CHAPTER ONE

INTRODUCTION

1.1 Background

Malaria is a parasitic disease that is endemic throughout the tropics and sub-tropics and is a cause of morbidity and mortality [9]. 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 [37]. About 80% of death occurs during the first 24 hours following admission into the hospital as a result of the disease [12] .

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 [19]. Malaria prevalence in Buea between 2011-2013 was 20.5%[12]. 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 [21]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 [37]). Malaria usually results in acute febrile illness, chronic debilitation, complications in pregnancy, and physical impairment of development and learning ability in children [1].

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 [26] ,Studies have shown that there are seasonal differences in the prevalence of malaria parasitaemia with peaks during the rainy season [2]Several factors contribute to high prevalence rates and these include drug and insecticide resistance.

1.2 Problem Statement

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 [38] 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 Research Questions

1.3.1 Main question

What is the prevalence of malaria and its predisposing factors among patient attending Buea Regional Hospital?

1.3.2 Specific questions

1. What is the prevalence of malaria among patients attending Buea Regional Hospital based on age?
2. What is the prevalence of malaria among patients attending Buea Regional Hospital based on gender?
3. What are the predisposing factors of malaria among patients attending Buea Regional Hospital?

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