MORBIDITY AND MORTALITY PREVALENCE OF SIX KILLER DISEASES AMONG UNDER FIVE CHILDREN IN ENUGU EAST LOCAL GOVERNMENT AREA OF ENUGU STATE (2006 – 2010)

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ABSTRACT

This study was undertaken to determine the morbidity and mortality prevalence of six killer diseases among under five children in Enugu East Local Government Area of Enugu State 2006 – 2010. Eight research questions were posited and six hypotheses were postulated to guide the study. The study adopted the descriptive method utilizing the expost – facto design. The sample for the study consisted of 544 children who area exposed to these six killer diseases in various hospitals, maternities, health centres and health post in Enugu East Local Government Area from 2006 – 2010. The data were collected using the researcher designed morbidity and mortality prevalence inventory profoma (MMPIP) which was used to gather information from folders of children under five years hospital, informations concerning morbidity and mortality prevalence (55.56) of six killer diseases among under five children. The data collected were analyzed using percentages for the purpose of answering the research questions while chi-square (c2) statistics was used to test the hypotheses at .05 level of significance. The results of the study revealed that the highest morbidity prevalence of measles was recorded in 2006 (39.5%) while the lowest morbidity prevalence (6.7%) occurred in 2010 and the highest mortality prevalence (55.5%) of measles occurred in 2006 while the lowest mortality prevalence (5.6%) occurred in 2007, 2009 and 2010. The result also showed that the highest morbidity prevalence of poliomyelitis occurred in 2007 (52.5%) while the lowest morbidity prevalence poliomyelitis occurred in 2006 and 2008 and the mortality prevalence (1.6%) of poliomyelitis occurred only in 2006. The highest morbidity prevalence (42.2%) of tuberculosis occurred in 2010 and the lowest morbidity prevalence (7.7%) occurred in 2007 while the mortality prevalence (100%), of tuberculosis occurred in 2006 only morbidity prevalence of tetanus occurred (20%) in each year and the mortality prevalence of tetanus recorded highest in 2007 (62.5%) and lowest in 2008, 2009 and 2010 each. The result also showed that diphtheria morbidity prevalence occurred once in each year from 2006 – 2010 (20%) and the mortality prevalence of diphtheria (20%) occurred once in each year from 2006 – 2010. There was no record of morbidity and mortality prevalence of pertussis during the period understudy. There was no significant difference in mortality prevalence of six killer diseases among under five children according to mothers’ level of education. There was no significant difference in morbidity prevalence of six killer diseases among under five children according to location. There was no significant difference in mortality prevalence of six killer diseases among under five children according to location. The results were extensively discussed and recommendations were made which were among others awareness about the six killer diseases should be created as it concern their signs and symptoms, prevention, treatment, and immunization schedules.

TABLE OF CONTENTS

Title Page
Table of Content
List of Tables
List of Figures
Abstract

Chapter One: Introduction
Background of the Study
Statement of the Problem
Purpose of the Study
Research Questions
Hypotheses
Significance of the Study
Scope of the Study

Chapter Two: Review of Related Literature
Conceptual Framework
Concept of morbidity
Concept of morbidity and mortality prevalence
Concept of six killer disease
The factors associated with morbidity and mortality
Prevalence of six killer diseases among under five children
Theoretical Framework
Demographic transition theory
The precede proceed theory
Empirical Studies
Summary of Literature Review

Chapter Three: Methods
Research Design
Area of Study
Population for the Study
Sample and Sampling Techniques
Instrument for Data Collection
* Validity of Instrument
* Revisits of Instrument
Method of Data Collection
Method of Data Analysis

Chapter Four: Results and Discussions
Results
Summary of Major Finding
Discussion
* Morbidity prevalence of six killer diseases
* Mortality prevalence of six killer diseases
* Socio demographic variables affecting the morbidity and mortality
*          Prevalence of six killer diseases, age of the child, mother’
*          Level of education and location (rural and urban)

Chapter Five:            Summary, Conclusions and Recommendations
Summary
Conclusions
Recommendations
Limitation for the Study
Suggestion for Further Study
References
Appendices

CHAPTER ONE

Introduction

Background to the Study

Despite several programmes aimed at promoting child survival, childhood morbidity and mortality have been an issue of major public health concern in Nigeria. A recent analysis of global child survival points out that more than ten million children die each year, mostly from six killer diseases in developing countries of the world. Under five mortality is highest in Africa particularly in sub-Sahara region. This may be declining but the rate remains unacceptably high when compared with other regions of the world (Adeyemi, 2008).

Every year, over 2 million children continue to die from disease which could have been prevented, if they were adequately covered by protective measures (WHO 2003). Under five morbidity and mortality prevalence are constantly on the agenda of public health and international development agencies. This is part of United Nations Millennium Development Goals. United Nations (1995) and United Nation Children Fund-UNICEF (2000) noted that mortality prevalence among children under the age of five remains strikingly high through out the majority of the developing and the industrialized countries of the world. Although developed countries are experiencing decline in the prevalence of six killer diseases over the years, most developing countries like Nigeria still maintain relatively high rate irrespective of action plans and intervention programmes that are made available, (WHO, 2004).

