Skip to main content
Top
Published in: BMC Infectious Diseases 1/2016

Open Access 01-12-2016 | Research article

Malaria Parasitaemia and the use of insecticide-treated nets (INTs) for malaria control amongst under-5 year old children in Calabar, Nigeria

Authors: Anthony Achizie Iwuafor, Chukwudi Charles Egwuatu, Agwu Ulu Nnachi, Ita Okokon Ita, Godwin Ibitham Ogban, Comfort Nneka Akujobi, Tenny Obiageli Egwuatu

Published in: BMC Infectious Diseases | Issue 1/2016

Login to get access

Abstract

Background

Malaria remains a major cause of febrile illness in Nigeria and interventions to reduce malaria burden in Nigeria focus on the use of insecticide-treated nets. This study determined the prevalence of malaria parasitaemia and the use of insecticide-treated nets (ITNs) for the control of malaria amongst under-five year old children in Calabar, Nigeria.

Methods

A total of 270 under-5 year old children were recruited and structured questionnaires were used to obtain information on the background characteristics of the respondents from their caregivers. Capillary blood samples were collected from each of the patients through finger-pricking and tested for malaria parasites by Rapid Diagnostic Test and microscopy.

Results

An overall parasitaemia prevalence of 32.2 % (by Rapid diagnostic test kit [RDT]) and 40.1 % (by microscopy) were obtained in this study. Forty-six (45.5 %) of the febrile patients had malaria parasitaemia (by RDT) or 41 (59.4 %) by microscopy. One hundred and fifty (55.6 %) of the caregivers acknowledged the use of nets on doors and windows for malaria prevention and control. One hundred and thirty-nine (51.5 %) mentioned sleeping under mosquito net while 138 (51.1 %) acknowledged the use of insecticide sprays. Although 191 (71.5 %) of the households possessed at least one mosquito net, only 25.4 % of the under-5 children slept under any net the night before the survey. No statistically significant reduction in malaria parasitaemia was observed with the use of mosquito nets among the under-5 children. Almost all the respondents (97.8 %) identified mosquito bite as the cause of malaria. Fever was identified by the majority of the respondents (92.2 %) as the most common symptom of malaria.

