RESULTS OF RESEARCH IN MALARIA IN EBONYI STATE - NIGERIA


 A total of 1000 blood specimens from donors were screened for the presence of Plasmodium species. The prevalence of Plasmodium  species  was 15.8% and the mean age in years of the donors screened was 31.36. The results are as summarized in the tables below.

Table 1 below shows the age distribution of P.falciparum among blood donors tested. The occurrence of this agent was more in the blood of individuals of 23-27 years age group with prevalence of 24.40 %. Donors of 38-42 years age group had the least prevalence of 9.93 %. Statistical analysis revealed that a significant relationship occurred between age and the occurrence of the parasite (P<0.05).

Table 1: The Distribution of P. falciparum   among Blood Donors Tested

Age Range (Yrs)
Number Tested
Number Positive
Percentage Positive
X2
18 – 22
98
13
13.26
0.45
23 – 27
250
61
24.40
13.89
28 – 32
224
34
15.19
0.065
33 – 37
212
28
13.21
1.073
38 – 42
141
14
9.93
3.67
43 – 47
75
8
10.66
1.49
Total
1000
158
15.8
20.63
P<0.05
Table 2 represents the distribution of Plasmodium with respect to sex and location of the donors examined. Male donors (914) were more involved than females (86). Higher prevalence of 16.19 percent was observed among the males
while the females recorded a lower prevalence of 11.63%. No significant statistical relationship exists between sex and the occurrence of the parasite among blood donors (P> 0.05). In terms of location, donors from urban areas (612) were more involved in the study. Of 388 donors from rural areas, 83 (21.39%) presented with Plasmodium parasitemia. Urban dwellers had the least prevalence (12.25%) of parasitemia.  Significant statistical relationship was shown between location and parasitemia among the donors. (P< O.O5)
Table 2: The distribution of P. falciparum with respect to Sex and Location among Blood Donors Examined
         
Social demographic factors
Number Tested
Number Positive
Percentage Positive
X2
Sex




Male
914
148
16.19

Female
86
10
11.63
1.23
Total
1000
158
15.8

Location




Rural
388
83
21.39

Urban
612
75
12.25   
14.9
Total
1000
158
15.8

      (P>0.05  for sex;    P<0.05  for location)
Table 3 represents the occupational distribution of Plasmodium among blood donors investigated. The number of Artisans who took part in the study (176) was higher than that of other occupational categories. Farmers had the highest prevalence (32.41%) followed by civil servants (15.65%). The clergy participated less and had the least prevalence (12.0%) of parasitemia. There was significant statistical relationship between occupation and the parasite occurrence among blood donors. (P<0.05). 
Table 3:   Distribution of P. falciparum occurrence among Blood Donors with respect to occupation Investigated

Occupation         
Number Tested
Number Positive
Percentage Positive
X2
Farmers
108
35
32.41
22.39
Artisans
176
26
14.77
       0.14
Civil Servants
174
23
15.65
0.87
Traders
164
22
13.41
0.70
Drivers
127
16
12.60
0.98
Students
134
20
14.93
0.08
Applicants
92
13
14.13
0.19
Clergy
25
3
12.00
0.27
Total
1000
158
15.8
26.62
P<0.05
Table 4 shows the relationship between the use of control measures (insecticide treated nets and insecticides) and Plasmodium occurrence among blood donors studied. Out of the 1000 donors screened, 5, 180, 136 and 679 reported “Always”, “Occasional”, “Rare” and “None” use of insecticide treated mosquito nets respectively. The highest prevalence of parasitemia (18.26%) was reported among “None” users. Statistical significant relationship exist between the use of insecticide treated nets and parasitemia (P<0.05). Concerning the use of insecticides, 758 individuals reported none use of it and the prevalence of 16.23% of Plasmodium parasitemia were reported among these donors. No donor reported using insecticide always. There was no statistical significant relationship between Plasmodium occurrence among blood donors and the use of insecticides. (P>0.05)
Table 4:  The distribution of P. falciparum with respect to the frequency of use of insecticides (I) and insecticide treated nets (ITN) among blood donors studied.
         
