Table of Contents  
ORIGINAL ARTICLE
Year : 2014  |  Volume : 16  |  Issue : 1  |  Page : 1-4

Prevalence of malaria parasitemia using rapid diagnostic test among apparently healthy children in Kano, Nigeria


Department of Biological Science, Bayero University, Kano, Nigeria

Date of Web Publication15-May-2014

Correspondence Address:
Zainab Gobir
Department of Biological Science, Bayero University, Kano
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2276-7096.132566

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  Abstract 

Introduction: Malaria remains the highest cause of morbidity and mortality in sub-Saharan Africa. Early diagnosis is therefore essential for treatment and management of the disease. The objective of this study is to determine malaria prevalence in some children in Kano Metropolis using rapid diagnostic test (RDT).
Methodology: 210 households were administered with a structured questionnaire and blood samples were collected from 85 children, while 125 children were non compliance. For each of these children, rapid diagnostic test (RDT) kit {Smart Check Malaria P.f cassette (Globalemed, 1101 King St. Suite 370, Alexandria, VA 22314 USA)} was used, using blood obtained from a finger prick.
Result: Blood sample obtained from 85 children showed that 26 (30.59%) were positive and 59 (69.41%) were negative. The age of the children range from 1-5 years and there were 40 males (38.46%) 45 females (61.54%). The prevalence of malaria is high among the respondents.
Conclusion: The majority of the respondents sought treatment from health facilities. However, few children got treatment from chemist and at home or did not get treatment for malaria. Children should be advised to seek treatment whenever they have malaria from health facility. This is to ensure that the treatment given is appropriate.

Keywords: Malaria, rapid diagnostic test, sub-Sahara Africa


How to cite this article:
Gobir Z, Tukur Z. Prevalence of malaria parasitemia using rapid diagnostic test among apparently healthy children in Kano, Nigeria. J Med Trop 2014;16:1-4

How to cite this URL:
Gobir Z, Tukur Z. Prevalence of malaria parasitemia using rapid diagnostic test among apparently healthy children in Kano, Nigeria. J Med Trop [serial online] 2014 [cited 2019 Dec 9];16:1-4. Available from: http://www.jmedtropics.org/text.asp?2014/16/1/1/132566


  Introduction Top


Malaria is a major public health problem with an estimated two million children worldwide dying of it yearly. Regardless of the fact that it is one of the oldest recorded diseases, malaria remains one of the world's most deadly infectious diseases. It is arguably, the greatest menace to modern society in terms of morbidity and mortality. Though preventable, treatable and curable, there is no known immunity. This makes it an efficient and unrepentant killer. Several centuries after its discovery, malaria still remains a devastating human infection, resulting in 300-500 million clinical cases and three million deaths every year. [1] Malaria is endemic throughout Nigeria. The Sahel regions and the high mountain area of the plateau states experience slightly lower rates of transmission malaria parasites. Malaria currently accounts for nearly 110 million clinically diagnosed cases per year, 60% of outpatient visits, and 30 percent hospitalizations. An estimated 300000 children die of malaria each year. It is also believed to contribute up to 11% maternal mortality, 25% infant mortality, and 30% under-five mortality. It is estimated that about 132 billion Naira lost to malaria annually in the form of treatment costs, prevention and loss of work time in Nigeria. [2] Malaria is a complex disease due to its complex transmission process. The complexity of the disease vector (the anopheles mosquito) is only articulated by the complex life cycle of the parasite (plasmodium). The sub- Saharan African region has the greatest number of people exposed to malaria transmission and the highest malaria morbidity and mortality rates in the world. [1] Malaria is known to have a negative impact on the performance and learning in children. [3] It also aggravates anemia and malnutrition in children and pregnant women. [4] It is estimated that in Africa, malaria is responsible for over one million deaths yearly particularly of infants and young children. [5],[6] Malaria usually presents with fever which may explain the frequent use of paracetamol and antimalarials forfebrile children. These medicines are frequently adulterated in Nigeria, thus losing their efficacy. In addition, they may become substandard as a result of chemical instability from inappropriate importation and storage conditions or due to poor quality control during their manufacture. (Bonati, 2009). Counterfeiting therefore has contributed to resistance of chloroquine and sulfadoxine-pyrimethamine to malaria parasites (FMOH, 2005b). Quinine or artemesinin derivatives have been recommended by the WHO for severe malaria treatment (WHO, 2006).

