INCIDENCE OF MALARIA AMONG CHILDREN UNDER FIVE

YEARS (A CASE STUDY OF SABUWA LOCAL GOVERNMENT

AREA KATSINA STATE, NIGERIA)

BY

SALIHU ARMAYA’U

18/EVT/102

CONSULTANCY SERVICE UNIT

KATSINA STATE COLLEGE OF HEALTH SCIENCES

IN COLLABORATION WITH

LIBERAL BILINGUAL UNIVERSITY OF TOGO, TOGO REPUBLIC

IN PARTIAL FULFILMENT FOR THE AWARD OF (B. SC)

DEGREE IN PUBLIC HEALTH

DECEMBER 2020
 DECLARATION

I hereby declare that this research project has been written by me and that is

a product of my own effort. It has not been presented elsewhere for any

other type of award. All literatures are dully acknowledged in the references.

MURTALA NUHU Sign/Date

_________________________

ii
 CERTIFICATION

This is to certify that this project has been read and approved by the under

signed supervision and has meet-all the requirement and standard of the

Department.

Project Supervisor:
Name: Dr. Bishir Ahmad
Sign: __________________________________

Date: ____________________________

Head of Department:

Dr. Bishir Ahmad

Sign: _______________________________

Date: ____________________________

External Supervisor:

Sign: __________________________________

Date: ____________________________

iii
 DEDICATION

This research project is dedicated to Allah (SWT) and his Prophet

Muhammad (SAW) who guide us successfully throughout the course of my

study, and to my parents, my wife and my children who in one way or the

other assisted me morally and with their prayers for the fulfillment of my

course.

iv
 ACKNOWLEDGEMENT

I seek the protection of Allah (SWT) against devil (Shaidan) and his act.

In the name of Allah, the most gracious the most merciful. All praises are to

Allah the lord of the world owner of the Day of Judgment, the creator of all

beings.

Glory is to Allah who gave me opportunity, power, courage, tolerance and

wisdom to complete this project and my study as whole.

I will like to extend my best regard to my supervisor in person of Dr.Bishir

Ahmadwho devoted himself, in guiding and supervising my research work

and study throughout the period of mycourse may Allah reward them

abundantly. Amen

I also like to extend my gratitude toward the lecturers especially Mal. Dikko

Nuhu, Mal. Aliyu Sani, Dr. BalaNuhu and the rest for their contributions.

And also my special gratitude goes to my family and friends for their

contribution.

v
 TABLE OF CONTENTS

Cover Page i

Declaration ii

Certificate iii

Dedication iv

Acknowledgement v

Table of Contents vi

Abstract ix

CHAPTER ONE

1.0 Introduction 1

1.1 Background of the Study 3

1.2 Statement of the Problem 4

1.3 Objectives of the Study 4

1.4 Significance of the Study 5

1.5 Research Question 5

1.6 Scope and Limitation 6

vi
1.7 Operational Definition 7

CHAPTER TWO

2.0 Literature Review 8

CHAPTER THREE

3.0 Design 17

3.1 Setting 17

3.2 Target Population 18

3.3 Sampling Technique 18

3.4 Instrument for Data Collection 18

3.5 Validity/Reliability of Instrument 18

3.6 Method of Data Collection and Data Analysis 18

3.8 Ethical Consideration 19

CHAPTER FOUR

4.0 Analysis of Data 20

4.2 Ability to Summaries Data Using Table 20

vii
 CHAPTER FIVE

5.0 Discussion of Findings 27

5.1 Implication for Nurses 29

5.2 Summary 30

5.3 Conclusion 31

5.4 Recommendation 31

5.5 Bibliography 32

viii
 ABSTRACT

This research was carried out the rate at which children under age of five
years are affected with malaria. The research was carried at paediatric
medical ward at General Hospital Sabuwa, Katsina State Nigeria.The study
tend to provide target information insight about the condition and try to
make health professionals aware of socio-economic implication it has,
where the study provide current information to student nurses, nurses to be
able to deliver information of this work for the aware of the whole people in
their respective community. The study also signifies and promotes further
research study. The study was carried out base on historical design i.e. base
on the analysis of the hospital records on the malaria cases note at
paediatric medical ward, at General Hospital Sabuwa, Katsina State
Nigeria. The study target about 300 cases of malaria that are admitted in
paediatric medical wards with age under five years old, where a sample of
about 60 patients cases record files where used through random
sampling.Moreover, research findings shows the distribution of research of
malaria on causes, age, complications, recovery and dead where all the
analysis of data was present using the tables and charts (Bar chart and pie
chart).

ix
 CHAPTER ONE

1.0 INTRODUCTION

Malaria is a protozoon transmitted diseases, the female anopheles mosquito

injects minute parasitic protozoa of the genus plasmodium which inject

human and insect hosts alternatively, and it is a very old disease and

prehistoric man through to have suffered from malaria (Anna Spector

C/mbio Page, < = m. your guide to infectious disease 1997).