Conclusions

The findings of the study showed high prevalence of parasitaemia and that fever was significantly associated with malaria parasitaemia. Mosquito net utilization among the under-fives was low despite high net ownership rate by households. Therefore, for effective control of malaria, public health education should focus on enlightening the caregivers on signs/symptoms of both uncomplicated and complicated malaria as well as encourage the use of ITNs especially among the under-fives.
Appendix
Available only for authorised users
Literature
2.
go back to reference Ketema T, Bacha K, Alemayehu E, Ambelu A. Incidence of Severe Malaria Syndromes and status of immune responses among Khat Chewer malaria patients in Ethiopia. PLoS One. 2015;10(7), e0131212.CrossRefPubMedPubMedCentral Ketema T, Bacha K, Alemayehu E, Ambelu A. Incidence of Severe Malaria Syndromes and status of immune responses among Khat Chewer malaria patients in Ethiopia. PLoS One. 2015;10(7), e0131212.CrossRefPubMedPubMedCentral
3.
go back to reference World Health Organization. World malaria report. Geneva: World Health Organization; 2011. World Health Organization. World malaria report. Geneva: World Health Organization; 2011.
5.
go back to reference Federal Ministry of Health [FMOH]/National Malaria Control Programme [NMCP]. Strategic Plan 2009–2013: A road Map for Malaria control in Nigeria, Abuja. 2008. Federal Ministry of Health [FMOH]/National Malaria Control Programme [NMCP]. Strategic Plan 2009–2013: A road Map for Malaria control in Nigeria, Abuja. 2008.
6.
go back to reference World Health Organization. World malaria report. Geneva: World Health Organization; 2013. World Health Organization. World malaria report. Geneva: World Health Organization; 2013.
7.
go back to reference World Health Organization. World malaria report. Geneva: World Health Organization; 2014. World Health Organization. World malaria report. Geneva: World Health Organization; 2014.
8.
go back to reference Kleinschmidt I, Mnzava AP, Kafy HT, Mbogo C, Bashir AI, et al. Design of a study to determine the impact of insecticide resistance on malaria vector control: a multi-country investigation. Malar J. 2015;14:282.CrossRefPubMedPubMedCentral Kleinschmidt I, Mnzava AP, Kafy HT, Mbogo C, Bashir AI, et al. Design of a study to determine the impact of insecticide resistance on malaria vector control: a multi-country investigation. Malar J. 2015;14:282.CrossRefPubMedPubMedCentral
9.
go back to reference National Malaria Control Programme [NMCP]/Roll Back Malaria [RBM]. NMCP/RBM Business Plan (2009–2010), Nigeria. 2009. National Malaria Control Programme [NMCP]/Roll Back Malaria [RBM]. NMCP/RBM Business Plan (2009–2010), Nigeria. 2009.
10.
go back to reference Muller O, Traore C, Kouyate B, Ye Y, Frey C, Coulibaly B, Becher H. Effects of insecticide-treated bednets during early infancy in an African area of intense malaria transmission: a randomized controlled trial. Bull World Health Organ. 2006;84:120–6.CrossRefPubMedPubMedCentral Muller O, Traore C, Kouyate B, Ye Y, Frey C, Coulibaly B, Becher H. Effects of insecticide-treated bednets during early infancy in an African area of intense malaria transmission: a randomized controlled trial. Bull World Health Organ. 2006;84:120–6.CrossRefPubMedPubMedCentral
11.
go back to reference World Health Organization. Handbook: Integrated Management of Childhood Illness [IMCI]. Geneva: WHO; 2005. p. 239–50. World Health Organization. Handbook: Integrated Management of Childhood Illness [IMCI]. Geneva: WHO; 2005. p. 239–50.
12.
