DETECTION OF PLASMODIUM FALCIPARUM ANTIGEN IN WHOLE BLOOD SPECIMEN OF SELECTED SECONDARY SCHOOL STUDENTS IN NASARAWA TOWN

DETECTION OF PLASMODIUM FALCIPARUM ANTIGEN IN WHOLE BLOOD SPECIMEN OF SELECTED SECONDARY SCHOOL STUDENTS IN NASARAWA TOWN

ABSTRACT

The rapid diagnostic tests (RDTs) was used to detect the presence of plasmodium falciparum antigen on 300 blood samples collected from selected secondary school students in Nasarawa Toto town. The overall prevalence of this antigen was 28.7% (86 student). The prevalence of this antigen is 33.1% in males compared to 24.3% in females. Plasmodium falciparum was highest among 16-18 age group (37.0%) while it was lowest in those greater than 18 years. The prevalence of plasmodium falciparum in relation to educational level, Jss1-Jss2 have the highest infection rate of (37.8%) while Jss3-ss1 have the lowest infection rate of (24.4%). Prevalence in duration to treatment, the highest prevalence rate (36.9%) was found among the samples of those who have treated malaria fever for more than 3 months while the least prevalence rate of (5.4%) was found among those that have treated malaria fever in the last one month. 

CHAPTER ONE

1.0                                                                  INTRODUCTION

Malaria is a parasitic disease which is easily preventable, treatable and curable, but still it remains one of the major public health problems in Nigeria (Federal Ministry of Health, 2000). The malaria burden as reported in the country is on the increase in spite of numerous interventions that have been instituted. The obstacles to the success of these interventions are socio-cultural, economic and political in nature. According to (UNICEF, 2004), it kills a child somewhere in the world every 30 seconds. 90% of malaria deaths occur in Africa, where malaria accounts for about one in five of all childhood deaths. Each year, there are approximately 515 million cases of malaria, killing between one and three million people, the majority of whom are young children in Sub-Saharan Africa (Snow, et al., 2005).

The overwhelming bulk of the world’s malaria burden rests upon the population of sub-Saharan Africa because of the unique coincidence of expanding human populations, weak health systems, the world’s most effective vector mosquito species, and environmental conditions ideal for transmission. Approximately 40% of the world’s populations live in regions where malaria transmission is endemic, mainly tropical and sub-tropical regions (Aultman et al., 2002). At the start of the new millennium, malaria is still deeply entrenched in Africa and effective malaria control is under threat from the inexorable spread of parasite strains resistant to anti-malarial drugs and the emergence of mosquitoes resistant to the pyrethroid insecticides used to impregnate bed nets (Aultman et al., 2002).

In Africa, on an average about one in 20 children die from malaria. In areas of low endemicity, where the immunity is low, severe infection occurs in all age groups including adults (Okiro et al., 2007). The morbidity and mortality due to malaria in children tends to be very high in these areas. Severe falciparum malaria is the commonest cause of death in infants and children in areas endemic and hyper endemic for malaria. Inadequate immunity results in rapid increase in the parasite count and development of complications. Delay in diagnosis and treatment also contributes to the mortality (Okiro et al., 2007).

In Nigeria, malaria is endemic throughout the country. World Health Organization (WHO) estimated malaria mortality rate for children under five in Nigeria at 729 per 100, 000. Malaria has a great morbidity and mortality than any other infectious diseases of the world (World Malarial Report, 2005; WHO, 2000); a child will be sick of malaria between two and four times in one year. The Ministry of Health reported in April 2004 that malaria is responsible for one out of ten deaths in pregnant women and has caused the Federal Government of Nigeria over one billion Naira annually in treating malaria (Aribodor et al., 2013). At least, 50% of the population suffers from at least one episode of malaria each year. The disease is the commonest cause of outpatient attendance across all age groups.