The association between the intermitted fever and environment was

recognized by Hippocrates 2500 years ago, however causative organisms or

agent of malaria or its vector not known until the end of 19th century.

Although is an accident disease it still African leading to health problem. It

has high mortality and morbidity rate and reduces human productivity.

Malaria is by far the world’s most important tropical parasitic diseases.

Though, it has been recognized since the earliest periods of man recorded

history is still continuous exist, it’s toll and human race (Anna Spector

C/mbio Page, < = m. your guide to infectious disease 1997).

Malaria is caused by intercellular protozoa called Plasmodium.

These four species that caused the infection in human being are identified:

1
- Plasmodium vivax, Plasmodium malariae, Plasmodium falcifarum and

plasmodium ovale.

Malaria remain the major health problem or hazards in tropical countries

these is endemic, are of the most serious complication of plasmodium

falcifarum, particularly in children.

Malaria most be considered in any patients whose fever is associated with

another central nervous systems dysfunction.

Typical clinical features presented is fever, headache and chills for two –

three days followed by convulsion in children (Taylor TE, Molyneux ME,

Wirima J.J, Fletcher KA, Morris K. Blood glucose levels in children before

and during the administration drug for severe fever, malaria Oct. 1988).

The discovery of plasmodium falcifarum, parasitaemia in such patients will

further boost the diagnostic, the pathogenesis of malaria considering the life

cycle of these parasites (plasmodia) whenever the female anopheles

mosquito inject the sporozoites of the parasites into mans blood stream after

these sprotozoites enter liver cells to start the pre-erythrocytic phase

development. Therefore, specific treatment must be commenced as soon as

the presumptive diagnosis is made.

2
Malaria kills more people than any other communicable disease except

tuberculosis (https://www.Unicef.org).

1.1 BACKGROUND OF THE STUDY

Malaria is not a serious problem in the United States. Over the past fifteen

years, only about 1,200 cases have been reported each year in this country.

In most cases a person was infected outside the United State while traveling

on business or on vacation.

Malaria is far more serious problem in other parts of the world. Between

300million and 500million people in Africa, India, South Asia, the Middle

East, the South Pacific and Central (WHO “2000” first Ed September –

October page 2 – 10) and South America have the disease every year most

of these deaths occur in South Africa.

A person can have malaria more than are in South parts of Africa, people

have up to forty bonts of malaria during their life time.

Malaria is becoming more serious problem because the organism that caused

the disease is growing resistant to drugs used to treat it (John and

Henderson 2004) Iwuafor a Egwuatu cc, Nnachi AU, Ha Okonko, Ogban

GI, et-al (2016). Malaria parasite and the use of insecticide, treated nets

3
(INTs) for malaria amongst under 5 years old children in Calabar, Nigeria

BMC, infect disease 16.51.

1.2 STATEMENT OF PROBLEM

African children under five years and pregnant women are most pre-

disposed to malaria parasite infection (WHO, 2000). Fatally afflicted

children often die less than 72 hours after developing symptoms. In those

children who survive, malaria drains vital nutrients from them impairing

their physical and intellectual development (WHO, 2000).

Increased risk of malaria during pregnancy causes low birth weight and

infant mortality during the first year of life by inducing intra-uterine

retardation and infant anemia (Aribodor et. al, 2007).

1.3 OBJECTIVE OF THE STUDY

1. To access the level of awareness of the community in the area of study

towards prevention and control of malaria.
2. To find out the mode of transmission of malaria and its early signs and
symptoms.
3. To find out the factors responsible for the spread of malaria within the
community in the area of study.
4. To find out the role of government and NGOs in the control and
prevention of malaria.

4
 5. To educate the community in the area of study on the prevention and
control of malaria.
6. To encourage community participation in the prevention and control of
malaria.
7. To encourage people of the community to form special programmes
such as malaria clubs roll back malaria as well as mosquito clubs.