go back to reference National Population Commission (NPC) [Nigeria]. National Malaria Control Programme (NMCP) [Nigeria], and ICF International. Nigeria Malaria Indicator Survey 2010. Abuja, Nigeria: NPC, NMCP, and ICF International; 2012. National Population Commission (NPC) [Nigeria]. National Malaria Control Programme (NMCP) [Nigeria], and ICF International. Nigeria Malaria Indicator Survey 2010. Abuja, Nigeria: NPC, NMCP, and ICF International; 2012.
13.
go back to reference Cheesbrough M. District Laboratory Practice in Tropical Countries. Part 1. Second edition. New York, USA: Cambridge University Press; 2006.CrossRef Cheesbrough M. District Laboratory Practice in Tropical Countries. Part 1. Second edition. New York, USA: Cambridge University Press; 2006.CrossRef
14.
go back to reference Mazigo HD, Meza W, Ambrose EE, Kidenya BR, Kweka EJ. Confirmed malaria cases among children under five with fever and history of fever in rural western Tanzania. BMC Res Notes. 2011;4:359.CrossRefPubMedPubMedCentral Mazigo HD, Meza W, Ambrose EE, Kidenya BR, Kweka EJ. Confirmed malaria cases among children under five with fever and history of fever in rural western Tanzania. BMC Res Notes. 2011;4:359.CrossRefPubMedPubMedCentral
15.
go back to reference Hozhabri S, Luby SP, Rahbar MH, Akhtar S. Clinical diagnosis of Plasmodium falciparum among children with history of fever, Sindh, Pakistan. Int J Infect Dis. 2002;6(3):233–5.CrossRefPubMed Hozhabri S, Luby SP, Rahbar MH, Akhtar S. Clinical diagnosis of Plasmodium falciparum among children with history of fever, Sindh, Pakistan. Int J Infect Dis. 2002;6(3):233–5.CrossRefPubMed
16.
go back to reference Dzeing-Ella A, Nze-Obiang PC, Tchoua R, Planche T, Mboza B, Mbounja M, et al. Severe falciparum malaria in Gabonese children: clinical and laboratory features. Malar J. 2005;4:1.CrossRefPubMedPubMedCentral Dzeing-Ella A, Nze-Obiang PC, Tchoua R, Planche T, Mboza B, Mbounja M, et al. Severe falciparum malaria in Gabonese children: clinical and laboratory features. Malar J. 2005;4:1.CrossRefPubMedPubMedCentral
17.
go back to reference Ejezie GC, Ezedinachi EN. Malaria parasite density and body temperature in children under 10 years of age in Calabar, Nigeria. Trop Geogr Med. 1992;44(1–2):97–101.PubMed Ejezie GC, Ezedinachi EN. Malaria parasite density and body temperature in children under 10 years of age in Calabar, Nigeria. Trop Geogr Med. 1992;44(1–2):97–101.PubMed
18.
go back to reference Mabunda S, Aponte JJ, Tiago A, Alonso P. A country-wide malaria survey in Mozambique. II. Malaria attributable proportion of fever and establishment of malaria case definition in children across different epidemiological settings. Malar J. 2009;8:74.CrossRefPubMedPubMedCentral Mabunda S, Aponte JJ, Tiago A, Alonso P. A country-wide malaria survey in Mozambique. II. Malaria attributable proportion of fever and establishment of malaria case definition in children across different epidemiological settings. Malar J. 2009;8:74.CrossRefPubMedPubMedCentral
19.
go back to reference Doolan DL, Dobano C, Baird JK. Acquired immunity to malaria. ClinMicrobiol Rev. 2009;22(1):13–36. Doolan DL, Dobano C, Baird JK. Acquired immunity to malaria. ClinMicrobiol Rev. 2009;22(1):13–36.
20.
go back to reference Nkuo-Akenji T, Ntonifor NN, Ndukumu MB, Kimbi HK, Abongwa EL, Nkwescheu A, et al. Environmental factors affecting malaria parasite prevalence in rural Bolifamba, South-West Cameroon. Afr J Health Sci. 2006;13:40–4.PubMed Nkuo-Akenji T, Ntonifor NN, Ndukumu MB, Kimbi HK, Abongwa EL, Nkwescheu A, et al. Environmental factors affecting malaria parasite prevalence in rural Bolifamba, South-West Cameroon. Afr J Health Sci. 2006;13:40–4.PubMed
21.