Frequency Use of Control Measures
Number Tested

Number Positive

Percentage Positive

X2


I
ITN
I
ITN
I
ITN
I
ITN
Always
2
5
-
-
-
-
0.38
0.94
Occasionally
68
180
7
21
10.29
11.67
1.55
2,32
Rarely
172
136
28
13
16.28
9.56
0.03
3.98
Not at all
788
679
123
124
16.23
18.26
0.10
3.09
Total
1000
1000
158
158
15.8
15.8
2.06
10.33
(P>0.05  for I ;     P<0.05  for ITN)
Keys: I = Insecticides; and  ITN = Insecticide Treated Nets
Table 5 shows the relationship between the use of prophylactic and therapeutic antimalarials and the occurrence of Plasmodium among blood donors examined.  Out of 493 that reported none use of antimalarial prophylaxis, 93 (18.86%) presented with parasitemia. No donor reported the monthly use of this prophylaxis. Significant relationship (P<0.05) exist between the use of antimalarial prophylaxis and Plasmodium parasitemia. In terms of the form of therapeutic antimalarials used, Out of 480 and 75 donors that reported use of single therapy and no formalized therapy respectively, 93 (20.2%) and 19 (25.33%) presented with parasitemia. The least prevalence (4.72%) was reported among individuals that use combination therapy as the only form of malaria treatment. Statistically, parasitemia was shown to be dependent on the form of antimalarial therapy used by the donors (P<0.05).
Table 5:   The distribution of P. falciparum with respect to the frequency of
  use of antimalarial prophylaxis and the form of antimalarial   therapy among   blood donors researched on

Prophylactic and Therapeutic factors Examined     
Number Tested
Number Positive
Percentage Positive
X2
Frequency of Use of  antimalaria prophylaxis




Monthly
-
-
-
-
Quarterly
59
3
5.08
5.10
Annually
52
9
17.31
0.09
Only when Symptoms Appear
396
53
13.38
1.74
Not at all
493
93
18.86
3.48
Total
1000
158
15.8
10.41
Form of antimalarial therapy




ST
480
97
20.21
7.01
ACT
212
10
4.72
19.57
SCT
233
32
13.73
0.73
NFT
75
19
25.33
5.12
Total
1000
158
15.8
32.46
          (P<0.05 for both prophylactic and therapeutic factors)
Keys:  ST = Single Therapy; ACT = Artemisinin based Combination Therapy
 SCT = Single and Combination Therapy; NFT = No Formalized Therapy

Table 6 shows the relationship between parasitemia among blood donors and different hospitals assayed. Out of the four hospitals used for this study, the prevalence of 17.65% and 11.73% were reported among donors from EBSUTH and Mile-4 hospital respectively. The highest prevalence of parasitemia was reported at EBSUTH. Statistically, there was no relationship between Plasmodium. Occurrence and the hospitals used for the study (P>0.05).
Table 6:   The prevalence of P. falciparum among blood donors with
Reference to hospitals visited

         
Hospitals   
Number Tested
Number Positive
Percentage Positive
X2
EBSUTH
340
60
17.65
0.87
FMC
313
48
15.34
0.05
MILE 4
162
19
11.73
2.02
MMH
185
31
16.76
0.13
Total
1000
158
15.8
3.07
P>0.05
Table 7 represents the relationship between the mode of blood donation and occurrence of Plasmodium among the donors tested. Commercial donors constituted greater part of the population (679) and also had the highest prevalence (17.82%). The least prevalence (8.60%) was reported among volunteer donors. Statistical significant relationship exists between parasitemia and the mode of blood donation in Ebonyi state (P<0.05).
Table 7: The relationship between the mode of blood donation and the  occurrence of Plasmodium  among Blood Donors Tested.

Mode of Blood Donation
Number Tested
Number Positive
Percentage Positive
X2
Commercial
679
121
17.82
2.83
Voluntary
93
8
8.60
3.622
Family




Replacement
228
29
12.71
1.62
Total
1000
158
15.8
7.332
P<0.05
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