1.4 RESEARCH QUESTION

1. What is the level of awareness of the community in the area of study

towards prevention and control of malaria?
2. How is malaria transmitted and what are its early signs and
symptoms?
3. What are the causes of malaria?
4. What roles do government and NGOs play in the control and
prevention of malaria?
5. What are the measures to reduce malaria?
6. What are the possible complications associated with malaria?

1.5 SIGNIFICANCE OF THE STUDY

The study is emphasize the effect of malaria children, the study will no

doubt bring out clearly the hazards of malaria on children to enable parents

guidance and enlighten them on how to prevent malaria disease and improve

health care services by expert management. It also contribute to the ongoing

government programme on environmental sanitation by educating parents

and guidance on presentation of malaria and cerebral malaria disease, the

5
achievement will continue by saving government money on important of

drugs for these disease.

The people can now be educated on the advantage of coming to hospital and

various facilities in order to be aware of the ways and the method of

preventing the breeding of mosquitoes.

The nurse will as much as possible try to enlighten parents and guardians to

remove their misconception and negative feelings or perception towards

coming to hospital. Which make them understand the hospital setting as a

place of treatment.

1.6 SCOPE AND LIMITATION OF THE STUDY

As regard to the scope, the study is said to cover only the paediatric medical

ward, General Hospital Sabuwa Local Government. However, due to time

factor, financial problems and lack of available resources in getting

information all over Sabuwa Local Government requires for projects, the

scope is limited only in paediatric medical ward.

6
1.7 OPERATIONAL DEFINITION OF TERMS

 INCIDENCE: It’s the number of particular new events which occur in a

population in a given period of time, for instance, number of new cases

of disease, such as malaria etc.

 MALARIA: The term malaria is derive from the Italian word “MAL”

ARIA” meaning “Bad Air”

Medically malaria is defined as an acute and chronic mosquitoes burned-

infectious disease of man, characterized by chills and fever.

 PAEDIATRIC: Is a branch of medicine that deals with the care and

development of children with the treatment of diseases that affect them.

 MEDICAL: [Referring to medicine] addition evaluative process applied

to the quality of clinical process applied to the quality of clinical practice

often by pear review of routine or especially collected, records of

individual cases.

 WARDS: Is a room with bed for patients in a hospital, division of a city

or town relating a councilor to present it to a person.

 SPECIALIST: Is an environment which comprised some specialized

department a specialized personnel are employ.

 HOSPITAL: Is an institute for the care diagnosis and treatment of the

sick and injured.

7
 CHAPTER TWO

LITERATURE REVIEW

In a modern interpretation of wisdom definition, Beagle hole and Bonita

(2000) defined malaria as “a febrile disease caused by protozoa species

called plasmodium which is introduced to the human body through female

anopheles mosquito characterized by fever, anorexia and spleenomegally”.

According to Anna Spector (1997) (/Mbio Page, < = m) YOUR GUIDE TO

INFECTIOUS DISEASE, defined malaria as “acute and chronic mosquitoes

burned infectious disease of man characterized by chills and fever, anaemia,

spleepnomegally and damage to the organs such as liver and brain.

Malaria is defined as “chronic infectious of all tropic area cause protozoa

group characterized by chills, fever and anorexia” by John and Henderson

(2004). Shrivastava and Yadau et-al (2000) defined malaria as “protozoa

transmitted infectious disease, which injected plasmodium is by female

anopheles mosquitoes into the human body thereby bringing variety of

clinical presentations.

Malaria, the disease as old as humanity itself, and often called as the ‘King

of Diseases’, continues to haunt and taunt mankind. Known since millennia,

malaria has played a major role in the history of mankind and it is often said

8
that but for malaria, the history and geographical demarcations of our planet

would have been different from what we have today. More than a century

after identification of the causative parasites, and more than half a century

after finding effective drugs and insecticides, it continues to wreak havoc on

millions, particularly in the poorest parts of our world. Malaria is the fifth

cause of death from infectious diseases worldwide (after respiratory

infections, HIV/AIDS, diarrhoeal diseases, and tuberculosis) and the second

in Africa, after HIV/AIDS. The dreaded disease is difficult to eradicate and

its control is possible ONLY with coordinated efforts of the general public,

healthcare personnel and government agencies. With global warming

threatening to increase the mosquito density and the spread of other

mosquito borne infections like Dengue and Chikungunya. The time has

come for all of us to wake up (Leder K et-al., 2006).