go back to reference National Population Commission (NPC) [Nigeria] and ORC Macro. Nigeria Demographic and Health Survey, NDHS, 2003. Abuja, Nigeria: NPC and ORC Macro; 2004. National Population Commission (NPC) [Nigeria] and ORC Macro. Nigeria Demographic and Health Survey, NDHS, 2003. Abuja, Nigeria: NPC and ORC Macro; 2004.
22.
go back to reference Ashikeni MA, Envuladu EA, Zoakah AI. Malaria and the use of the Insecticide Treated Net (ITN) among under-five children in Kuje Area Council of the Federal Capital Territory Abuja, Nigeria. Int J Mosq Res. 2013;3(6):45–53. Ashikeni MA, Envuladu EA, Zoakah AI. Malaria and the use of the Insecticide Treated Net (ITN) among under-five children in Kuje Area Council of the Federal Capital Territory Abuja, Nigeria. Int J Mosq Res. 2013;3(6):45–53.
23.
go back to reference Daboer JC, Chingle MP, Ogbonna C. Malaria Parasitaemia and Household use of Insecticide Treated Bed Nets: a cross-sectional survey of under-five in Jos, Nigeria. Niger Med J. 2010;51(1):5–9. Daboer JC, Chingle MP, Ogbonna C. Malaria Parasitaemia and Household use of Insecticide Treated Bed Nets: a cross-sectional survey of under-five in Jos, Nigeria. Niger Med J. 2010;51(1):5–9.
24.
go back to reference Garcia-Basteiro BL, Schwabe C, Aragon C, Baltazar G, Rehman AM, Matias A. Determinants of bed net use in children under five and household bed net ownership on Bioko Island, Equatorial Guinea. Malar J. 2011;10:179.CrossRefPubMedPubMedCentral Garcia-Basteiro BL, Schwabe C, Aragon C, Baltazar G, Rehman AM, Matias A. Determinants of bed net use in children under five and household bed net ownership on Bioko Island, Equatorial Guinea. Malar J. 2011;10:179.CrossRefPubMedPubMedCentral
25.
go back to reference Stratton L, O’Neill MS, Kruk MS, Bell ML. The persistent problem of malaria: addressing the fundamental causes of a global killer. Soc Sci Med. 2008;67(5):854–62.CrossRefPubMed Stratton L, O’Neill MS, Kruk MS, Bell ML. The persistent problem of malaria: addressing the fundamental causes of a global killer. Soc Sci Med. 2008;67(5):854–62.CrossRefPubMed
26.
go back to reference Oresanya OB, Hoshen M, Sofola OT. Utiliszation of insecticide-treated nets by under-five children in Nigeria: assessing progress towards the Abuja targets. Malar J. 2008;7:145.CrossRefPubMedPubMedCentral Oresanya OB, Hoshen M, Sofola OT. Utiliszation of insecticide-treated nets by under-five children in Nigeria: assessing progress towards the Abuja targets. Malar J. 2008;7:145.CrossRefPubMedPubMedCentral
27.
go back to reference Arogundade ED, Adebayo SB, Anyanti J, Nwokolo E, Ladipo O, Ankoma A. Relationship between care-givers misconceptions and non-use of ITNs by under-five Nigerian children. Malar J. 2011;10(170):1–10. Arogundade ED, Adebayo SB, Anyanti J, Nwokolo E, Ladipo O, Ankoma A. Relationship between care-givers misconceptions and non-use of ITNs by under-five Nigerian children. Malar J. 2011;10(170):1–10.
28.
go back to reference National Population Commission (NPC) [Nigeria] and ICF Macro. Nigeria Demographic and Health Survey, NDHS, 2008. Abuja, Nigeria: NPC and ICF Macro; 2009. National Population Commission (NPC) [Nigeria] and ICF Macro. Nigeria Demographic and Health Survey, NDHS, 2008. Abuja, Nigeria: NPC and ICF Macro; 2009.
29.
go back to reference Tobin-West CI, Alex-Hart BA. Insecticide-treated bednet ownership and utilisation in Rivers State, Nigeria before a state-wide net distribution campaign. J Vector Dis. 2011;48:133–7. Tobin-West CI, Alex-Hart BA. Insecticide-treated bednet ownership and utilisation in Rivers State, Nigeria before a state-wide net distribution campaign. J Vector Dis. 2011;48:133–7.
30.
go back to reference Ordinioha B. The use of insecticide-treated bednet in a semi-urban community in south Nigeria. Niger J Med. 2007;16:223–6.PubMed Ordinioha B. The use of insecticide-treated bednet in a semi-urban community in south Nigeria. Niger J Med. 2007;16:223–6.PubMed
