1.1 Introduction
Malaria is primarily caused by protozoa (Plasmodium species), and it is spread by the bite of an infected female Anopheles mosquito (Mwangangi et al., 2013). Human malaria is considered to be the most widely distributed vector-borne disease in the tropics and sub-tropics (Ahmad et al., 2011). All patients who have a fever and who reside in or have recently visited an endemic area should be suspected of having malaria, and any patient who has an untreated P. falciparum infection faces a rapid progression to coma, renal failure, pulmonary edema, and death (MMWR, 2004).
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).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of 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.
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.
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). Plasmodium falciparum is one of the genus and cause the most ere and virulent form of the disease and the only one to cause acute ality. In this study Plasmodium falciparum will be on focus since it is most prevalent in Nigeria. This genus of malaria spend a part of their cycle in the red cell of the host where the erythrocyticschizogony. They develop into merozoites and undergo a cycle producing schizonts. Each cycle terminates when the red cell rupture releasing merozoites into the circulation to infect new red cells eliciting an immune response. Malaria infection leads to the formation of circulating immune complexes (Mibeiet al., 2005). Therefore, in Nigeria where the research was carried out, the activities that was conducted is to assess the Malaria Control Intervention Knowledge, Availability and Utilization among Out-Risk Group.
1.3 Statement of Problems
Investigation revealed that inadequate sanitation is a major cause of malaria disease world-wide and improving sanitation is known to have a significant beneficial impact on health both in households and across communities. In addition, environmental sanitation according to World Health Organization is the control of all those factors in man's physical environment which exercise or may exercise a deleterious effect on his physical development, health and survival (Alabi, 2010).
1.4 Aim and Objectives of Study
The aim of the study is to determine the Serum Protein Levels and CIC Level in Cerebral Malaria Patients. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the serum protein levels and CIC level in cerebral malaria patients, those currently on treatments, severe malaria and apparently healthy individuals;
- To compare the level among the different groups studied; and
- To make recommendations based on the results obtained and use of circulating immune complexes (CIC) in the diagnosis of malaria.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the level among the different groups studied?
- What is the serum protein levels and CIC level in cerebral malaria patients, those currently on treatments, severe malaria and apparently healthy individuals?
1.6 Justification / Significance of Study
The findings in this study are important to the government because it elucidates the need for government to provide an effective waste management and control scheme in order to eradicate the challenges of malaria. The science of immunology have suggested the use of CIC to measure variety of clinically oriented condition, this current studies ,suggest that CIC determination can be important in the evaluation of in disease and sometimes in monitoring the efficiency of therapy.
Studies have suggested that plasma protein pattern is frequently abnormal in patients with acute malaria and disturbance in immune responses makes the disease a major cause of morbidity and mortality in patients with malaria. There is therefore need to determine CIC and serum proteins in patients suffering from malaria with a view to understand the pathology of the infection.
1.7 Scope of Study
The scope of the research is focused on the Determining the Serum Protein Levels and CIC Level in Cerebral Malaria Patients.
1.8 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection.
- Research Material: availability of research material is a major setback to the scope of the study.
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
1.9 Definition of Terms
Diagnosis:
It is the act or process of identifying or determining the nature and cause of a disease injury through evaluation, examination review of a patient laboratory data.
Medication:
A medication is a substance that is taken into or placed on the body that does one of the following things: most medications are used to cure disease or condition. (For example, antibiotics are given to cure an infection. Medications are also given to treat a medical condition).
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