Malaria is an infectious disease caused by the parasites of Genus

Plasmodium. There are five identified species of this parasite causing human

malaria, namely, Plasmodium vivax, P. falciparum, P. ovale, P. malariae

and P. knowlesi. The infection is transmitted between humans by the female

anopheles mosquito. It is a disease that can be treated in just 48 hours, yet it

can cause fatal complications if the diagnosis and treatment are delayed.

9
Despite centuries of efforts, malaria parasite continues to infect millions and

kill thousands (Leder K et-al, 2006).

According to the latest World Malaria Report 2015 (WMR 2015), malaria

transmission occurs in five of the six WHO regions, with Europe remaining

free. Globally, an estimated 3.2 billion people continue to be at risk of being

infected with malaria and developing disease, and 1.2 billion are at high risk

(>1 in 1000 chance of getting malaria in a year). There were 214 million

cases globally in 2015, of which 88% were from the African region, 10%

from South East (SE) Asia region and 2% from Eastern Mediterranean

region. There were an estimated 438000 deaths, 90% from Africa, 7% from

southeast (SE) Asia region and 2% from Eastern Mediterranean region. Of

these, 306000 deaths have occurred in children aged under 5 years (WMR

2015).

In comparison, 198 million infections and 584 000 deaths were estimated in

2013.(WMR 2014) More than 3,0000 cases of malaria are reported annually

among travelers from developed world visiting malaria endemic areas.

(Leder K. et-al, 2006). With the shrinking globe, perennially prevalent

malaria, therefore, remains an ever existing danger for humanity, in every

part of the globe. In most areas, malaria and poverty co-exist, with the

10
average gross domestic product and average growth of per capital gross

domestic product. Sporozoiteendemic countries being about one fifth of

those in non-malaria endemic countries (WMR 2014).

CAUSES

Malaria is caused by four different types of parasites which belongs the

plasmodium family. “A parasite is an organism that lives on other

organisms. Animals can also get malaria but malaria cannot be passed from

human to animals or from animals to humans”. Shell Ether Puppet

“Resurgence of deadly diseases” Atlantic monthly (August 1997).

From Anna Spector (1997) (/Mbio Page, < = m) YOUR GUIDE TO

INFECTIOUS DISEASE </> professional guide to disease, eight edition,

stated that “malaria is caused by one of protozoa species called plasmodium

sporozoites e.g. plasmodium falcifarum, plasmodium vivax, plasmodium

ovale and plasmodium malariae”.

According to www.NHS.uk (2004) stated that “the causes of malaria is

plasmodium parasites like falcifarum, malariae, ovale and vivax”.

11
Centers for disease control malaria that line (770) 332 – 4555 mentioned the

causes of malaria as “plasmodium malariae, plasmodium falcifarum,

plasmodium vivax and plasmodium ovale”.

INCIDENCE

Malaria is one of the foremost health problems in India. During the first half

of the twentieth century, malaria affected every walk of life so much that

one of the major problems of malaria.

According to Kristie, Nicholas De Estimate in New York time (January 8,

1997) “about 100 million cases is reported and one million death occurs in

United States of America.

Mack, Alison et-al “collaborate efforts underway” stated that, “In India, sub

continental about 75million cases of clinical diagnosed malaria was reported

(21.8% population) and 800,000 deaths. By the total population of Indian

was about 344 millions.

Malaria research center has also carried out a few studies to estimate true

incidence of malaria in a certain situations. Sharma et-al (1998) found that

malaria incidence in PHC Kharhoda in district (Haryana) was high

compared to a small number of cases reported base on forminghly

surveillance. During 1998 – 1999 in Kichha, the state authorities recorded 63

12
malaria cases and no case of falcifarum. While MRC recorded during the

same period in the same population, 1984 malaria cases of which 1961 were

of plasmodium vivax, 20 of plasmodium falcifarum and 3 mined infections

similar observations were also made in Kharhoda PHC in district some part

in Haryana State.

According to Sharma (1998) and Ansari et-al (1998) stated that “about

900million cases of malaria were reported in African countries which make

(82.2%) of the population in the year 1997. And about 40% were death out

of the total population; moreover children of age 3-4 years were affected

more frequently than other group of ages”. And these increased the mortality

and morbidity rate among children under 5 years old.

