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A Hospital Based Study Of Malaria
[IN NDIEGORO COMMUNITY, ABA SOUTH L.G.A. ABIA STATE] -
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CHAPTER THREE
3.0 Materials and methods
3.1 The Study Area
The study area is Ndiegoro, a semi-urban community in Aba South L.G.A. in AbiaState southeastern Nigeria. It is located between latitude 8o and 10oNof equator and longitude 8o and 10o E of the meridian. The vegetation is typically rainforest. The mean annual rainfall of about 2250 to 2500mm and mean annual temperature is 25 to 27oc with high relative humidity. The rainy season is observed from May to October while the dry season runs through the months of November to April. The community is made up of four villages namely: Umudike, Umuokorie, Umuonyinke and Umuzogwu. The occupation of the people includes: subsistence farming sometimes combined with petty trading. The main crops farmed include: cassava, vegetables, cocoyam and yams.
3.2 The Study Subjects.
The study subjects include inhabitants, who had resided in Ndiegoro community for one year and above. The sample population includes all those attending local hospitals.The samples collection was done at Victory Christian hospital, located in the community. Permission from the medical director was sought upon presenting to him the motive of the study. Microscopy was also carried out in the laboratory section of the hospital. Informed consent was obtained from the participants in the study. For children in the study, the consent of their parents was obtained prior to finger prick blood collection.
Procedure:
Before the collection of the blood, question was put to the patient whether any anti-malarial drugs have been taken recently (less than past two weeks).Those who answered in the positive were dropped while blood samples were collected from those who answered in the negative.
After the patient information has been recorded in the appropriate form, the blood films are made as follows.
1. With the patient’s left hand, palm upwards, the forefinger was selected . Cotton wool lightly soaked in methylated spirit was used to clean the finger. With a clean cotton wool the finger was dried, using firm strokes to stimulate blood circulation.
2. A disposable sterile blood lancet was used to puncture the ball of the finger. By applying gently pressure to the finger, the first drop of blood was expressed and wipe it away with dry cotton wool. Care was taken to ensure that no strands of cotton remain on the finger.
3. Handling clean slide only by the edges, the blood was collected as follows:
Gentle pressure was applied to the finger and a single small drop of blood was collected onto the middle of the slide, this is for the thin film.
Further pressure was applied to express more blood and two or three large dropswas collected on the slide about 1cm from the drop intended for the thin film.
The remaining blood was wiped away from the finger with cotton wool.
4. Thin Film: Using another clean slide as a “spreaderâ€, and with the slide with the blood drops resting on a flat, firm surface, the small drop of blood was touched with the spreader and the blood allowed to run along its edge. The spreader was firmly pushed along the slide, away from the largest drops, keeping the spreader at an angle of 450. I ensured the spreader is in even contact with the surface of the slide all the time the blood is being spread.
5. Thick Film: Always handle slides by the edges, or by a corner, to make the thick film as follows: using the corner of the spreader, the larger drops of blood was quickly joined and spread to make an even thick film. Care was taken to avoid the blood to be excessively stirred. The blood could be stirred in a circular form with 3-6 movements.
6. The blood film was then allowed to air-dry with the slides in a horizontal position in a safe place. Label the dry film with a marker pencil by writing across the thicker portion of the thin film the patients’ number and date.
STAINING BLOOD FILMS WITH GIEMSA STAIIN
1. The film was allows to air-dry thoroughly.
2. The thin film was fixed by gently dabbing with cotton wool dampened with methanol for 1-2 minutes. Care was taken to ensure that the methanol does not touch the thick film.
2. Gently pour the prepared stain (10% Giemsa solution) on the slide in a staining dish.
3. Stain for 5-10 minutes.
4. Gently flush the stain off the slide by adding drops of clean water; do not tip the stain and then wash, as this will leave a deposit of scum over the smear.
5. The slide was placed in the rack, film side downward, to drain and dry, making sure the film does not touch the slide rack.
REPORTING BLOOD FILMS FOR MALARIA PARASITES
Blood films were examined microscopically using the x40 and x100 objectives. The 7 x eyepiece was used according to WHO (1991) and Payne (1993). The thick film allow for the detection of the presence Plasmodium. The film was considered positive if the ring forms trophozoite or any blood stage of erythrocyte schizogony was detected. The thick film was considered negative if no parasite were seen after scanning at least 100 fields. The thin films allows for the identification of the species of plasmodium including staining and morphological features. The plasmodium species were identified using the key according to Cheesbrough (1998).
3.4 Qualitative Data Collection
The structured questionnaires were used. The section A of the questionnaire was for Bio-data such as: age, sex, marital status, educational qualifications. Questions on the help-seeking behavior pattern of the population was asked in section B. Questions on the preventive measures adopted was asked in section C. Questions on the treatment methods such as: buy anti -malarial drugs from chemist, attend hospitals, use herbs was in section D.
3.5 Analysis of Results:
The quantitative data were analyzed using: tabulations, percentages, bar charts and test of statistically significant differences using chi-square (X2). The statistical package used was the Minitab software.
