longitude 70001 and 70051 of the Greenwich meridian. The areas studied were rural 2.3 Data analysis: Data collected were communities with thick vegetation and a daily analyzed using descriptive statistics and temperature of between 200C to 300C. The variations were tested using chi-square. The annual rainfall and humidity were relatively significance level was fixed at p<0.05. high. The inhabitants were predominantly farmers. 4.0 Results The study comprised of 16 randomly 4.1 Prevalence Of Malaria selected village clusters which are The sex and age related prevalence of enumeration Areas as mapped out during the malaria is illustrated in table 1. A total of 1216 2005 National census by the National individuals were involved in the study and Population Commission. One thousand, two were tested for malaria parasitemia. Out of hundred and sixteen persons made of 526 this number, 312 (25.5%) were positive for males and 692 females were sampled in 356 malaria by rapid diagnostic test. Though households . Rapid Diagnostic Test can detect previous infection, its ability to detect all stages of 2.2 Malaria test: Capillary blood samples Plasmodium infection informed the usage of were collected from finger-pricked blood and its results in the descriptive analysis of the sole-pricked blood in infants between 0-12 study results. months. On the spot (field) test for malaria Table 1: Prevalence of Plasmodium spp. parasite in Owerri West L.G.A by age and sex from RDT results MALE FEMALE TOTAL Age group No. No. (%) No. No. (%) No. No. (%) Years) examined infected examined infected examined infected 0-9 180 64 (35.6) 216 92 (42.6) 396 156 (39.4) 10-19 104 44 (42.3) 108 44 (40.7) 212 88 (41.5) 20-29 68 16 (23.5) 112 8 (7.1) 180 24 (13.3) 30-39 52 12 (23.1) 84 4 (4.8) 136 16 (11.8) 40-49 36 8 (22.2) 48 0 (0.0) 84 8 (9.5) 50-59 32 0 (0.0) 68 8 (11.8) 100 8 (8.0) 60-69 20 0 (0.0) 24 8 (33.3) 44 8 (18.2) 70-79 16 0 (0.0) 16 0 (0.0) 32 0 (0.0) 80-89 16 0 (0.0) 16 4 (25.0) 32 4 (12.5) Total 526 144 (27.5) 692 168 (24.3) 1216 312 (25.5) Male and Female subjects investigated had (p>0.05). The highest prevalence (41.5%) was 27.5% and 24.3% prevalence rates, found in teenagers (10-19 yrs of age) and the respectively. The difference in sex-related lowest (0%) was in subjects aged 70-79yrs. prevalence was not statistically significant West African Journal of Industrial & Academic Research Vol.14 No.1 June 2015 92 There was a significant difference in age- 1) while no person was infected (0%) in related prevalence (p<0.05) (Table 1). Umuokpo. There was no significant difference Among the clusters investigated, in malaria infection of individuals in the Plasmodium infection was highest (44.0%) in clusters sampled (p>0.05) (Table 2) Obegwu Okuku infecting 100 persons (cluster Table 2: Cluster prevalence of Plasmodium spp. parasite in Owerri West L.G.A. from RDT results Cluster Name Number examined Number infected (%) Obegwu-Okuku 100 44 (44.0) Ohohii-Ohii 108 36 (33.3) Umueju Umuoma 68 16 (23.5) Umunnali Umuoma 68 8 (11.8) Umuoyo Irete 108 12 (11.1) Umuokpiri Orogwe 60 12 (20.0) Oforola 76 16 (21.1) Umuelem Ihiagwa 64 28 (43.8) Umuanunu Obinze 104 40 (38.5) Umuike Amakohia-Ubi 68 28 (41.2) Umuerim Nekede 48 8 (16.7) Okwu ext. Umuoma Nekede 92 16 (17.4) Umuiwuala Okolochi 48 20 (41.7) Umuchima Ihiagwa 100 20 (20.0) Umucheche Emeabiam 52 8 (15.4) Umuokpo 52 0 (0.0) Total 1216 312 (25.7) 4.2 Knowledge On Symptoms and Signs Of Malaria The result revealed that individuals in 248 result showed that 4.5% of the household (69.7%) of 356 households sampled in the clusters did not know the symptoms and signs clusters knew that fever is a major symptom of malaria. Only 2.2% attributed of malaria. Other symptoms and signs that seizure/convulsion and salty tasting palms to household clusters associated with malaria malaria. Households in cluster 3 (Umueju, include feeling cold (21.3%), headache Umuoma) showed a better understanding of (41.6%), body weakness (21.3%), vomiting symptoms of malaria (Table 3). (12.4%) and loss of appetite (19.1%). The Table 3: Responses of participants in household clusters on symptoms and signs of malaria ________________________________________________________________________________________________________________________ Cluster Name No. of Fever Feeling Body Vomiting Loss of Diarrhea Pale eyes Seizure/ Dizziness Headache Joint/ Don’t know House- cold weakness appetite convulsion body pains holds _________________________________________________________________________________________________________________________ egwu- Okuku 20 20(100) 8 (40.0) 8 (40.0) 0 4 (20.0) 0 4 (20.0) 0 0 4 (20.0) 8 (40.0) 0 Ohohiii- Ohii 28 28 (100) 8 (28.6) 12 (49.2) 12 (49.2) 4 (14.3) 0 0 8 (28.6) 8 (28.6) 12 (42.9)