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Prevalence and Severity of Hypoglycemia and Lactic Acidosis in Children Diagnosed with Plasmodium Falciparum Malaria

Prevalence and Severity of Hypoglycemia and Lactic Acidosis in Children Diagnosed with Plasmodium Falciparum Malaria

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Reference ID: PS-25740-TM

DEDICATION

This research work titled "Prevalence and Severity of Hypoglycemia and Lactic Acidosis in Children Diagnosed with Plasmodium Falciparum Malaria" is dedicated to God for his enabling grace and to all computer enthusiasts who help to make life a pleasant experience.

ACKNOWLEDGEMENT

I owe my indebtedness to my Supervisor (Name of your Supervisor), the Head of Department (Name of your HOD), the Lecturers in the department of Public Health, Book Authors and Profound Scholars of existing/related research material for your moral support that facilitated the successful completion of my (Tertiary Institution level). I am grateful to God Almighty and my parent for their financial support in my career. I really appreciate you all for everything, Thank you very much.

TABLE OF CONTENTS

PRELIMINARY PAGES


CHAPTER ONE

INTRODUCTION


CHAPTER TWO

LITERATURE REVIEW

  • 2.1 Introduction
  • 2.2 Conceptual Review
  • 2.3 Theoretical Framework
  • 2.4 Empirical Studies

CHAPTER THREE

RESEARCH METHODOLOGY

  • 3.1 Introduction
  • 3.2 Research Design
  • 3.3 Population of Study
  • 3.4 Sampling and Sampling Technique
  • 3.5 Validation of Research Instrument
  • 3.6 Method of Data Collection
  • 3.7 Method of Data Analysis
  • 3.8 Questionnaire Administration
  • 3.9 Ethical Consideration
  • 3.10 Statistical Analysis

CHAPTER FOUR

DATA ANALYSIS, RESULT AND DISCUSSION

  • 4.1 Introduction
  • 4.2 Presentation and Analysis of Data
  • 4.3 Re-statement of Research Questions
  • 4.4 Test of Hypotheses
  • 4.5 Discussion of Findings

CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATION

  • 5.1 Introduction
  • 5.2 Summary of Findings
  • 5.3 Conclusion
  • 5.4 Recommendation
  • 5.5 Suggestion for Further Study

REFERENCES

APPENDIX A - “QUESTIONNAIRE”


Prevalence and Severity of Hypoglycemia and Lactic Acidosis in Children Diagnosed with Plasmodium Falciparum Malaria

CHAPTER ONE

1.1 Introduction

Plasmodium falciparum is the most common cause of severe and life-threatening malaria, which causes over 2 million deaths every year (Bruneel et al., 2003; Njuguna and Newton, 2004). In Africa, a vast majority of these deaths occur in children under five years of age (WHO, 2012). 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 preventable and treatable mosquito-borne disease, whose main victims are children under five years of age in Africa. The World Malaria Report 2012 summarizes data received from 104 malaria-endemic countries and territories for 2011. Ninety-nine of these countries had on-going malaria transmission. According to the World Malaria Report, 2011, there were 655,000 malaria deaths worldwide in 2010, compared to 781,000 in 2009 (WHO, 2000; World Malaria Report, 2011). It has been estimated that 91% of deaths in 2010 were in the African Region, followed by the South-East Asia (6%) and Eastern Mediterranean Regions (3%) (World Malaria Report, 2011).

Acute malaria is estimated to cause 225 million cases of ill health per year, resulting in over one million deaths per year, most of which occur in sub-Saharan Africa (World Malaria Report, 2010; Murray et al., 2012). Malaria is particularly virulent among children, constituting one of the principal causes of child morbidity as well as mortality in sub-Saharan Africa (WHO, 2000). Exposure to the malaria parasite not only results in bouts of high fevers among children, but also increases the risk of malnutrition and anaemia among children under five (Ehrhardt et al., 2006).

Malaria is world’s most widespread infection. According to the World Malaria Report 2011, malaria is prevalent in 106 countries of the tropical and semitropical world, with 35 countries in central Africa bearing the highest burden of cases and deaths (World Malaria Report, 2011). Compared to a century earlier, the area of malaria risk has reduced from 53% to 27% of the Earth’s land surface and the number of countries exposed to some level of malaria risk has fallen from 140 to 106 (Hay et al., 2004; Uk Aid, 2010; World Malaria Report, 2011).