SIGNS AND SYMPTOMS

“Clinically, malaria is characterized by fever, hepatimegally,

spleenomegally, varying degree of anaemia and various symptoms resulting

from the movement of individual organs” Lucas and Gillies (1999) SHORT

TEXT BOOK OF PUBLIC HEALTH MEDICINE FOR TROPIC 14 th

Edition.

According to Roberts and Desowortz, it mentioned the clinical manifestation

of malaria as; “A person infected with malaria passes through three of vary

13
distinctive symptoms. The first stage is characterized by uncontrollable

shivering for an hour or two hours. In the next stage, the patient’s

temperature rise quickly. It may reach 106of (41oc) for the period of up to six

hours. In the third stage, the patient begins to sweet profusely and his/her

temperature drops rapidly. Other symptoms may accompany these stages,

they include; fatigue, severe headache, nausea and vomiting, after the third

stage, the patient falls asleep from exhaustion’.

The three stages are often repeated the following days, two days later or at

some later time. In many cases a person experiences repetition of the stages

again and again during their lifetime. Some people go many years before the

symptoms repeat.

Michael Kristie et-al mentioned clinical features of malaria as ‘severe fever,

headache, anorexia, vomiting, anaemia, malaise, yellow coloration of urine,

gastroenteritis, constipation, hepatomegally, spleenomegally, oliguiria,

delirium and coma.

THE LIFE CIRCLE OF MALARIA PARASITE

The parasite undergoes developmental stages in the mosquitoes and the

female of the species required a blood meal to mature her eggs. They bites

human and material from her glands which contain primitive malaria

14
parasite called spozoites before feeding. These spozoites circulate in the

liver where they enter parachyma cells and multiply. This stage is known as

pre-erythrocytic schizopony. After about 12 days there may be many

thousands of young parasites known as merozoites enter the red malaria can

be seen in the section on diagnosis. In the case of plasmodium ovale the

lower circle contains and requires a course of premaquire to eliminate if

plasmodium falcifarum, on other hand it does not continuing liver circle.

The sexual cycle produce male and female genelodes which circulate in the

blood and are taken up by a female mosquito when taking a meal, the male

and female gametocyte fuse in mosquito stomach and form oecyst develop

over a period of days and large number of spozoites which moves to the

shivery glands and ready to be injected to man, when the mosquitoes next

take a meal in the sexual circle the developing parasites from schizoites in

the red blood cells which contain many merizoites, the injected red blood

cells rupture and release a batch of young parasites merezooted, which

invade new red blood cells in plasmodium vivax, p. ovale and probably p.

malarae all the cases of p. falcifarum only ring form and game toggles are

usually present in the peripheral blood. However, in the case of p. falcifarum

only ring form appears to stick in the blood vessels of the large organs. Such

as the brain restrict the blood flow with serious consequences.

15
White all four species have a heamolytic component that in when a new of

parasite breakout of the red blood cells, this is usually of the little

consequences. The exception is falcifarum malaria when the parasites

multiply very rapidly and may occupy 30% or more of the blood cells

causing a very significant level of haemolysis. One reason for there is that p.

falcifarum invades red blood cells of all ages where as p. vivax and p. ovale

prefer younger red blood cells while p. malariae mature red blood cells.

Spozoites

Tripizoite Liver Schizoite

Merozoites

PATHOPYSIOLOGY

Considering the life circle of the plasmodium falcifarum in malaria fever

commences whenever the female anopheles mosquito inject the sprozoites

16
these parasite move in for the man’s blood stream. After staying in the blood

about 30minutes, these sprozoites in the liver inflamed the liver cell’s

causing hepatitis.

Within the liver, the sprozoites substances derived several time to form

menozoites following up the liver cells, as at that time there is pro-life of the

reticulo-erythelial cells especially in the liver, spleen and bone marrow

producing more lymphocytes and phagocytes cells like neutrophile and

monocytes. The lymphocytes produce antibodies to in active these parasites

toxins. The filling up of the liver spleenic tissue by the menozoites, as well

as liver (hepatomegally) and spleen (spleenomegally) with tenderness.

The liver cells they burst to release the merezoite and their toxins in to the

blood stream. Some of these menozoites enter fresh blood to get up

erythrocytic phase; the menozoites subdivided insides the red blood cells to

form mature schizons containing daughter menozoites, the red blood cells

rupture to release these parasites into the blood stream. It is the rupturing of

red blood cell that causes the characteristics attack with rigor in malaria

fever excessive destruction of red blood cells especially by plasmodium

falcifarum leading to severe anaemia since falcifarum is the severest of

plasmodium anaemia causes tenderness, the victim complain of pain in the

legs and joint due to inflammatory effect of parasites toxins in the body.
17
INVESTIGATION

In order to access the degree of infection and to diagnose the disease, the

following are done;

- Blood test in covered out for estimation of haemoglobin.

