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Assessment Of The Effectiveness Of Environmental Sanitation In The Control Of Malaria
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CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Malaria still remains a significant public health problem especially in low and middle income countries. According to the World Health Organisation (WHO), malaria transmission in Nigeria is abysmally high with over 76% of the population reporting more than 1 case per 1,000 populations annually. There was a less than 50% decrease in projected incidence of malaria from 2000–2015. Nigeria and the Democratic Republic of Congo account for more than 35% of the global total of estimated malaria deaths.
Malaria is principally caused by protozoa (Plasmodium species) and is transmitted through the bite of an infected female Anopheles mosquito (Mwangangi et al., 2013). Within the tropics and sub-tropics, human malaria is seen to be the most wide spread vector-borne disease (Ahmad et al., 2011). Available statistics have documented that malaria is highly endemic in Nigeria with over 90% of the populace at risk of infection. It is the prime cause of 60% outpatient consultation for all age groups and at least half of the Nigerian populace are exposed to at least one bout of malaria attack every year (Idowu J., 2012).
An integrative approach has been recommended to mitigate the spread of malaria parasites. One of such strategy or approach is the Integrated Vector Management (IVM) through a combination of biological and chemical methods. It is aimed at improving ecological soundness and sustainability for the control of vector borne diseases, improve efficacy and cost effectiveness (Zacchaeus and Amadi, 2012). From a triad perspective which includes the agent, host and environment, researchers and scholars have encouraged the source reduction, elimination and eradication of mosquitoes breeding sites by concentrating on the environment. These tend to be essential because, the proliferation of mosquitoes continually perpetuate the transmission of malaria. So, it can be postulated that if the sources of mosquitoes breeding sites is eradicated or eliminated, malaria would be drastically reduced. This implies that good environmental sanitation practices could help mitigate malaria transmission, promote healthiness and improve quality of life of the populace.
In its modern concept, environment includes not only water, air and soil but also the social and economic conditions under which we live (Park, 2011). The key to man‟s health lies largely in his environment. In fact, much of man‟s ill-health can be traced to adverse environmental factors such as water, soil and air pollution, poor housing conditions, presence of animal reservoir and insect vectors of diseases which pose threats to man‟s health. Often, man is responsible for the pollution of his environment through urbanization, industrialization and other human activities.
According to the National Sanitation Foundation of USA, the word sanitation is defined as a „„way of life that is expressed in the clean home, farm, business, neighborhoods and community (Park, 2011). Also, World Health Organization (WHO) defines sanitation as the provision of facilities and services for the safe disposal of human urine and faeces (UNICEF AND WHO, 2012).
Environmental hazards are responsible for about a quarter of the total burden of disease worldwide and as much as 30% in regions such as sub-Saharan Africa. As many as 13 million deaths can be prevented every year by making our environments healthier. These facts and figures highlight the impact of environmental factors on public health. More than 2.4 billion people in the world currently lack access to adequate sanitation and are forced to dispose of their excreta in unimproved and unsanitary conditions. Those who suffer from this, lack most basic human needs and also tend to be victims of poverty, ill health and an overall poor quality of life (WHO, 2013).
In developing countries like Nigeria, the main diseases of the environment are diarrhoeal disease, lower respiratory infections, unintentional injuries, and malaria. In children under the age of five, one third of all disease is caused by the environmental factors such as unsafe water and air pollution (WHO, 2010). The poor state of food sanitation in the country has been shown to play a significant role in the etiology of food borne diseases. One of the most significant diseases that arise from poor sanitation is diarrhea. Deaths resulting from diarrhea are estimated to be between 1.6 and 2.5 million every year (WHO, 2012). National records show that every year, about six hundred thousand (600,000) episodes of diarrhoea occur in children under the age of five (Alabi, 2010).
Similarly, there have been increasing numbers of cases of cholera over the years. From January to December 2010, Nigeria reported 41,787 cases including 1,716 deaths from 222 Local Government Areas (LGAs) in 18 States of the country. The most affected states were Borno, Bauchi and Katsina. In addition to the disease burden, Nigeria loses about N455 billion annually which is equivalent to 1.3% of Gross Domestic Product (GDP), due to poor sanitation as reported by water and sanitation program of the World Bank (Vanguard 2013). Most of the affected are young children below the ages of five. Other diseases that are caused by poor sanitation include schistosomiasis, trachoma, soil transmitted helminthiases, and malaria (WHO, 2013).
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