The result of the most comprehensive study of the malaria situation in Nigeria conducted across the six geographical zones in Nigeria have signified the public health importance of malaria the study confirmed that malaria is a major cause of morbidity and mortality especially among vulnerable groups including pregnant women and children aged less than 5 years. The incidence of malaria among the under fives across six geographical zones during the study were as follows: South-South 32.7%, South-West 36.6%, South East 30.7%, North-Central 58.8%, North-East 55.3% and North-West 33.6%. Malaria also accounted for 63% of the diseases reported in healthcare facilities across the six geographical zones (Aribodor et al., 2013).

Effective management of malaria requires accurate diagnosis accompanied by prompt treatment (Wongsrichanalai et al., 2007). Microscopy is the gold standard and in remote settings where adequate expert performance is needed, this method is a challenge due to few trained personnel to carry out microscopy (Amexo et al., 2004). Application of other malaria diagnostic tests such as Rapid Diagnostic Tests (RDT) to circumvent the drawbacks is therefore necessary. Kits from different companies may differ in sensitivity and specificity. It is therefore imperative to conduct field evaluation of kits from different manufacturers before they are recommended for widespread use in diagnosis of malaria (Fancony et al., 2013). This is important since their performance may be impacted by extreme temperatures and high humidity (Maltha et al., 2013). Studies on performance of malaria rapid diagnostic test kits have been conducted in various parts of Kenya and findings indicated better sensitivities and specificities (Wanja et al., 2016).

Understanding the current incidence and transmission patterns of malaria in Nasarawa can positively influence the choice of control tools deployed in different epidemiological zones. These necessitate extensive malaria screening to map out the possible existence of  foci  with  prolonged  transmission,  necessary  for  the  estimation  of  the  malaria  burden (Fancony et al., 2013). Unfortunately, few studies are usually conducted in low transmission areas leading to scarcity of information, hence no interventions or inappropriate measures are put in place to curb the malaria transmission (Silal et al., 2013). Information  on  Plasmodium falciparum malaria parasite  species  infection  risks  and  clinical  epidemiology  in  Nasarawa is limited and only very scantly documented (Snow et al., 2009). This has necessitated this study to determine the detection of the antigen of Plasmodium falciparum in whole blood specimens of secondary school students in Nasarawa.

1.1       Statement of the problem

Malaria remains one of the most serious health problems. There are an estimated one million deaths each year, with nearly seventy five percent (75%) occurring in children living in sub-Saharan Africa. Malaria is caused by a parasite, transmitted from one person to another through the bite of certain species of mosquito in parasite endemic regions. A very efficient mosquito (Anopheles Gambiae) is responsible for high transmission.

The causative agents of malaria (malaria parasite) are four species of plasmodium protozoa which includes; Plasmodium ovale, Plasmodium malariae, Plasmodium falciparum, Plasmodium       vivax.

Plasmodium falciparum and plasmodium malariae accounts for the majority of malaria infection in Nigeria. plasmodium falciparum pose the greatest threat. In Nigeria the percentage distribution of species is; Plasmodium falciparum: 75%, Plasmodium malariae: 15% (bamigboye et al., 1990).

Malaria has become very common and is increasing in an uncontrolled way throughout Nigeria and world as whole, due to the bite of the female anopheles mosquito which carries the plasmodium in an attempt to eradicate this deadly disease, a massive response need to be mounted by the government to enlighten the public about the prevalence of malaria.

1.2       Justification of the study

This study is justifiable as the findings of this study provide relevant information that  will aid intervention and maintain cost effectiveness and equity in prevention, treatment and management of malaria in Nasarawa and Nigeria at large

1.3       Aim of the study

Detection of Plasmodium falciparum antigen in whole blood specimen of selected secondary school students in Nasarawa Town

1.4  Specific Objectives

The Specific of objectives were to

1. To determine the prevalence of Plasmodium falciparum malaria infection among secondary school students in Nasarawa in relation to their demographic factors

2. To determine Plasmodium falciparum in relation to use of nets (Bed, window, door).