1.1 Introduction
Malaria symptoms usually occur between seven and fifteen days after a mosquito inoculation. Signs and symptoms related to malaria infection are varied, but the majority of patients have fever. It is generally characterized by recurrent attacks with moderate to severe shaking chills, high-fever, profuse sweating during the fall of body temperature, general feeling of unease and discomfort (malaise). Other signs and symptoms are headache, nausea, vomiting and diarrhea. Malaria should be suspected in every febrile patient who lives or has traveled to an endemic area and in the differential diagnosis of patients who have fever of unknown origin, malaria should also be considered. Any patient with an untreated P. falciparum infection can rapidly progress to coma, renal failure, pulmonary edema, and death (MMWR, 2004).
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, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
Malaria is a tropical disease transmitted by an infected plasmodium species of mosquito and constitutes an important cause for global burden of morbidity and mortality among pregnant women and under five year old children. The 2013 World Malaria Report has it that in 2012, an estimated 627,000 deaths occurred as a result of malaria and of this, 90% occurred in Sub-Saharan Africa with 77% recorded among under-Five years. The report also revealed that about half the world population of 3.4 billion people remains at risk of malaria exposure living in endemic regions. In Africa, malaria constitute the primary cause of infectious disease burden and bears considerable proportion of the global burden of about 2.7 million deaths attributable to the disease with an estimated 300 million people who live with it yearly (WHO, 2010).
The populations at highest risk of morbidity are young children and pregnant women, because of their low immunity against the disease (Roca-Feltrer, Carneiro, Armstrong-Schellenberg, 2008; Rogerson, 2010). Malaria accounts for serious pregnancy-related complications during childbirth and a major cause of anemia in both children and pregnant women (Ekejindu, Udigwe & Chijioke, 2006; Matangila, Lufuluabu, Ibalanky, da Luz, Lutumba, & Van Geertruyden, 2014). As a result of the deteriorating health conditions of populations in the developing world, and the impact of malaria to the health of pregnant women and under five year old, the Millennium Development Goals (MDG) initiative was launched in 1990 with the aim of encouraging governments of nation states to initiate policies and mobilize resources that would significantly impact on factors responsible for health disparities, poverty in diverse communities, environmental degradation and social inequality. The Millennium Development Goal particularly for maternal health, and reversal of the incidence of malaria calls for a reduction in maternal mortality by two-thirds by the year 2015(Sachs, 2005; Orton & Omari, 2008).
Malaria continues to constitute a cause for morbidity and mortality among populations of pregnant women and children in regions of the world with high transmission. The persistent poor pregnancy outcomes and unacceptably high mortality despite efforts to facilitate reduction are reasons to continue malaria research in order to fully understand the behavioral factors associated with current trends. During pregnancy, malaria is more likely to result in severe disease among non-immune women (Nosten et al., 2004). The risk of pregnancy malaria is highest in a first pregnancy and among HIV infected pregnant women.
Malaria symptoms usually occur between seven and fifteen days after a mosquito inoculation. Signs and symptoms related to malaria infection are varied, but the majority of patients have fever. It is generally characterized by recurrent attacks with moderate to severe shaking chills, high-fever, profuse sweating during the fall of body temperature, general feeling of unease and discomfort (malaise).
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Knowledge, Attitude and Prevention of Malaria among Antenatal Attendees.
1.3 Statement of Problems
Investigation revealed that the treatment of clinical disease in non-immune pregnant women Non-immune pregnant women is at great risk of developing severe disease. Quinine is generally recommended for treatment of P. falciparum in pregnant women who are not immune. In high quinine resistance areas, the treatment of choice when available should be artemisinins. Nevertheless, problems such as safety and lack of registration in most endemic areas have to be taken into consideration.
1.4 Aim and Objectives of Study
The aim of the study is to examine the Knowledge, Attitude and Prevention of Malaria among Antenatal Attendees. In achieving this aim, the following specific objectives were laid out as follows:
- To assess the knowledge, attitude and practices of pregnant women in preventing malaria during pregnancy.
- To assess the level of knowledge of pregnant women about malaria prevention.
- To identify the measures utilized by pregnant women in prevention of malaria.
- To ascertain whether there exist any relationship between knowledge and practice of malaria prevention among pregnant women attending Enugu State Primary Health Care Services (PHC).
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:
- Are there measures utilized by pregnant women in prevention of malaria?
- Is there any relationship between knowledge and practice of malaria prevention among pregnant women attending Enugu State Primary Health Care Services (PHC)?
- What is the level of knowledge of pregnant women about malaria prevention?
- What are the knowledge, attitude and practices of pregnant women in preventing malaria during pregnancy?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There are no significant measures utilized by pregnant women in prevention of malaria
- H1: There are significant measures utilized by pregnant women in prevention of malaria
Hypothesis Two
- H0: There is no significant relationship between knowledge and practice of malaria prevention among pregnant women attending Enugu State Primary Health Care Services (PHC)
- H1: There is a significant relationship between knowledge and practice of malaria prevention among pregnant women attending Enugu State Primary Health Care Services (PHC)
1.7 Significance of Study
This study will be of immense benefit to midwives and other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.
1.8 Scope of Study
The scope of the research is focused on the Knowledge, Attitude and Prevention of Malaria among Antenatal Attendees in Enugu State Primary Health Care Services (PHC).
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- 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.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- 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 (internet, questionnaire and interview).
1.10 Definition of Terms
Malaria: Malaria is a tropical disease transmitted by an infected plasmodium species of mosquito and constitutes an important cause for global burden of morbidity and mortality among pregnant women and under five year old children.
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