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, Limitation of the study and Definition of terms.
1.2 Background of Study
Pregnant women are particularly susceptible to anopheles (Lindsay et al., 2000) and it is well known that they are at higher risk to become infected (Duffy et al., 2001 and Menendez, 1995). Furthermore, during pregnancy the likelihood of microscopic parasitemia increases several fold (Brabin, 1991 and Gilles et al., 1969). This susceptibility exists throughout pregnancy but especially in the second trimester, and to some extent into the puerperium (Diagne et al., 1997). 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 w98x.
Although all four Plasmodium species can infect pregnant women, only susceptibility to P. vivax and P. falciparum is known to increase during pregnancy. Around 50 million pregnant women live in endemic areas (half in sub-Saharan Africa), and most of them in areas of intense P. falciparum transmission. Malaria infection during pregnancy poses substantial risk to the mother, her fetus (and the neonate). It is a major cause of severe maternal anemia and responsible for an estimated 30–35% of low birth weight (LBW) babies and for 75,000–200,000 infant deaths each year (Steketee et al., 2001). Recent evidence suggests that the impact of malaria on the mother in sub-Saharan Africa has been underestimated and that it may be an important cause of maternal mortality in this region.
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).
Recent data support that parasitemic pregnant women in sub-Saharan Africa do not frequently present clinical signs and, therefore, it is difficult to detect and cure early infections in pregnancy (Briand et al., 2006).
Placental infection is very variable and ranges from 3.5% to 75% depending on the malaria epidemiology in the area, seasonality of infection etc. (Menendez et al., 2000). The only species that was shown to colonize the human placenta is P. falciparum, and there is no evidence that other species such as P. vivax can do it.
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Treatment of Malaria at Pregnancy.
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. The risk of induced hypoglycemia has to be considered (Looareesuwan et al., 1985). 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 ascertain the Treatment of Malaria at Pregnancy. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the factors limiting the Treatment of Malaria at Pregnancy in Enugu State Primary Health Care Services (PHC)
- To identify the ways of Treating Malaria at Pregnancy stage
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 factors limiting the Treatment of Malaria at Pregnancy in Enugu State Primary Health Care Services (PHC)?
- What are the ways of Treating Malaria at Pregnancy stage?
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 factors limiting the Treatment of Malaria at Pregnancy in Enugu State Primary Health Care Services (PHC)
- H1: There is a significant factors limiting the Treatment of Malaria at Pregnancy in Enugu State Primary Health Care Services (PHC)
1.7 Significance of Study
This study will be of immense benefit to 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 the Study
The scope of this research is focused on the Treatment of Malaria at Pregnancy 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).
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