Epidemiology of Malaria in Wukari Local Government Area, Taraba State, Nigeria

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1 International Journal of Public Health and Health Systems 2019; 4(1): Epidemiology of Malaria in Wukari Local Government Area, Taraba State, Nigeria Ade Tolulope Iorwuese 1, *, Aji David Adashu 2, Otti Emeka Emmanuel 2 1 Department of Microbiology, Federal University, Wukari, Nigeria 2 Department of Mathematics and Statistics, Federal University, Wukari, Nigeria address * Corresponding author To cite this article Ade Tolulope Iorwuese, Aji David Adashu, Otti Emeka Emmanuel. Epidemiology of Malaria in Wukari Local Government Area, Taraba State, Nigeria. International Journal of Public Health and Health Systems. Vol. 4, No. 1, 2019, pp Received: December 29, 2018; Accepted: January 24, 2019; Published: March 6, 2019 Abstract The public health significance of malaria disease is one of a lingering global health concern. The disease is a global menace particularly endemic to communities and regions with weak health systems, primarily affecting low- and lower-middle income countries. A retrospective epidemiological survey was conducted to evaluate the prevalence of the malaria disease in Wukari Local Government Area of Taraba State from January to September, Malaria records from four different primary health centres within Wukari metropolis were approved for collection and analysis. Within the period, a total of 3013 malaria cases were recorded, of which 51% were female and 49% were male. The highest prevalence rate for malaria was recorded for patients in the age groups and with 21% each while the lowest prevalence rate was recorded for patients in the age group with 0%. At a significance level of 0.05, there was no significant difference in the prevalence of malaria between genders (p= ); although there was significant difference in the prevalence of malaria between age groups (p=0.009). The high prevalence of malaria in Wukari is of great significance and hence public enlightenment efforts should be intensified in the region to help prevent and control the spread of malaria. Keywords Public Health, Disease, Malaria, Epidemiology, Retrospective Study 1. Introduction Human malaria is a protozoan disease which is widely distributed in the tropics, caused by protozoan parasites in the genus Plasmodium and transmitted to man through the bite of an infected arthropod vector, the female Anopheles mosquito [1-3]. Plasmodium falciparum, P. vivax, P. ovale, P. malariae, P. knowlesi have been identified as the aetiologic agents in humans; of which more deaths have been recorded for P. falciparum [4]. Malaria exacts a heavy burden on the poorest and most vulnerable communities, primarily affecting low- and lowermiddle income countries [5]. In short, the disease flourishes in situations of social and environmental crises, weak health systems and disadvantaged communities. Symptoms of the disease include abdominal discomfort, headache, joint aches, muscle aches, vomiting, lethargy and anorexia [6]. If antimalarial treatment is not given on time, it leads to severe malaria, particularly in P. falciparum malaria. In severe malaria, the parasite burden in the patient elevates and may develop into lethal severe malaria. The severe malaria manifests such symptoms as hypoglycaemia, metabolic acidosis, acute pulmonary oedema, severe anaemia, coma and acute renal failure [6]. The malaria disease is a complex one which varies widely in epidemiology and clinical manifestations in different parts of the world. This variability has been reported to be due to factors such as the predominant malaria parasites in the geographical area, the parasite s susceptibility to commonly used or available antimalarial drugs, distribution and vectorial capacities of mosquito vectors, climate and other environmental conditions and the behaviour and level of