- White blood count and different.
- Malaria parasites to known the types of causative organism and effects of
treatment.
- Urine analysis for acetone, in urine which indicate dehydration.

COMPLICATION

African children with malaria either recover completely or succumb with

long term impairment disability. Especially when the disease is complicated

with hypoglycemia or cerebral malaria such complications include the

following:

- Deafness
- Blindness
- Hemipledgia
- Cerebral malaria
- Hepatic failure
- Renal failure
- Cerebral damage
- Anaemia
- Abortion in pregnant woman

18
 CHAPTER THREE

METHODOLOGY

3.1 STUDY SETTING

The study was conducted around Sabuwa health center from January to

May, 2021. Sabuwa is one of the Local Government of Katsina State,

Nigeria. Its headquarters are in the town of Sabuwa in the south of the area

near Sabuwa new market on the border of Kaduna State at

110100’00”7007’00”E. It has an area of 642km2 and population of 136,500 at

the 2006 census, with an average rainfall from 750 mm3 to 930 mm3 with

mean annual temperature range 16 to 37°c. General Hospital is located in the

centre of Sabuwa LGA. Malaria transmission is highly seasonal, and

unstable. The study area has an entomological inoculation rate of 17.1

infectious bites per person per year. Malaria infection is primary due to P.

falciparum. Subsistence farming and fishing are the main occupation in the

area. There are suitable places for mosquito breeding throughout the year

because of lack of proper sewage network in the area.

3.2 STUDY DESIGN

This is an institution based cross-sectional study conducted from January to

May 2021 in children under five years old (children aged between 12

19
months and 59 months). Children under 5 years old who attend the health

center were the source population, and those children under 5 years with

febrile cases who attended in the health center during the study period were

the study population. Children <12 months old, and children <5 years’ old

who did underwent chemotherapy with antimalarial drugs five months prior

to the study commencing and during the study were excluded.

Sample Size Determination and Sampling

3.3 TECHNIQUE FOR DATA COLLECTION

The sample size was calculated using single population proportion formula

based on the analysis of the hospital record by some patient’s files.

3.3.1 SEMI-STRUCTURED QUESTIONNAIRE DATA

Parents or guardians of eligible children were given oral informed consent to

allow the children to participate in the study. Data of socio-demographic,

economic, and environmental were collected from their parents/caregivers

using structured and pretested questionnaire using trained data collectors.

Data including sex, age, caregivers age, level of education, place of

residence (rural or urban), important points about knowledge of malaria,

type of block of the house, type of the roofing of the house, ownership and

number of ITNs, usage of ITNs, IRS within the five months prior to the

survey and other relevant demographics were collected from the selected

20
children’s parents or guardians visiting the health center. All data of socio-

demographic data, determinant factors, and knowledge and prevention

practices of malaria were prepared and reviewed by the project supervisor

including data collection. All information on questionnaire was standard and

adapted from the national malaria survey of Nigeria and other published

research on reputable journals. The questionnaire was developed in English

language and was translated into Hausa language.

3.3.2 DATA QUALITY ASSURANCE

To maintain the quality of the data, Standard Operating Procedure (SOP)

was used and followed in each step of the test procedures and structured

questionnaires and a check list was used. The working solution of Giemsa

(2005) was prepared by filtering the crystals. In addition, the glass slides

were labeled in such a way that the slide code matched the file of the

particular individual. During blood sample collection one sterile lancet was

used per one child and a color atlas was used during microscopic

examination and the smear was examined by three readers.

3.4 METHOD OF DATA ANALYSIS

The method to be use in analysis of data is in tabular form and chart

presentation.

21
 CHAPTER FOUR

DATA PRESENTATION AND ANALYSIS

The method to be use in the analysis of the collected data is through

tabulation and chart.

TABLE I

Distribution according to causes/predisposing factors of malaria in

General Hospital Sabuwa at paediatric medical ward from 15th August

2020 to 15th August 2021.