31.
go back to reference Eisele TP, Keating J, Littrell M, Larsen D, Macintyre K. Assessment of insecticide-treated bednet use among children and pregnant women across 15 countries using standardized national surveys. Am J Trop Med Hyg. 2009;80:2009–214. Eisele TP, Keating J, Littrell M, Larsen D, Macintyre K. Assessment of insecticide-treated bednet use among children and pregnant women across 15 countries using standardized national surveys. Am J Trop Med Hyg. 2009;80:2009–214.
32.
go back to reference Lim SS, Fullman N, Stokes A, Ravishankar N, Masiye F, Murray CJL, et al. Net benefits: A multi-country analysis of observational data examining associations between insecticide-treated mosquito nets and health outcomes. PLoS Med. 2011;8, e1001091.CrossRefPubMedPubMedCentral Lim SS, Fullman N, Stokes A, Ravishankar N, Masiye F, Murray CJL, et al. Net benefits: A multi-country analysis of observational data examining associations between insecticide-treated mosquito nets and health outcomes. PLoS Med. 2011;8, e1001091.CrossRefPubMedPubMedCentral
33.
go back to reference Abdulla S, Schellenberg JA, Nathan R, Mukasa O, Marchant T, et al. Impact on malaria morbidity of a programme supplying insecticide treated nets in children aged under- 2 years in Tanzania: community cross sectional study. BMJ. 2001;322:270–3.CrossRefPubMedPubMedCentral Abdulla S, Schellenberg JA, Nathan R, Mukasa O, Marchant T, et al. Impact on malaria morbidity of a programme supplying insecticide treated nets in children aged under- 2 years in Tanzania: community cross sectional study. BMJ. 2001;322:270–3.CrossRefPubMedPubMedCentral
34.
go back to reference Noor AM, Moloney G, Borle M, Fegan GW, Shewchuk T, et al. The use of mosquito nets and the prevalence of Plasmodium falciparum infection in rural south central Somalia. PLoS One. 2008;3, e2081.CrossRefPubMedPubMedCentral Noor AM, Moloney G, Borle M, Fegan GW, Shewchuk T, et al. The use of mosquito nets and the prevalence of Plasmodium falciparum infection in rural south central Somalia. PLoS One. 2008;3, e2081.CrossRefPubMedPubMedCentral
36.
go back to reference Yewhalaw D, Kassahun W, Woldemichael K, Tushune K, Sudaker M, Kaba D, et al. The influence of the Gilgel-Gibe hydroelectric dam in Ethiopia on care-givers’ knowledge, perceptions and health-seeking behaviour towards childhood malaria. Malar J. 2010;9:47.CrossRefPubMedPubMedCentral Yewhalaw D, Kassahun W, Woldemichael K, Tushune K, Sudaker M, Kaba D, et al. The influence of the Gilgel-Gibe hydroelectric dam in Ethiopia on care-givers’ knowledge, perceptions and health-seeking behaviour towards childhood malaria. Malar J. 2010;9:47.CrossRefPubMedPubMedCentral
37.
go back to reference Oreagba AL, Onajole AT, Olayemi SO, Mabadeje AFB. Knowledge of malaria amongst care-givers of young children in rural and urban communities in Southwest Nigeria. Trop J Pharm Res. 2004;3(1):299–304. Oreagba AL, Onajole AT, Olayemi SO, Mabadeje AFB. Knowledge of malaria amongst care-givers of young children in rural and urban communities in Southwest Nigeria. Trop J Pharm Res. 2004;3(1):299–304.
38.
go back to reference Sanjana P, Barcus MJ, Bangs MJ, Ompusunggu S, Elyazar I, Marwoto H, et al. Survey of community knowledge, attitudes and practices during a malaria epidemic in central Java, Indonesia. Am J Trop Med Hyg. 2006;75:785–9. Sanjana P, Barcus MJ, Bangs MJ, Ompusunggu S, Elyazar I, Marwoto H, et al. Survey of community knowledge, attitudes and practices during a malaria epidemic in central Java, Indonesia. Am J Trop Med Hyg. 2006;75:785–9.
39.