According to the World Health Organization (WHO) World Malaria Report (2008), the number of annual malaria cases worldwide is actually decreasing, yet the impact of the disease burden remains an enormous challenge, for sheer numbers and threat to human life. Nigeria is one of Africa's hardest-hit, accounting for between 30 and 40% of malaria deaths on the continent (WHO, 2008). This magnitude of occurrence in this part of the world correlates with poverty, ignorance, and social deprivations in the community (WHO, 2008). On the possible eradication of malaria, Arigbabuwo, [7] opined that prevention is better than cure, advising that people should learn to maintain personal and environmental hygiene. In view of the negative socioeconomic and health impacts of malaria on children, this retrospective study was carried out to examine the prevalence of malaria among parasitemia using Rapid Diagnostic Test among apparently healthy children in Kano, Nigeria from April 2011-September 2011.

Research Questions

What is the prevalence of malaria infection among children under 5 years under the studied period?

Hypotheses

There is no significant association among children under 5 yearly prevalence of malaria using RDT kit.


  Methodology Top


Study Area

Kano State is located in North Western Nigeria. Historically, Kano State has been a commercial and agricultural State which is known for the production of groundnut as well as minerals. This study was a multi-centre study that comprised eight (8) Local Government Areas randomly sampled within Kano metropolis from June to August during raining season. Study population comprised children under the age of 5 years.

Blood Sampling

30 by 7 cluster sampling technique described by the WHO (Hoshaw-Woodard 2001) was used in this study because of its appropriateness. This is a two-stage cluster sampling. First, 30 clusters were selected from a total of 88 wards in Kano metropolis in which the bed nets were distributed more than 1 year ago. Then in each cluster, the first household was selected randomly from the list of houses. The other six houses within each cluster were then selected starting from the closest house to the first moving to the next closest and so on. A structured questionnaire was used whereby children were asked verbally whether they have experienced an episode of malaria frequently to the survey and whether they sought treatment and the sources of treatment. This was then used to determine the prevalence of malaria among children prior to the survey and their treatment seeking behaviors. The questionnaire was interviewer administer whereby respondents were asked questions and their responses were recorded by the research assistants. Two hundred and ten (210) blood samples were intended to be collected but 85 blood samples were collected while one hundred and twenty-five (125) were non-compliance.

Blood Sample Collection

Blood samples were collected by first disinfecting the fore finger with cotton wool containing alcohol before pricking the finger with a sterile lancet and about 5 μl of the blood sample was drawn using a pipette. The blood sample was then dropped on the sample well and about two drops of buffer solution was dropped on the sample. The kits were then allowed to stay for 5 min so that the result can be read. [8]

Procedure with RDT

The First Response RDT kit used is specific for P. falciparum and has a test band along its length impregnated with monoclonal antibodies which are specific for the HRP2 antigen for P. falciparum. The test was conducted according to the specifications provided by the manufacturer. Both positive and negative controls were set for each box of the kit that was used to be sure of the viability of the pieces of cassettes in each box. About 5μl of whole blood was taken for the RDT for each participant with a label on the kit as stated earlier. The blood sample was added into the sample well after which two drops (60 μl) of assay buffer were added into the buffer well and the results read in 20 min at room temperature. A positive reaction was identified by the presence of two rose-pink color bands at the control (C) and test (T) labels. A visible rose-pink label at the control (C) label only was indicative of a negative reaction.

The absence of rose-pink color at both control and test labels indicated an invalid result but none was recorded in the course of the research.

Data Analysis

Descriptive statistics was used to analyze the frequency, percentage, mean, and standard deviation.