2 16 Ade Tolulope Iorwuese et al.: Epidemiology of Malaria in Wukari Local Government Area, Taraba State, Nigeria acquired immunity of the exposed human populations [3]. It is because of these factors that malaria control operations must be location-specific, taking into consideration the epidemiological, economic, institutional and cultural settings of the geographical location [7]. Despite a maintained level of commitment towards the control of Malaria, it still remains a major public health challenge on the world scale [8]. In 2013, 198million cases of malaria occurred globally with 584,000 recorded deaths of which 90% occurred in the WHO African Region with children being the most affected [5]. Effective interventions to combat malaria are available but they are not reaching the people with the greatest burden of malaria because the capacity for malaria control is inadequate in endemic countries, where health systems are often weak [7]. Intensification of malaria control interventions, including long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS) of insecticides, and prompt treatment with artemisinin-based combination therapies (ACTs) has been accompanied by marked reductions in transmission intensity, parasite prevalence, malaria incidence, malaria-associated hospitalizations, and malaria-associated deaths in some settings, but not in others [9-13]. Substantial success in malaria control has been mostly limited to relatively lowtransmission settings [14]. 2. Methods Description of the study area: Wukari is largely a multireligious town mainly dominated by the Jukuns [15]. Once a major part of the Kwararafa confederacy, Wukari is located between longitude and latitude of the equator and stands as one of the 18 Local Government Areas that make up Taraba State, Nigeria [16]. The Local Government is bounded by Ibi LGA, Donga LGA, Gassol LGA, and Ukum LGA to the North, East, Northeast and South respectively [17]. Having a land area of about 4,308km 2 and a population of about 241,546 people, it is no wonder that the predominant occupations are farming, cattle rearing, fishing and trading [18]. Wukari is home to Federal University Wukari, Kwararafa University, National Open University of Nigeria, Wukari study centre, as well as numerous primary and secondary schools. The area is also adorned with different social and cultural attractions. Other than the predominantly spoken Jukun language, other languages which are also spoken, though to a lesser degree are Kutep, Tiv, Hausa, and Fulani [19]. Study design, time period and ethical clearance: This was a retrospective cross-sectional study carried out in Wukari Local Government Area of Taraba State from January to September, Malaria data were collected from four different primary care hospitals frequented by citizens of Wukari. The four hospitals included two private hospitals (Kwararafa hospital and Biyama hospital) and two public hospitals (General hospital Wukari and CRCN health-center) all within the Wukari metropolis. Prior to data collection, ethical clearance for the study was obtained from the hospital management through their respective Chief Medical Directors. Statistical analyses: Microsoft Excel 2016 and Statistical Package for Social Sciences (SPSS) version 20 were used for the analyses of collected data. Pie charts were used to display the descriptive and the contribution of each age group across the four hospitals. One way analysis of variance (ANOVA) was used to test for significance difference in the prevalence of malaria between age groups. Bar charts were used to check the discrepancy between genders. Furthermore, independent sample t-test was carried out to check whether there is significant difference in the prevalence of malaria between the two genders (male and female). 3. Results The study was conducted to estimate the prevalence of malaria in Wukari Local Government Area of Taraba State. Data was collected from four different primary healthcare centres within the Wukari metropolis which are most frequented by the citizens and which had the requested data. A total of 3,013 malaria cases were reported within the period under review. From the records analysed, more female (51%) have suffered malaria than males (49%). Figure 1 is a bar chart showing variations in gender (male and female) with respect to the different hospitals from which the data were collected. Table 1 shows the result from an independent sample t-test to test if there is significant difference between the prevalence of malaria between the genders. With a p-value of which is greater that the level of significance (0.05), the no significant difference hypothesis should not be rejected and it can hence be concluded that there is no significant difference in prevalence of malaria in both male and female patients. Figure 2 depicts the age distribution of all patients to have suffered malaria within the nine months period. The highest prevalence was recorded for patients within the age groups and with 21% each while the lowest prevalence was recorded for patients within the age group with 0% prevalence rate. Table 1. Hypothetical testing for significant difference in malaria prevalence between gender (male and female). Male Female Mean Variance Observations 4 4 Pooled Variance Hypothesized Mean Difference 0 Df 6 t Stat P (T<=t) two-tail t Critical two-tail

3 International Journal of Public Health and Health Systems 2019; 4(1): Figure 1. Hospital-specific gender variation in malaria cases in Wukari LGA. Figure 2. Age distribution of malaria patients in Wukari Local Government Area. Table 2 shows a one way analysis of variance to test for significant difference in malaria prevalence between the different age groups. With a p-value of 0.009, which is less than the level of significance (0.05), the no significant difference hypothesis should not be accepted and it can hence be concluded that there is significant difference in malaria prevalence by the age groups. Table 2. Analysis of variance (ANOVA) in malaria prevalence between age groups. ANOVA Number of Reported Malaria Cases Sum of Squares Between Groups Within Groups Total df Mean Square F Sig..009

4 18 Ade Tolulope Iorwuese et al.: Epidemiology of Malaria in Wukari Local Government Area, Taraba State, Nigeria 4. Discussion The prevalence of malaria is a lingering public health challenge, especially in the African region. The disease has been known to be the cause of worldwide infections, especially in children and pregnant women in tropical and subtropical areas. The higher prevalence rate of malaria in females than in males has also been reported in a similar study carried out in Takum Local Government Area [20]. Despite the higher prevalence rate in females than in males, the prevalence of malaria in Wukari Local Government Area is unaffected by gender, which is in congruence with other similar studies [21-22]. Malaria prevalence differed between the different age groups under review with age groups and recording the highest prevalence rates with 21% each while the least prevalence rate was 0% recorded for the age group There also exists significant difference in the prevalence rates of malaria across the different age groups. 5. Conclusion and Recommendation Malaria in Wukari showed a higher prevalence in females than in males although this prevalence is not statistically significant. Also, the disease is more predominant among the middle-aged individuals in the community. The prevalence rate of malaria in Wukari Local Government Area is alarming, affecting males and females of all age groups. It is therefore pertinent for infrastructures to be put in place to help curtail and checkmate the spread of malaria within the community. References [1] Adefioye, O. A., Adeyeba, O. A., Hassan, W. O., and Oyeniran, O. A. (2007). 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