Many elements of human behavior profoundly affect the epidemiology of malaria- uncontrolled urbanization; subsistence agriculture; population movements; wood- gathering in the forest; open-cast mining; gem-silver and other mining, agricultural production of cotton, sugar-cane, rubber and rice.
Behavioral patterns emerge in different communities and are influenced by cultural, ethnic and religious backgrounds.
The introduction of electricity into rural areas has resulted in promoting late-night outdoor activities and thus increased biting opportunities for mosquitoes.
Genetic factor
Some inherited disorders of haemoglobin such as sickle cell confer a reasonable degree of resistance or immunity against malaria to certain groups of individuals. It has been found that those individuals who are heterozygous for haemoglobin (AS) suffer malaria less frequently and less severely than to normal individuals (Olumeseet al, 1997). It has also been found that those individuals with ß – thalassaemias are protected against malaria. In a clinic-based case control study in Northern Liberia, sickle cell carries showed about 70% reduction in their risk of clinical malaria while carries of ß –thalassaemias showed 50% reduction in risk (Willcoxet al ;1983).
2.3 STUDIES ON THE PREVALENCE OF MALARIA
High prevalence of malaria has been reported in various parts of Nigeria. In a Survey of the prevalence of Plasmodium species and common clinical symptoms in a rural community in ImoState, Chukwuochaet al, (2008) found a 68% prevalence of malaria in the study community. They reported that P.falciparum(67.8%) was the dominant parasite while P.malariae occurred in mixed infection with both parasites at a 0.9%.
Ukpai and Ajoku (2001) in a hospital-based study of the prevalence of malaria in Okigwe and Owerri areas of ImoState, reported a prevalence of 321(80.25%) out of 400 individuals examined. Okigwe had a higher prevalence rate (85.5%) than Owerri (75.00%). Infections with P. falciparum was the highest in the two areas studied with 53.00% infection rate at Owerri an 60.00% infection rate at Okigwe.
Some authors have reported a significantly higher prevalence in males than females (Obiukwu and Okwuon (2008), Ikeh and Udem (2008), Ukpai and Ajoku (2001); Matur et al, (2001).
Studies on prevalence of malaria and management practices of the Azia Community in Ihiala L.G. A., AnambraState, South east, Nigeria, showed a 76% prevalence rate of malaria, all were infections of Plasmodium falciparum. (Aribodoret al, 2004). Matur et al (2001) in a study of prevalence of malaria parasites amongst the undergraduates of the university of Abuja reported a prevalence rate of 121 (61%) out of 200 blood samples examined.Similarly, Mbanugo and Ejims (2000) reported a prevalence of 233 (58.3%) out of 400 children examined for malaria parasites in Awka Metropolis, AnambraState. All positive cases were infections of Plasmodim falciparum.
A three year study to investigate the seasonal variations in episodes of malaria among residents in a semi-urban community in south east Nigeria, showed that between January and December 1996, 755 (62.9%) individual had parasitaemia of either P. falciparum or P. malariaeor both. The age-specficprevalences were: 73.8% for (0-4) years; 76.4% for (5-9) years, 67.2% for (50-59) years; 43.5% for
60 years (Eneanya, 1998.)Usip and Opara (2008), reported a malaria prevalence of 552 (54.4%) out of 1, 012 patients attending St. Luke’s General Hospital, Anua, Uyo State between May 2003 and April 2004. All malaria positive cases reported were due to Plasmodium falciparum.
In a study on the prevailing knowledge, attitude and practices (KAP) amongst mothers and caregivers in Aba South L.G.A., AbiaState towards malaria infection, Ukpai and Amaechi (2008) reported a remarkable mix-up of traditional and modern medications (orthodox) among the respondents in the treatment of malaria. A good number of he respondents (53.19%) visited the chemist each time they fell ill of malaria. Some (37.85%) used herbs called ‘OgwuIgbo’.Some of the herbs were boiled before drinking, inhaled or used to bathe. Only a few of the respondents(5.98%) visited the hospital. Prevention against mosquito bites included use of aerosols (17.13%), use of mosquito coils (49.60%), and use of nchawu (15.74%) among others.
Aribodoret al (2004), reported that the management practices of the Azia community, IhialaL.G.A.AnambraState include: attend hospitals (24.6%); use traditional medicine from local healers (12.0%) and buy anti-malarial without physician prescription (25.0%).
Similarly result from Ibeju-Lekki communities of South Western Nigeria (Nebeet al, 2002) reported a general low level of knowledge on the management practice adopted by mother and care providers. The prevailing methods of management of childhood convulsion were noted: traditional healers (26.4%), health centers (16.6%), among others.
Furthermore, Obiukwu and Okwuonu (2008) in a study of prevalence of malaria and management practices adopted in Abba Njikoka L.G.A., Anambra State, Nigeria reported that greater number of respondents resorted to patent medicine
128 (36.6%) for treatment purposes. None of the poorest respondents used prophylactic drugs and insecticide treated nets. They attributed this to financial constriant and non-awareness of these preventive measures by the people.
Oyewole and Ibidapo (2007) in a study of attitudes to malaria prevention, treatment and management strategies associated with the prevalence of malaria in a Nigerian urban center, reported that preventive measures adopted against mosquito bite include sleeping under net (treated and untreated) 17(4.2%), door and window screening 37(9.2%),cover cloth 55(13.8%), mosquito repellant/insecticides spray 39(9.8%), environmental hygiene 26(6.5%), herbal decoction 26(6.5%), and chemoprophylaxis 45(11.3%). Also in the study, self treatment (medication) accounted for 267(66.8%) as against hospital treatment 93(23.3%).Attapeu provincial Health service (2003) in a survey of knowledge, attitude and practice (KAP) in Lao PDR reported that 48.5% responded that they visit a doctor for treatment in hospital, 17.8% said they go to a health center, 51.8% goes to buy and take medicine, by themselves and 9.5% undergoes traditional healing practice. The preventive strategies adopted include: sleeping under mosquito nets (91.3%), drinking boiled water (15.5%), keeping the house and surrounding clean (54.8%) and wearing long sleeves shirts (23%).
Legesseet al(2007) in a survey of KAP about malaria transmission and its preventive measures among households in urban areas of Assosa zone, western Ethiopia, reported that the major malaria preventive measures includes: sleeping under a mosquito net (55%) and eliminating mosquito breeding sites (52%) respectively.
Abd/El-Gayoumet al (2006) in a survey of knowledge, practices and perceptions which affect acquiring malaria in man –made malaria area in Khartoum state, Sudan reported that the preventive measures against malaria were: insecticides use (22.9%),bed nets (23.9%), screened window (25.8%) and 39.5% reported no attempt to use any preventive measures. Among the treatment methods adopted were: health centers (83.2%), private clinics (65.9%) and hospitals (42.5%)
