Malaria Endemic In Ashanti Region

Malaria Endemic In Ashanti Region

 BACKGROUND

Malaria remains one of the endemic health issues in Ghana as one of the tropical countries in Africa. In Subsaharan Africa (SSA), pregnant women and children under the age of 5 are the most vulnerable (Badirou et al. 2018, Owusu Boateng and Autro 2017; WHO 2017). Malaria accounts for 14% of all outpatient cases, 11% of the hospital admissions, and 9% of all deaths among pregnant women in Ghana. (Boateng et al. 2018).  Plasmodium falciparum malaria 0ne of the major contributors to morbidity accounting for 40% of morbidity in the Ashanti region of Ghana. This poses a significant socioeconomic challenge to families living in this region.

Method Used to Identify the issue.

Several methods were used to identify the issue. One of them is a literature review where several books and articles were read. They provided incite on the current and past qualitative and quantitative data on the state of the endemic in the region. A cross-sectional study was conducted where Questionnaires were used to interview 240 out 1200 women who were in child bearing age of their life and who had children. Discussion among the students in my class also augmented the insights obtained from other sources.

Problem Statement

In the last decade, Ghana recorded a significant success in the distribution of bed nets to malaria endemic regions in her effort to mitigate the disease. They were Insecticide Treated Nets(ITN) supplied to pregnant women and children under five years. This measure made 49% of households own the nets in 2011 and 68% in 2013 (J. Hill, J. Hoyt, A. M van Eijk et al 2013). The supply to households had hit 90% by the year 2018. However, this has not produced the targeted acceptable margin of the reduction in malaria prevalence in Ashanti. This raises the question of effectiveness of ITN in controlling the prevalence.

          Project Hypothesis

1. The coverage of INT Ashanti region is 100% .
2. Utilization of INT effectively reduced malaria prevalence.
3. ITN are effective in preventing malaria among pregnant women and children under the age of 5.

Research questions

1. What is the approximate coverage of ITN in households in Ashanti in terms of ownership?
2. What is the relative utilization of ITN in families in the Ashanti region?

iii. How effective are ITN  in preventing malaria?

Research objectives

The purpose of this project is to:

1. Determine the approximate coverage of ITN in the households in the Ashanti region.
2. Investigate the level of relative utilization of ITN in the region

• Know relative effectiveness of ITN reducing morbidity among pregnant women and Children in the region.

Target Population

The target population are women in child bearing age, pregnant women and children under the age of five years in Nkaranza North located in Ashanti region. This region forest savannah vegetation zone. The residents of different ethnic group who are farmers in the rural area. The Akan community that speak Twi are the majority and therefore Twi is predominant language in the region.  Temperature range between 17⁰C and 37⁰C while average annual rainfall is 1200mm. This is a conducive ecological condition for the mosquitoes which are the malaria vectors. It is estimated that 50% of children under 5 years had the parasite during the study. There were 269 bites for every person every year in 2009 (S. Owusu-Agyei, K. P. Asante, M. Adjuik et al 2009). Placental malaria prevalence was 40% by 2010 (K. P. Asante, S. Owusu-Agyei et al. 2013)

The Study Design

The Research design will be composed of qualitative methods. These are Observation, In-Depth Interviews and Focused Group Discussion. A qualitative interview guide will be used to obtain responses on identified questions like whether a respondent has ever used ITN. Group discussion guides, in-depth interview guides and Observation will be main data collection tools. These would be done by four research officers where one moderates the interview while the other records the data. The third officer facilitates inspection of homes with the ITN the fourth moderates the Focused Group Discussion. These activities will be held in places convenient to the target communities Observation of households with ITN was recorded using digital cameras. The table below shows communities interviewed and the respondents that participated.

Sample size

A sample of 240 participated in the interview of whom 80 were pregnant women at the time of the study. This sample was taken randomly from a total population of 1200 women in the area.

60% of the population in the area are women and children under the age of 5years.

Questionnaire

This is a study on the effectiveness of ITN IN combating Malaria among Pregnant women in Ashanti Region Ghana.

I voluntarily agree to participate by filling in the questionnaire

Data Managament and Analysis

All records are arranged chronologically. The interview and Group discussion records will be translated to English. They will later be compared with the existing notes about the same subject. A thematic analysis will be treated to data by clustering similar responses under the same theme.

The Outcome of the Study

Most of the respondents are literate with their education level ranging from primary to senior high school. The average age of the respondent is 25 years.

(a)95% of all interviewed respondents are aware of availability of ITN and their method of supply. A fair percentage appreciate that sleeping in the nets is highly likely to going to prevent malaria infection of their pregnant women, the unborn and their children under the age of 5.

(b) There are challenges towards the effectiveness of the ITN in protecting the community from the infection. These challenges constitute the exposure reasons for the community under study constitute resulting from the confusion that the same community have about getting and using the ITNs.

1. Access to the ITN

Lack of money to purchase the ITN was cited by 45% as one of the reason why they did not have the nets. The were claiming that the nets should be available in hospitals and should be give free to the vulnerable pregnant women and children under 5 years to reduce morbidity.

1. Inability to hang the nets.

24% of the respondent claimed that they could not properly hang the nets and this      contributed toward their not using the net. These were mostly the unmarried women.

• Uncomfortable using the net.

Most of the respondents claimed they were not comfortable using the nets.

This is because the nets trap heat over the bed and make the temperature rise above the normal temperatures. This gave them problems when sleeping.

1. The ITN maintenance

Most of the respondents said that the nets developed holes on the fourth and fifth time of washing. The malaria vectors would come in through the holes making the nets ineffective. They also claimed that rats interfered with nets by eating part of them and making holes that would subsequently make the net ineffective in keeping mosquitoes away.

1. Disposal of the nets.

A small fraction of the population had a problem disposing the nets.

References

Agyare, C. S., Osafo, N., Agyare, C., Buabeng, K. O., & Abruquah, A. A. (2017). Supply chain management of anti-malarials in the district hospitals in Kumasi Metropolitan Area, Ashanti region of Ghana.

Paintsil, E. K., Omari-Sasu, A. Y., Addo, M. G., & Boateng, M. A. (2019). Analysis of Haematological Parameters as Predictors of Malaria Infection Using a Logistic Regression Model: A Case Study of a Hospital in the Ashanti Region of Ghana. Malaria research and treatment, 2019.

Schuldt, K., Ehmen, C., Sievertsen, J., Evans, J., May, J., Ansong, D., … & Horstmann, R. D. (2017). Lack of association of CD55 receptor genetic variants and severe malaria in Ghanaian children. G3: Genes, Genomes, Genetics, 7(3), 859-864.