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ABSRACT - [ Total Page(s): 1 ]ABSTRACTThe study surveyed the prevalence of malaria as well as management practices adpted in Ndiegoro community, Aba South L.G.A., Abia state between May and August 2009. Blood samples of 300 individuals who attended local hospital were examined using Giemsa stained thick and thin films, One hundred and fifty two (152) persons (51%) were infected with Plasmodiumfalciparum . The age group 0-5 years ( 74.3%) had the highest prevalence, while the age group 36-45 years ( 40.0%) recorded the lowest ... Continue reading---
APPENDIX A - [ Total Page(s): 2 ]depends on sex. ... Continue reading---
QUESTIONNAIRE - [ Total Page(s): 1 ]QUESTIONNAIRE NNAMDI AZIKIWE UNIVERSITY AWKA DEPARTMENT OF PA ... Continue reading---
LIST OF TABLES - [ Total Page(s): 1 ]LI ST OF TABLES Table 1: Age prevalence of malaria Table 2: Sex prevalence of m alaria Table 3: Help-seeking behaviour of the respondents Table 4: Preventive measures adopted Table 5: Methods of malaria treatments used Table 6: Educational background and method of treatment ... Continue reading---
LIST OF FIGURES - [ Total Page(s): 1 ]LIST OF FIGURESFigure 1: Geographic Distribution of Malaria Figure2: The Life Cycle of Malaria ... Continue reading---
TABLE OF CONTENTS - [ Total Page(s): 1 ]TABLE OF CONTENTTitle page Certification Dedication Acknowledgement Table of content List of tables List of figures Abstract Chapter OneIntroduction 1.2Aims and objectives Chapter TwoLiterature Review 2.1 Geographical distribution of malaria 2.2 Epidemiology of malaria 2.2. Environmental factors 2.2.2 Vectorial factors 2.2.3 Host factors 2.3 Studies on the prevalences of malaria 2. ... Continue reading---
CHAPTER ONE - [ Total Page(s): 1 ]CHAPTER 1 MALARIAINTRODUCTION: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% ... Continue reading---
CHAPTER TWO - [ Total Page(s): 5 ]sporozoites which migrate to the salivary gland of the mosquito (Good et al, 2001). Some of these sporozoites will be expelled into the vertebrate host as the mosquito takes a blood meal, and thus reinitiate the infection in the vertebrate host.Malaria can also be transmitted through blood transfusion from infected person or transplacentaly from pregnant mother to the fetus. However, transmission of this nature accounts for a negligible percentage.2.6 Pathogenesis and Pathology of MalariaM ... Continue reading---
CHAPTER FOUR - [ Total Page(s): 2 ]CHAPTER FOUR4.0 RESULTSThe results showed that 153 patients were positive for malaria parasite out of the 300 sampled. Therefore the prevalence of malaria was found to be 51.0% for the period between May and August, 2009. The prevalence of malaria with regards to age groups were found to be statistically significant (p) yrs. (Table 1). It was also observed that all the malaria cases detected were infections of only P. falciparum. No cases of mixed infections were identified.More ma ... Continue reading---
CHAPTER FIVE - [ Total Page(s): 2 ]CHAPTER FIVEDiscussion:Malaria is acknowledged to be by far the most important tropical parasitic disease causing great suffering and loss of lives (WHO, 1993).The days of labor lost, the cost of treatment of patients and the negative impact of the disease make malaria a major social economic burden (WHO, 1993).Results from the study indicate that more than half (51.0%) of the individuals examined were positive for malaria parasites in their blood.Table 1 shows the prevalence of malaria infectio ... Continue reading---
CHAPTER SIX - [ Total Page(s): 2 ]CHAPTER 6 SUMMARY AND RECOMMENDATION6.1 SummaryThis research set out to determine the prevalence of malaria infection among members of Ndiegoro community, Aba South L.G.A., AbiaState, attending hospital and to ascertain their management practices.The prevalence of malaria parasites was done using both thick and thin blood film microscopy on those attending local hospitals. On the knowledge of management practices of the people, qualitative data was elicited using structured questionnaire. ... Continue reading---
REFRENCES - [ Total Page(s): 4 ]Report of an Informal Consultation WHO, Geneva 8-9 June 2000. WHO/CDS/RBM/2001:281-8WHO (1998). Malaria: Know the facts, World Health Organization News Letter 13 (1): 6-7.WHO (1998).Examining blood for malaria parasites. Bench Aids for the Diagnosis of Malaria, 1-8 plates.World Health Organization.WHO (2000). Roll Back Malaria. Promise for Progress. Roll Back Malaria Cabinet Project, WHO Geneva, 4-6.WHO (2003a). The African Malaria Report 2003, Geneva, World Health Organization/United Nati ... Continue reading---
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ABSRACT - [ Total Page(s): 1 ]ABSTRACTThe study surveyed the prevalence of malaria as well as management practices adpted in Ndiegoro community, Aba South L.G.A., Abia state between May and August 2009. Blood samples of 300 individuals who attended local hospital were examined using Giemsa stained thick and thin films, One hundred and fifty two (152) persons (51%) were infected with Plasmodiumfalciparum . The age group 0-5 years ( 74.3%) had the highest prevalence, while the age group 36-45 years ( 40.0%) recorded the lowest ... Continue reading---
CHAPTER THREE -- [Total Page(s) 1]
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CHAPTER THREE -- [Total Page(s) 1]
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