No Causes/Predisposin Tally Figure

g Factors of Malaria
i. Mosquito bite IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 60
ii. Poor personal and IIIIIIIIIIIIIIII 20

environmental

hygiene
iii. Exposed sleeping IIII 5

accommodations
iv. Lack of IIII 5

immunization

Bar chart showing distribution of the causes and predisposing factors of

malaria in General Hospital Sabuwa at Paediatric Medical Ward

22
 60

50

40

30 60

20

10 20
5 5
0
te e on n
bi ien ati tio
ito hy
g
od iza
squ tal om un
o c m
m en c im
m ga f
iro
n
pi
n
cko
v ls ee la
en
nd ed
ala pos
so
n ex
er
orp
po

Bar chart showing distribution of the causes and predisposing factors of malaria in Ahmad Sani Yariman
Bakura specialist Hospital at paediatric medical ward

Figure 1: Showing distribution of the causes and predisposing factors of

malaria

TABLE II

Distribution according to age

Age Frequency

23
 0 – 18 months 4
18 – 1½ years 7
1½ - 2 years 8
2 – 3 years 19
3 – 4 years 22

From the above table, the causes occur mostly during the period of 3 – 4

years of age presentation of the data using pie chart below in fig 4.

7%

13%

37%
0-18Months
1 1/2-2Years
18-1 1/2 Years
12%
2-3 Years
3-4 Years

32%

Figure 4: Age Distribution

No of item
Using ¿ Total no of item X 360

 For 0 – 18 months

4 X 360
¿
60

1440
¿
60

¿ 24 %

24
 For 18 – 1½ years

7 X 360
¿
60

2520
¿
60

¿ 42 %

 For 1½ - 2 years

8 X 360
¿
60

2880
¿
60

¿ 48 %

 For 2 – 3 years

2 X 360
¿
60

6840
¿
60

¿ 114 %

 For 3 – 4 years

22 X 360
¿
60

7920
¿
60

¿ 132 %

Using a tabular form to represent the number of age,

frequency and percentage
25
 No of Age Frequency Percentage
0 – 18 months 4 24%
18 – 1½ years 7 42%
1½ - 2 years 8 48%
2 – 3 years 19 114%
3 – 4 years 22 132%

The above pre-chart represents the distribution according to age which

indicates that 0 – 18 months are 24%, 42% are 1½ years of age, 48% are 1½

- 2 years of age, 2 – 3 years are 114% of total circle, the remaining 132% are

children with range of age 3 – 4 years.

TABLE III

Distribution base on complication

Complication Number of Patients Percentage

Anaemia 15 65%
Hepatomegally 5 10%
Spleenomegally 8 15%
Otitis media 2 10%
Total 30 100%

From the table, above it shows that most of the patient admitted will have

anaemia.

TABLE IV

Distribution of discovery and death of patients during the period of

hospitalization

Number of Patients Percentage

Recovered 52 91%
26
Dead 8 9%

The above table shows that out of 60 patients only 8 patients are dead.

ANSWERING RESEARCH QUESTION/HYPOTHESIS

- From the above analysis, the number of patients admitted with malaria in

Paediatric Medical Ward at General Hospital Sabuwa, Katsina State

Nigeria, increase which is mostly due to mosquito bite.

- It also explains that number of patients who had complications is shown

in table III.

- It also affects children during the period of 3 – 4 years old more from

table II.

- Eight patients died out of 60 sample cases as shown in table IV.

27
 CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMEDATION

5.0 DISCUSSION OF FINDING

The discussion of finding will be focused based on the analysis of data

collected in the previous chapter.

In table I, the shows the distribution of the causes and predisposing factors

of malaria in General Hospital Sabuwa, Katsina State Nigeria at paediatric

medical ward.

According to this table, it shows that the most common cause of malaria

responsible for increased plasmodium falcifarum which corresponds to the

views of John Wiley and sons (1997) recognized the association of

plasmodium falcifarum with malaria which is 6 – 8 times as frequent years.

Moreover, it is shown in a bar chart presentation that mosquito bite has a

higher frequency in relation to malaria, and this findings answer are of the

question in on research questions.

28
In table II, it is shown that the distribution according to age in malaria case.

According to the table, it shows that the incidence of malaria is more within

the range of 3 – 4 years of age. Analysis corresponds to the view of Sharma

an Ansan et-al (1998) which stated that children within 3 – 4 of age are

affected more frequent than other group of ages among children. This

analysis was presented using pie chart of which shows 132% are children

within the age range of 3 – 4 years old, 114% are children with 2 – 3 years,

48% are children with 1½ - 2 years, 42% are children with 0 – 18 months of

age. This information goes ahead to answer questions related to age

distribution.