  Results Top


[Table 1] shows the frequency and percentage of how malaria was treated.
Table 1: Malaria and treatment seeking behavior

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[Table 2] shows the prevalence rate of malaria parasite among 85 children recruited
Table 2: Prevalence of malaria parasitemia by sex

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  Discussion Top


A total of 12.9% of the children reported that they have malaria frequently and 87.1% do not have malaria frequently as in [Table 1]. Out of this, majority got treatment while a few did not get treatment for malaria. The most common source of treatment mentioned by respondents was health facility. This observation is similar with other studies done in Tanzania [9],[10],[11] Eritrea, [12] and Sudan. [13] Other source of malaria treatment such as chemist was also mentioned by children. This act of self-treatment is consistent with findings from study done in other part of Uganda and other studies done in India, [14] Tanzania, [11] and Bangladesh. [15] A few of the pregnant women reported not to have got treatment for malaria.

[Table 2] showed that 26 children (30.59%) out of 85 children had parasitemia. Malaria prevalence of 30.59% was obtained using smart check P. falciparum Rapid Diagnostic Test Kit. This is comparable to the prevalence rate ranging from 2.6 to 81.1% obtained from various malaria endemic regions using various kinds of Rapid Diagnostic Test Kit. [16],[17],[18],[19],[20] The result showed evidence of high infection of malaria parasite in Kano Metropolis. This finding is not in line with a report from Ibadan with a prevalence rate of 7.8%. [21] The study is also in concordance with reports from other parts of Nigeria that indicated malaria prevalence ranging from 30.2-40.9% among blood donors. [22],[23],[24] Reports from other areas of stable malaria transmission in sub Sahara Africa have also indicated high prevalence (above 33%) of malaria parasite in blood donor. [25],[26]

The main limitations of this study that we used were asking children verbally whether they have experienced an episode of malaria to determine the prevalence of malaria. This could have bias the findings since any fever that was experienced by the children could have been treated as malaria. The majority reported using health facilities for treatment which is a good step for public health campaign.


  Conclusion Top


The prevalence of malaria is high among the respondents. The majority of the respondents sought treatment from health facilities. However, few children got treatment from chemist and at home or did not get treatment for malaria. Children should be advised to seek treatment whenever they have malaria from health facility. This is to ensure that the treatment given is appropriate.

 
  References Top

1.World Health Organization. World Health Organization, Geneva: WHO World Malaria Report; 2005.  Back to cited text no. 1
    
2.FMOH. Federal Republic of Nigeria training manual for management of malaria in Nigeria Participants' Manual Federal Ministry of Health National Malaria and Vector Control Division, Abuja- Nigeria, 2009.  Back to cited text no. 2
    
3.Holding PA, Snow RW. Impact of Plasmodium falciparum malaria on performance and learning: Review of the evidence. Am J Trop Med Hyg 2001;64 (1-2 Suppl):68-75.  Back to cited text no. 3
    
4.Murphy SC, Breman JG. Gaps in the childhood malaria burden in Africa: Cerebral malaria, neurological sequelae, anemia, respiratory distress, hypoglycemia, and complications of pregnancy. Am J Trop Med Hyg 2001;64 (1-2 Suppl):57-67.  Back to cited text no. 4
    
5.Angyo LA, Pam CD, Szlachetba R. Clinical patterns and outcome in children with acute severe Plasmodium falciparum malaria at Jos University Teaching Hospital, Nigeria. East Afr Med J 1996;73:823-6.  Back to cited text no. 5
    
6.Ofovwe EG, Eregie CO. Manifestations of severe falciparum malaria in children aged 6 months to 5 years in Benin City, Nigeria. Resid Doct 2001;5:16-20.  Back to cited text no. 6
    
7.Arigbabuwo Adeleye. Malaria: Killer at large. Vanguard Newspaper special report, 2010.  Back to cited text no. 7
    
8.Gilles H. Diagnostic methods in malaria. In: Warrell DA, Gilles HM, editors. Essential Malariology. 3 rd ed. London: Edward P. Arnold; 1993. p. 78.  Back to cited text no. 8
    
9.de Savigny D, Mayombana C, Mwageni E, Masanja H, Minhaj A, Mkilindi Y, et al. Care-seeking patterns for fatal malaria in Tanzania. Malar J 2004;3:27.  Back to cited text no. 9
    
10.Mboera LE, Mlozi MR, Senkoro KP. Malaria and agriculture in Tanzania. Impact of land use and agricultural practices on Malaria in Mvomero district," National Institute for Medical Research, Dar es Salaam, Tanzania, 2007.  Back to cited text no. 10
    
