Abstract

Malaria is a parasitic disease that is endemic throughout the tropics and sub-tropics and is a cause of morbidity and mortality (Danielle and Glenda, 2016). It is estimated that 400-600 million cases of malaria occur every year with up to three million deaths and the majority of these cases occur in African children under the age of five years and pregnant women (WHO, 2017). Although the prevalence of malaria and its associated predisposing factors have been widely documented worldwide. There is a need for an update of the current status of malaria especially in Cameroon with a very high prevalence. This study sought to investigate the prevalence of malaria and its predisposing factors among patient attending Regional Hospital Buea. Demographic data and predisposing factors to malaria were obtained by administering a structured questionnaire. Venous blood was collected by venipuncture and malaria parasite status determined by light microscopy. A total of 231 individuals aged 08 to 60 years were enrolled. The mean [± SD] age, was 28.89 [± 9.18] which ranges from 8-60 years. The highest age was 60years old and lowest was 8years old. Most participants were females (57.1%), resident at high altitude (68.4%), Afebrile (65.5%) and negative for malaria infection (73.5%). The nature of the environment was the most important predisposing factor with the highest prevalence of 85.2% in a clean environment and the least in an unclean environment with a prevalence of 14.8% in the study population. The highest prevalence was in the age group 16-30 with a prevalence of 63.9% and the least was in the age group ≤15 with a prevalence of 4.9% in the study population. Also, the highest prevalence was found among females with a prevalence of 65.6% than the males with a prevalence of 34.4%.

These results suggest a low prevalence of 26.5 % of malaria parasites infection in the Buea Health District, South West Region Cameroon.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Malaria is a parasitic disease that is endemic throughout the tropics and sub-tropics and is a cause of morbidity and mortality (Danielle and Glenda, 2016). It is estimated that 400-600 million cases of malaria occur every year with up to three million deaths and the majority of these cases occur in African children under the age of five years and pregnant women (WHO, 2017). About 80% of death occurs during the first 24 hours following admission into the hospital as a result of the disease (Dzeing-Ella, 2005). The disease is endemic in Cameroon causing a significant rate of morbidity and mortality with 70% of the population being at risk and no malaria-free zone (Jada et al., 2017). According to Yekakong et al., (2017) malaria prevalence in Buea between 2011-1013 was 20.5%. Malaria is caused by a protozoan of the genus Plasmodium and is transmitted by female mosquitoes of the genus Anopheles. Five species of Plasmodium are responsible for human infections namely; P. falciparum, P. ovale, P. vivax, P. malariae, and P. knowlesi with P. falciparum being the most fatal.

The most significant outcome of malaria is anaemia (Mims, 2004) which has three clinical patterns. These include; anaemia which develops rapidly following an acute attack by malaria, chronic anaemia where patients present general symptoms of ill health often without high fever and some individuals may present haematological changes that are between acute and chronic anaemia. Other outcomes in pregnant women are stillbirths and low birth weights (WHO, 2017). Malaria usually results in acute febrile illness, chronic debilitation, complications in pregnancy, and physical impairment of development and learning ability in children (Adams et al., 1994). These represent a huge negative social impact in the endemic areas. In addition, the macroeconomic toll is severe, particularly in sub-Sahara Africa, where malaria may cause more than one percentage point of economic growth every year (Sachs and Malaney, 2002). Studies have shown that there are seasonal differences in the prevalence of malaria parasitaemia with peaks during the rainy season (Nkuo-Akenji and Deas, 1994). Several factors contribute to high prevalence rates and these include drug and insecticide resistance.

1.2 Statement of the problem

Malaria remains a major public health problem in Sub-saharan Africa and a major killer of humans worldwide, threatening the lives of more than one-third of the world’s population (WHO, 2018). Despite the efforts put in place in the eradication of malaria, the disease still strives. Moreover, control strategies are becoming less successful due to antimalarial drug resistance in the parasite, insecticide resistance in mosquitoes and the existence of some predisposing factors. Therefore, there is an urgent need to determine the level of malaria and its predisposing factors in patients living in the Buea Health District, Southwest Cameroon. This will go a long way to give baseline data for the level of malaria in Buea.

1.3 Objectives of the study

1.3.1 Main objective

The main objective of this study is to investigate the prevalence of malaria and its predisposing factors among patient attending Regional Hospital Buea.

1.3.2 Specific objectives

1. To determine the prevalence of malaria among patient attending Buea Regional Hospital with respect to age.
2. To determine the prevalence of malaria among patient attending Buea Regional Hospital with respect to gender.
3. To investigate the predisposing factors of malaria among patient attending Buea Regional Hospital.