Table III shows the distribution of patients with complications of anaemia, 5

hepathomegally, 8 has complications spleenomegally and finally 2 has otitis

media which gave the total number of 30 patients, who had complications

during the period of research.

The analysis of findings gave detailed explanation or response to the

questions asked in my research questions.

In table IV, it shows the distribution in the number of patients who died

during the period of hospitalization from 15th April 2018 to 15th April 2019

and the number of patients that had recovered, 8 patients died and this goes

29
ahead to explain their percentage where the number of 52 patients that had

recovered is 91% and the number of dead patients as 9%.

From the above analysis, we learnt that the rate at which patients are dying

of malaria in paediatric medical ward General Hospital Sabuwa, Katsina

State Nigeria is on decrease according to what was said during data

collection.

5.1 IMPLICATION OF THE STUDY

The implication of this study cannot be over emphasize according to

analysis, the most common problem responsible for increase of malaria is

malaria parasite called plasmodium falcifarum through mosquito bite and

other related factors which needs the nurses knowledge and skills to provide;

- Health education to the public in the community to help to abolish, those

associated factors of malaria e.g. personal and environmental hygiene.

- Importance of nutrition seeking early diagnosis and treatment of malaria.

- The study also helps expose the nurse in current information about this

condition and its treatment.

- It also create a due or ways of seeking knowledge to help them research

for another issue in relation to this study.

The cross sectional nature and the small sample size of the children under

the age of five years, especially those with fever and malaria parasites, may

30
have contributed to the lack of temporal association between malaria and

other variables. In addition, a relatively small sample of children under 5

who participated in the study who seek health services at the study health

centre. Furthermore, the present study was conducted during dry season,

during which malaria transmission is known to be low. This may have

contributed to the low prevalence of p. falcifarum malaria observed in the

present study participants, despite the area being located in holoendemic

area. Further investigation on malaria prevalence, with comparisons between

seasons, predications’ of malaria and use of malaria intervention tools is the

present study area are warranted. Humphrey D Magizo, Wilfred Meza,

Emanuella C Ambrose, Benson R Kidenya and Eliningaya J Kweka (2011)

(confirmed malaria cases among children under five with fever and history

of fever in rural western Tanzania).

5.2 SUMMARY

This study is trying to find out on incidence of malaria among children under

five years of age in paediatric medical ward, General Hospital Sabuwa,

Katsina State Nigeria.

Generally the research is aiming at:

1. Determining the factors responsible for the increase cases of malaria.

31
 2. Determining the number of cases seen, recorded in General Hospital

Sabuwa from stipulated time of the study.

3. It also aimed at providing health education to people in the ways of

promoting health and the ways of preventing disease like malaria.

The study was carried out base on the analysis of hospital records from the

study also help to expose the nurse in current information about this

condition and its treatment.

Also it creates a clue or ways of seeking knowledge, to help them in research

for another issue in relation to this study.

5.3 CONCLUSION

Conclusively, the researchers is advising anybody who may fortunately

come across this study to build upon my study and bring more current

information that will ensure great eradication in the occurrence of malaria.

5.4 RECOMMENDATION

The recommendations and suggestions of this study are as follows:

1. Nurses should engage themselves in promoting their knowledge

through research and finding of current information on health related

issue.

2. There is need for nurses and other health cars personal to improve

their skill in public health education on those common factors

32
 associated with malaria e.g. poor personal hygiene and environmental

hygiene, as well as poor nutritional status for them to be abolished in

order to ensure continuity in reduction of the diseases.

3. Anybody that may come across this study should make his/her all

possible best in promoting this study by building upon my study.

BIBLIOGRAPHY

- O Lucas (1997) “Preventive Medicine for Tropic London the

University Press Page 189 – 191.

- Anna Spector <1 mbio page, <=m>, Your Guide to Infectious

Diseases.

- Desowize and Roberts (1997) Quotation.

- Barbara F. W. (1999) Nurse Dictionary.

- Jonathan Couther (2000) English Dictionary 5th Edition.

- John and Henderson (2004) Quotation.

- Lucas and Gil (1999) Short Text Book of Public Medicine for Tropic

4th Edition.

- Srivastara and Yadau, et-al 92000) Quotation.

- Thomas F. H. (1998) “Encomtogy Page 195 – 219.

33
- World Health Organization (2000) First Ed. September – October Page 2

– 10.

34