A Hospital Based Study Of Malaria
[IN NDIEGORO COMMUNITY, ABA SOUTH L.G.A. ABIA STATE]

CHAPTER 1 MALARIA
INTRODUCTION:
Malaria is a life-threatening disease of man caused by parasite of the genus Plasmodium, which is transmitted from person to person, through the bite of infected female Anopheles mosquitoes. It is a killer and debilitating disease and remains a formidable health and socio-economic problem in the world (Nebeet al, 2002). Jaine and Michael (1990) described it as the leading cause of death in the developing world. The World Health Report (2002) reported that about 90% of all malaria deaths in the world today occur in Africa, South of the Sahara. And that this is because majority of the infections in Africa are caused by Plasmodium falciparum, the most dangerous of the four human malaria parasites. Anopheles gambiae is the most effective malaria vector, the most widespread in Africa and the most difficult to control. Global estimate on morbidity and mortality resulting from malaria shows between 300-500 million clinical cases and between 1.5-2.7 million deaths attributed to malaria annually (Obi, 1997; Salako, 1997; WHO, 1998 and UNICEF, 2000), and an estimated one million people in Africa die from malaria each year and most of these are children under 5 years old and women in their first pregnancy (WHO, 2002; Sherman, 1998). NIH (2001) reported that the number of deaths from malaria are on the increase due to insecticide resistance, antimalarial resistance and environmental changes.
The four important species of the parasite that cause this disease are Plasmodium falciparum.P. malariae, P ovaleand      P. vivax. Various species of the malaria parasites such as P.falciparum and P. malariaeare reported in Nigeria (Eneanya, 1998; Matur, et al, 2001). Anopheles gambiae, An. funestus and An. arabiensis have been implicated for malaria transmission in Nigeria with major impacts (Umaru et al, 1997). Scientific investigations revealed many pathological effects of malaria on man which include varying degrees of anaemia, splenic enlargement and various syndromes resulting from physiological and pathological involvements of certain organs like the brain, liver and the kidneys (Adams and Macgraith, 1985). Chukwuraet al (2003) described P. falciparummalaria as the most prevalent and virulent in Nigeria, capable of causing mental apathy, weakness and generally slowing down economic development; accounting for up to 98% of severe cases with significant mortality and morbidity (WHO, 2000). Malaria has been observed to keep people away from school or work thereby affecting;
(i)    The amount they learn at school
(ii)    The quantity of food they are able to grow and
(iii)    The money they can earn (WHO, 1991). Salako (1996) and Cooker et al, (2001) reported that malaria accounts for over (600) six hundred deaths daily in Nigeria, especially in children less than five years of age in the rural, peri-urban and urban settlements; with high index of child mortality from the disease.
Mbanugo and Ejims (2000) also reported that malaria is holoendemic in many countries and directly responsible for up to 10-25% of the infant mortality. Poor knowledge, attitude and practice (KAP) by our people in handling malaria seems to compound the issue of this disease in our various communities, particularly in AbiaState. Studies in Nsukka, Enugu state by Briegeret al (1997) and in a coastal area of Lagos state by Nebeet al (2002) confirmed that the perception of malaria by the inhabitants were not helpful. Many believe that malaria is caused by such factors as excessive heat, malnutrition, eating too much palm oil and other superstitious considerations. This poor malaria perception stimulated the present study ‘A study to determine the prevalence of malaria infection among members of Ndiegoro community, Aba South L.G.A., Abia State., attending hospital and to ascertain their management practices’. The outcome of the study is hopefully expected to disclose some strategies for eliminating or reducing to the barest minimum this health problem of man and enhancement of his health, generally.
1.2    AIMS AND OBJECTIVES OF THE STUDY
The aims and objectives of this study are;
•    To determine the prevalence of malaria in the study area andto document the management practices by the people in the community.
(ii)    Specific Objectives:
These are:
•    To determine the prevalence of malaria with regards to age and sex
•    To identify the Plasmodium species prevalent in the study area
•    To document the help-seeking behavior of the people
•    To document the preventive measures adopted by the people
•    To document the treatment methods by the people