As the world enters into the 21st century, under five morbidity and mortality prevalence of the six killer diseases remain a big issue for developing countries. Many researchers have attempted to identify many factors that are contributing to the high morbidity and mortality of under five children. UNICEF (2008) was of the opinion that morbidity and mortality prevalence of under five will be used as a guide or as a yard stick for measuring the standard of living of any country in the world especially as they reflect the health status of the children and their mothers.


Morbidity as defined by Brailler (1986) is a state of being diseased. Lucas and Gilles (2006) defined it as information on the occurrence and severity of sickness in a community or in an area. Obionu (2006) was of the opinion that morbidity is a measure of frequency the occurrence of diseases within a defined population during a specific period of time in an area or in a community. This may be used to assess the health status of the community. Morbidity as used in the study refers to the occurrence and severity of sickness (that is the six killer diseases) in the area of the study among the under five children.

The data on the occurrence of the six killer diseases within the community can provide more detailed assessment of the health of the community (Lucas & Gilles, 2006). The data on the morbidity of six killer diseases may be obtained from a number of sources, for example from previous records of health institutions, or from nursing mothers and health workers who are working in the primary health sectors. Morbidity prevalence can be calculated as the number of new and old cases of a disease over the population at risk at a given time multiplied by one thousand (Lucas & Gilles, 2006). Morbidity is usually linked to mortality if not adequately taking good care it leads to death.
Mortality is defined by Brailler (1986) as the state of being liable to die. Butterworths (1988) defined mortality as the condition or quality of liability to death. Obionu (2006) described mortality as the number of deaths among a given population in a community. Mortality is the number of deaths in a particular situation or period of time (Hornby, 2006). According to Park (2009), mortality is defined as the number of deaths in a given population annually. Mortality as used in the study refers to the number of deaths (by six killer diseases) recorded in an area annually per one thousand population of under five children. Morbidity and mortality prevalence of the six killer diseases are high among under five children.

Prevalence, is defined by Hornby (2006) as something which exists or is very common at a particular time and in a particular place. Park (2009), described prevalence as the total number of all individuals who have attributes or diseases at a particular time or during a particular period divided by the population at risk. Obionu (2006) maintained that prevalence is the number of people in a population who have the disease (both new and old cases) at a given point in time. Prevalence as used in this study refers to the number of under five children (both old and new cases) who have been diseased by these six killer disease and death of children from these six killer diseases during a particular time and during a particular period of the diseases. There are two types of prevalence: Point prevalence and period prevalence. Point prevalence as described by Park (2009) is the number of all current and old cases at one point in a time in relation to defined population. Butterworths (1986) defined period prevalence as the proportion of cases or manifestation occurring during a specific period of time. Prevalence mathematically is represented as P=1 X D where P is prevalence, I is incidence and D is disease.
Morbidity and mortality prevalence of six killer diseases among under five children have been an issue of global crisis especially in health sectors. (WHO 2002) Efforts have been made to reduce under five morbidity and mortality prevalence of these killer diseases. According to Park (2009), under five mortality is defined as number of deaths that occur in ages from one to five years in a given population. He also stated that under five morbidity is the number of sickness which occurs at ages one to five years in a given population.

Lucas and Gilles (2006) defined under five as the children at the ages of one to five years old. In is the study, the under five refers to these children under one to five years of ages who are been exposed to these six killer diseases. They further maintained that under five morbidity and mortality serve as indicator related to the overall health status of children and are widely accepted as one of the most useful single measure of the health status of the community. Morbidity and mortality prevalence of under five may be high in communities where health and social services are poorly developed. Under five morbidity and mortality account for approximately forty per cent of the total morbidity and mortality in most developing countries (Adeyemi, 2008). The situation may not be same with the developed countries where major health interventions are available to improve the life of children especially the under five children. The under five children’s health is not only regarded as an important index of child health but it is a sensitive measure of the effectiveness of health services as well as the socio-economic progress of a country (Obionu, 2006). The under five morbidity and mortality prevalence are mostly from six killer diseases, which are mostly preventable.

Obionu (2006) defined the six killer diseases as the six specific infectious diseases which most children develop (especially in the tropical countries) and which are usually preventable through immunization and adequate utilization of health intervention programme for children. Six killer diseases as used in the study refers to the immunizable or preventable disease which have high morbidity and mortality prevalence among under five children in area of study. Preventable diseases are measles, tuberculosis, whooping cough, poliomyelitis, diphtheria and tetanus (Park, 2009). With adequate immunization coverage and provision of health care services to the rural areas, the prevalence of six killer diseases will be adequately reduced (Park, 2009).


Poliomyelitis, according to Obionu (2006), is a disease caused by the poliovirus (an enterovirus). It is an acute infectious disease which involves the motor neurons of the spinal cord and brain resulting in asymmetric flaccid paralysis of the involuntary muscles. Type one has.....

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