ABSTRACT

BACKGROUND: Malaria is the most prevalent tropical disease in the world today. Each year, it causes disease in approximately 650 million people and kills between one and three million, most of them, young children in Sub-Saharan Africa . Nigeria is known for high prevalence of malaria and it is a leading cause of morbidity and mortality in the country. Available records show that at least 50 per cent of the population of Nigeria suffers from at least one episode of malaria each year and this accounts for over 45 per cent of all outpatient visits. Malaria infection during the first five years of life is a major public health problem in tropical and subtropical regions throughout the world. The disease accounts for 25 per cent of infant mortality and 30 per cent of childhood mortality in Nigeria thereby imposing great burden on the country in terms of pains and trauma suffered by its victims as well as loss in outputs and cost of treatments. This study is aimed at assessing the management of malaria in children in Jos University Teaching Hospital

METHODS: A retrospective descriptive study in which data was retrieved from the record folders of children attending Paediatric outpatient clinic and admitted into Paediatric wards within the stipulated study period. Data was analyzed using Statistical Package for social science (SPSS v 23.0) and represented in tables and charts for interpretations.

RESULTS: From the results obtained, the prevalence rate of malaria is 44.8%.Females had the higher prevalence of 45.7% than males. Age group, 1-5 years recorded the highest prevalence of 58.5%. Those parents’ of the children who resides in Villages had higher infectious rates of 41%.Those who attained secondary and tertiary institutions respectively had higher and similar infectious rates of 34.4% whereas those with lower socioeconomic status had higher rates of 59%.Preventive means commonly adopted by parents of the patients is Door/Window nets with 50.8%. The commonly prescribed antimalarial class are the Artemisinin combination therapy with Arthemeter-lumenfantrine (29.5%) being the most frequently prescribed antimalarial and Artesunate injection (14.1%) for uncomplicated and severe forms of malaria.

CONCLUSION: The prevalence rate of malaria infection in this study still showed malaria is still a burden in Nigeria, particularly in Jos, Plateau State. Parents/guardians socio demographic characteristics such as education and place of residence have a great effect in reducing malaria infection among children which are the vulnerable group. The management protocols is very much in-line with WHO treatment guidelines.

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CHAPTER ONE

1.0     INTRODUCTION/LITERATURE REVIEW

Prevalence (specifically Disease prevalence) is the proportion of persons with a current disease in a population at a particular point in time or over a specified period. It is also the number of existing cases at a particular point in time/a specified period. Prevalence is broadly categorized into two types;

·        Period Prevalence: is the total number of existing cases within a specified period of time.

·        Point Prevalence: is the total number of existing cases at a particular point in time. [Centre for Disease Control; 2012]

Malaria is a life threatening infectious disease caused by protozoan parasites (Plasmodium spp) transmitted through the bite of a female Anopheles mosquito (Anopheles gambiae). There are 5 parasite species (P.Knowlesi, P.falciparum, P.malariae, P.ovale & P.vivax) that cause malaria in humans, and 2 of these species – P. falciparum and P. vivax – pose the greatest threat. P. falciparum is the most prevalent malaria parasite on the African continent. It is responsible for most malaria-related deaths globally. P. vivax is the dominant malaria parasite in most countries outside of sub-Saharan Africa. [World Health Organization Worksheet; 2017]

Malaria is the most prevalent tropical disease in the world today. Each year, it causes disease in approximately 650 million people and kills between one and three million, most of them, young children in Sub-Saharan Africa. (Hay S.et al., 2004)

Malaria accounts for 25 to 45% of all outpatient clinic attendances, between 20 and 45% of all hospital admissions and cause 17% of under-five mortality in African region (WHO, 2006, 2008). Malaria prevalence is governed by three predominant factors which are medical condition, environmental factors and human status (Bassey E. et al., 2017).

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Nigeria is a high endemic country for malaria. Its large population, diverse weather conditions and cultures make it a bit difficult implementing the same malaria control measures throughout the country. (Umaru .L et al.,2015)

Global Malarial Endemicity in 2003

FIGURE 1: Map Showing Malaria Endemic Countries.

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1.1       CLINICAL MANIFESTATIONS OF MALARIA

v Uncomplicated malaria is symptomatic malaria that has no vital organ dysfunction or life threatening manifestations. The classical (but rarely observed) malaria attack lasts 6-10 hours. It consists of

·        A cold stage (sensation of cold, shivering)

·        A hot stage (fever, headaches, vomiting; seizures in young children)

·        And finally a sweating stage (sweats, return to normal temperature, tiredness).

Classically (but infrequently observed) the attacks occur every second day with the "tertian" parasites (P. falciparum, P. vivax, and P. ovale) and every third day with the "quartan" parasite (P. malariae).

More commonly, the patient presents with a combination of the following symptoms:

ü   Fever

ü   Chill

ü   Sweats

ü   Nausea and vomiting

ü   Body aches

ü   General malaise

v Severe malaria occurs when there is an asexual form parasitaemia and no other confirmed cause of their symptoms; and the presence of life threatening clinical or laboratory features like;

·        Cerebral malaria,

·