11.Mazigo HD, Obasy E, Mauka W, Manyiri P, Zinga M, Kweka EJ, et al. Knowledge, attitudes, and practices about Malaria and its control in rural Northwest Tanzania. Malar Res Treat 2010;2010:794261.  Back to cited text no. 11
    
12.Hans H, Tewolde G, Selam M, Jacob M, Andemariam G. Knowledge, attitudes and practices (KAP) about malaria among people visiting Referral Hospitals of Eritrea. J Eritrean Med Assoc 2008; p. 42-6.  Back to cited text no. 12
    
13.Elmardi KA, Noor AM, Githinji S, Abdelgadir TM, Malik EM, Snow R.W. Self-reported fever, treatment actions and malaria infection prevalence in the northern states of Sudan. Malar J 2011;10:128.  Back to cited text no. 13
    
14.Sabin LL, Rizal A, Brooks MI, Singh MP, Tuchman J, Wylie BJ, et al. Attitudes, knowledge, and practices regarding malaria prevention and treatment among pregnant women in eastern India. Am J Trop Med Hyg 2010;82:1010-6.  Back to cited text no. 14
    
15.Ahmed SM, Haque R, Haque U, Hossain A. Knowledge on the transmission, prevention and treatment of malaria among two endemic populations of Bangladesh and their health-seeking behaviour. Malar J 2009;8:173.  Back to cited text no. 15
    
16.Singer LM, Newman RD, Diarra A, Miran AC, Huber CS, Stemmies G, et al. Evaluation of malaria in Rapid Diagnostic Test for assessing the burden of malaria during pregnancy. Am J Trop Med Hyg 2004;70:418-5.  Back to cited text no. 16
    
17.Mockenhaupt FP, Bedu-Addo G, von Gaertner C, Boye R, Fricke K, Hannibal I, et al. Detection and clinical manifestation of Placental Malaria in Southern Ghana. Malar J 2006;5:119.  Back to cited text no. 17
    
18.Djibo A, Cenac A. Congenital malaria. Parasitological and Serological studies in Niamey (Niger). Sante 2000;10:183-7.  Back to cited text no. 18
    
19.Onyenekwe CC, Arinola OG, Meludu SC, Salimonu LS, Adewale IF, Obisesan AK. Malaria Parasitaemia and Plasmodium falciparum Specific IgG in maternal peripheral, placental and cord Circulation. J Vector Borne Dis 2004;41:72-5.  Back to cited text no. 19
    
20.Singh N, Sexena A, Awadhia SB, Shrivastava R, Singh MP. Evaluation of rapid diagnostic test for assessing the burden of malaria at delivery in India. Am J Trop Med Hyg 2005;73:855-8.  Back to cited text no. 20
    
21.Akinboye DO, Ogunrinde AF. Malaria and Laosis among blood donors at Ibadan, Nigeria. Trans R Soc Trop Med Hyg 1987;81:398-9.  Back to cited text no. 21
    
22.Ibhanesebho SE, Otobo ES, Ladipo OA. Prevalence of malaria parasitaemia in transfused donor blood in Benin City, Nigeria. Ann Trop Paediatr 1996;16:93-5.  Back to cited text no. 22
    
23.Okocha EC, Ibeh CC, Ele PU, Ibeh NC. Prevalence of malaria parasitaemia in blood donors in a Nigeria Teaching Hospital. J Vector Borne Dis 2005;42:21-4.  Back to cited text no. 23
    
24.Uneke CJ, Ogobu O, Nwojiji V. Potential risk of induced malaria by blood transfusion in Southern_Eastern Nigeria. McGill J Med 2006;9:8-13.  Back to cited text no. 24
    
25.Kinde-Gazard OJ, Gnaboui I, Massougbodji A. The risk of malaria transmission by blood transmission at Cotonou, Benin. Sante 2000;10:382-9.  Back to cited text no. 25
    
26.Ali MS, Yousif AG, Mustapha MS, Ibrahim MH. Evaluation of Malaria parasite screening among Sudanese blood donors. Clin Lab Sci 2005;18:69-73.  Back to cited text no. 26
    



 
 
    Tables

  [Table 1], [Table 2]



 

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