Malaria remains the most devastating human parasitic infection in the world today. it has been estimated that between 1-2 billion people throughout the world lives in areas at risk of malarial infection and each year up to 500 million people contract the disease out of which 1.7 million to 2.7 million people die. Several recent reports indicate that more than 90% of these causalities are from Africa, south of the sahara where the most virulent species of the parasite Plasmodium Falciparum thrives. Malaria is hyper endemic in all parts of Nigeria, which lies in the tropical region of Africa, with the entire population of an estimated one hundred and sixty million at risk. Transmission occurs all year round with seasonal variations during the rainy season. Malaria is the number one cause of morbidity in Nigeria accounting for ninety percent of all out-patient illnesses, sixty percent of all admissions and thirty-three percent of all deaths in children under five years.
TABLE OF CONTENTS page
ATTESTATION ......................................................................................................................................... iii
CERTIFICATION ...................................................................................................................................... iv
DEDICATION ............................................................................................................................................. v
ACKNOWLEDGMENTS ........................................................................................................................... vi
TABLE OF CONTENTS ........................................................................................................................... vii
LIST OF TABLES ...................................................................................................................................... xi
LIST OF ACRONYMS ............................................................................................................................. xiii
SUMMARY ............................................................................................................................................... xv
DEFINITION OF TERMS ....................................................................................................................... xvii
CHAPTER ONE .......................................................................................................................................... 1
INTRODUCTION ....................................................................................................................................... 1
1.1 Background Information ......................................................................................................................... 1
1.2 Problem Statement .............................................................................................................................. 4
1.3 Justification ........................................................................................................................................ 6
1.4 Research Questions ............................................................................................................................. 7
1.5 General Objectives and Specific Objectives ....................................................................................... 7
1.5.1 General objectives ............................................................................................................................ 7
1.5.2 Specific objectives ........................................................................................................................... 7
CHAPTER TWO ......................................................................................................................................... 8
LITERATURE REVIEW ............................................................................................................................. 8
2.1 Malaria Overview of Malaria in Pregnancy ........................................................................................ 8
2.2 Malaria Transmission .......................................................................................................................... 8
2.3 Life cycle of malaria parasites ............................................................................................................ 9
............................................................................................................................................................... 10
2.4 Epidemiology of Malaria .................................................................................................................. 11
2.4.1 Group susceptible to malaria.......................................................................................................... 12
2.5 Consequences of Malaria in Pregnancy ............................................................................................ 12
2.6 Current Practices in Preventing Malaria in Pregnancy in Nigeria .................................................... 13
2.7 Overview of Intermittent Preventive Treatment for Malaria (IPTp)................................................. 14
2.8 Safety of Sulfadoxine-Pyrimethamine .............................................................................................. 14
2.9 Use of SP for Intermittent Preventive Treatment .............................................................................. 15
2.10 Determining Gestational Age for SP Administration ..................................................................... 15
2.11 Dosage of SP .................................................................................................................................. 16
2.12 Gestational Age at First ANC Visit ................................................................................................ 17
2.13 Knowledge on Malaria .................................................................................................................... 18
2.14 Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) ............................................... 19
2.15 Knowledge of Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) ....................... 20
2.16 Factors that influence IPT Utilization ............................................................................................. 21
CHAPTER THREE ................................................................................................................................... 23
METHODOLOGY .................................................................................................................................... 23
3.1 Study Area ....................................................................................................................................... 23
3.2 Study Designs .................................................................................................................................. 24
3.3 Study Population ............................................................................................................................... 24
3.3.1 Inclusion Criteria ........................................................................................................................... 24
3.3.2 Exclusion Criteria .......................................................................................................................... 25
3.4 Sample Size Determination ............................................................................................................... 26
3.5 Sampling Technique ......................................................................................................................... 27
3.6 Study Instruments ............................................................................................................................. 30
3.7 Data Collection Methods .................................................................................................................. 30
3.8 Data Management ............................................................................................................................. 31
3.8.1 Measurement of variables .............................................................................................................. 31
3.8.1.1 The independent variables: ......................................................................................................... 31
3.8.1.2. Dependent variables ................................................................................................................... 31
Use of IPTp (IPT Utilization) ................................................................................................................. 31
3.8.2 Statistical Analyses ........................................................................................................................ 32
3.9 Ethical Considerations ...................................................................................................................... 33
3.10 Limitations ..................................................................................................................................... 33
CHAPTER FOUR ...................................................................................................................................... 35
RESULTS .................................................................................................................................................. 35
4.1: Socio-demographic characteristics .................................................................................................. 35
4.2 Gestational Age at First ANC Booking ............................................................................................ 37
4.3 Knowledge of Malaria ...................................................................................................................... 38
4.4 Knowledge of IPTp ........................................................................................................................... 41
4.5 Utilization of SP among the studied subjects .................................................................................... 45
Table 10: Multi Variable Analysis of some Determinants 0f IPT immunization ....................................... 49
CHAPTER FIVE ....................................................................................................................................... 50
DISCUSSION ............................................................................................................................................ 50
CHAPTER SIX: CONCLUSION AND RECOMMENDATIONS ............................................................ 55
6.1 CONCLUSION ................................................................................................................................ 55
6.2 RECOMMENDATION .................................................................................................................... 56
REFERENCES .......................................................................................................................................... 57
APPENDICES ........................................................................................................................................... 67
Appendix 1: Questionnaire ..................................................................................................................... 67
Map of Nigeria showing Jigawa State .................................................................................................... 76