go back to reference Deressa W, Ali A, Birhane Y. Maternal responses to childhood febrile illnesses in an area of seasonal malaria transmission in rural Ethiopia. Acta Trop. 2007;102:1–9.CrossRefPubMed Deressa W, Ali A, Birhane Y. Maternal responses to childhood febrile illnesses in an area of seasonal malaria transmission in rural Ethiopia. Acta Trop. 2007;102:1–9.CrossRefPubMed
40.
go back to reference Tanner M, Vlassoff C. Treatment-seeking behaviour for malaria: a typology based on endemicity and gender. Soc Sci Med. 1998;46:523–32.CrossRefPubMed Tanner M, Vlassoff C. Treatment-seeking behaviour for malaria: a typology based on endemicity and gender. Soc Sci Med. 1998;46:523–32.CrossRefPubMed
41.
go back to reference Baume C, Helitzer-Allen D, Kachur P. Patterns of care for children malaria in Zambia. Soc Sci Med. 2000;51:1491–503.CrossRefPubMed Baume C, Helitzer-Allen D, Kachur P. Patterns of care for children malaria in Zambia. Soc Sci Med. 2000;51:1491–503.CrossRefPubMed
42.
go back to reference Patel VL, Eisemon TO, Arocha JF. Causal reasoning and the treatment of diarrhoeal diseases by mothers in Kenya. Soc Sci Med. 1988;159:1061. Patel VL, Eisemon TO, Arocha JF. Causal reasoning and the treatment of diarrhoeal diseases by mothers in Kenya. Soc Sci Med. 1988;159:1061.
43.
go back to reference Lars O, Beth E. Malaria in the United Republic of Tanzania: cultural considerations and health seeking behaviour. Bull World Health Organ. 2000;78(11):1352–7. Lars O, Beth E. Malaria in the United Republic of Tanzania: cultural considerations and health seeking behaviour. Bull World Health Organ. 2000;78(11):1352–7.
44.
go back to reference Chukwuocha MU, Nwankwo OB, Amadi NA, Esomonu CO, Dozie INS, Ikegwuoha EA, et al. Treatment seeking behaviour of mothers for febrile children in some rural parts of Imo state Nigeria: Implications for Home management of malaria in Endemic areas. Int J Trop Med. 2009;4(3):132–5. Chukwuocha MU, Nwankwo OB, Amadi NA, Esomonu CO, Dozie INS, Ikegwuoha EA, et al. Treatment seeking behaviour of mothers for febrile children in some rural parts of Imo state Nigeria: Implications for Home management of malaria in Endemic areas. Int J Trop Med. 2009;4(3):132–5.
45.
go back to reference Agu AP, Nwojiji JO. Childhood malaria: mothers’ perception and treatment-seeking behavior in a community in Ebonyi State, South East Nigeria. J Com Med Prim Health Care. 2005;17(1):45–50. Agu AP, Nwojiji JO. Childhood malaria: mothers’ perception and treatment-seeking behavior in a community in Ebonyi State, South East Nigeria. J Com Med Prim Health Care. 2005;17(1):45–50.
46.
go back to reference Hill ZC, Kendali P, Arthur B, Kirikwood E, Adjei E. Recognizing childhood illness and their traditional explanations: exploring options for care-seeking interventions in the context of the IMCI strategy in rural Ghana. Trop Med IntHealth. 2003;8:668–76.CrossRef Hill ZC, Kendali P, Arthur B, Kirikwood E, Adjei E. Recognizing childhood illness and their traditional explanations: exploring options for care-seeking interventions in the context of the IMCI strategy in rural Ghana. Trop Med IntHealth. 2003;8:668–76.CrossRef
Metadata
Title
Malaria Parasitaemia and the use of insecticide-treated nets (INTs) for malaria control amongst under-5 year old children in Calabar, Nigeria
Authors
Anthony Achizie Iwuafor
Chukwudi Charles Egwuatu
Agwu Ulu Nnachi
Ita Okokon Ita
Godwin Ibitham Ogban
Comfort Nneka Akujobi
Tenny Obiageli Egwuatu
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2016
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-016-1459-5

Other articles of this Issue 1/2016

BMC Infectious Diseases 1/2016 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.