In 2007, 2.37 billion people were estimated as being at risk of Plasmodium falciparum malaria worldwide, with 26% located in the World Health Organization Regional Office for Africa (WHO/AFRO) region compared to 62% in the combined South-East Asia and Western Pacific Regional Offices (SEARO/WPRO) regions (Uk Aid, 2010). Of this total population at risk, about 42% or almost 1 billion people lived under extremely low malaria risk (Uk Aid, 2010).

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.

Malaria is principally caused by protozoa (Plasmodium species) and is transmitted through the bite of an infected female Anopheles mosquito (Mwangangi et al., 2013). Within the tropics and sub-tropics, human malaria is seen to be the most wide spread vector-borne disease (Ahmad et al., 2011). 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).

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.

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to examine the Prevalence and Severity of Hypoglycemia and Lactic Acidosis in Children Diagnosed with Plasmodium Falciparum Malaria.


1.3 Statement of Problems

Investigation revealed that inadequate sanitation is a major cause of disease world-wide and improving sanitation is known to have a significant beneficial impact on health both in households and across communities. The word ‘sanitation' also refers to the maintenance of hygienic conditions through services such as garbage collection and waste-water disposal. 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.

It could also be seen as the principle and practice of effecting healthful and hygienic conditions in the environment to promote public health and welfare, improve quality of life and ensure a sustainable environment (Alabi, 2010). The essential components of environmental sanitation include: solid waste management; medical waste management; excreta and sewage management; food sanitation; sanitary inspection of premises; market and abattoir sanitation; adequate potable water supply; school sanitation; pest and vector control; management of urban drainage; control of reared and stray animals; disposal of the dead animals; weed and vegetation control; hygiene education and promotion.


1.4 Aim and Objectives of Study

The aim of the study is to examine the Prevalence and Severity of Hypoglycemia and Lactic Acidosis in Children Diagnosed with Plasmodium Falciparum Malaria in Ussa Metropolis, Taraba State. In achieving this aim, the following specific objectives were laid out as follows:

  1. To examine the relationship between blood glucose, lactate and haemoglobin concentrations in childhood malaria;
  2. To determine the prevalence and severity of hypoglycaemia in the subjects diagnosed with Plasmodium falciparum;
  3. To examine the relationship between the parasite load and some biochemical parameters;
  4. To examine the prevalence and severity of lactic acidosis in the subjects; and
  5. To assess the prevalence of Plasmodium falciparum malaria in out-patients at specialist children hospital in the area under study.

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 relationship between blood glucose, lactate and haemoglobin concentrations in childhood malaria?
  • What is the prevalence and severity of hypoglycaemia in the subjects diagnosed with Plasmodium falciparum?
  • What is the relationship between the parasite load and some biochemical parameters?
  • What is the prevalence and severity of lactic acidosis in the subjects?
  • What is the prevalence of Plasmodium falciparum malaria in out-patients at specialist children hospital in the area under study?

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 is no significant relationship between blood glucose, lactate and haemoglobin concentrations in childhood malaria
  • H1: There is a significant relationship between blood glucose, lactate and haemoglobin concentrations in childhood malaria

Hypothesis Two

  • H0: The Prevalence and severity of hypoglycaemia in the subjects diagnosed with Plasmodium falciparum is significantly low
  • H1: The Prevalence and severity of hypoglycaemia in the subjects diagnosed with Plasmodium falciparum is significantly high

1.7 Significance of Study

Considering the significant of the environment on the control and prevention of malaria, this study was aimed at assessing environmental sanitation practices on malaria prevention and control in Ussa Metropolis. The findings in this study are also important to the government because it elucidates the need for government to provide an effective waste management and control scheme.

This study will enhance the existing body of literature by contemplating the areas of the literature that have not yet been examined or considered and incorporating these factors into the current study. The study will thus form the basis for further studies in the field.


1.8 Scope of Study

The scope of the research is focused on the Prevalence and Severity of Hypoglycemia and Lactic Acidosis in Children Diagnosed with Plasmodium Falciparum Malaria using Ussa Metropolis, Taraba State as a case study.


1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

  1. 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.
  2. Research material: availability of research material is a major setback to the scope of the study.
  3. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
  4. 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

Symptoms: Is the sign given when a particular thing want to happen

Vaccines: Are things you do to keep something away or to prevent a disease.

Diagnosis: 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

CHAPTER TWO

2.0 Literature Review

2.1 Introduction

This chapter focuses on the review of related literature. A literature review includes the current knowledge as well as theoretical and methodological contributions to a particular topic. It documents the state of the art with respect to the topic you are writing. It surveys the literature in the topic selected. In this research work the literature review includes the …

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