CHAPTER 1
INTRODUCTION1.1 Background to the Study
Malaria contributes substantially to the poor health situation in Africa. It is on record that, subSaharan Africa (SSA) accounts for 90% of the world‟s 300 to 500 million cases of malaria and 1.5 to 2.7 million deaths annually. About 90% of these deaths in Africa are of young children, suggesting some serious demographic consequences for the continent. Malaria is a great burden on the health system in Africa, as it is responsible for 20 to 40% of outpatient visits and 10 to15% of hospital admissions, according to the World Health Organisation (WHO, 1999). In subSaharan Africa (SSA), 10.8% of all disability-adjusted life years (DALYs) were lost to malaria in 1990. Again, among the 10 leading factors in DALYs in the world in 1998, malaria ranked eighth with a share of 2.8% of the global disease burden. In SSA however, malaria ranks second after HIV/AIDS, accounting for 10.6% of the disease burden. According to the World Bank, malaria accounted for an estimated 35 million DALYs lost in Africa in 1990 due to ill health and premature death (World Bank, 1993). The estimate was 39 million DALYs in 1998 and 36 million DALYs in 1999 (WHO, 1998, 1999, 2000). Furthermore, while malaria contributed 2.05% to total global deaths in 2000, it was responsible for 9.0% of all deaths in Africa (WHO, 2002).
The WHO also estimated that the total cost of malaria to Africa was US$1.8 billion in 1995 and US$2 billion in 1997 (WHO, 1997). Malaria is therefore a massive problem that affects all segments of society. While its effect on people of all ages is quite immense, the most serious impact of malaria is on pregnant women and children because they have less immunity. When a malaria infection is not properly treated in pregnant women, it can cause anaemia and also lead to miscarriages, stillbirths, underweight babies and maternal deaths. Also, frequent cerebral malaria can lead to disabling neurological consequences. With regard to school children, malaria is a major cause of absenteeism in endemic countries. It is estimated that about 2% of children who recover from cerebral malaria suffer brain damage including epilepsy (WHO/UNICEF, 2003). Hence, among young children, frequent episodes of severe malaria may harm their learning abilities and educational attainment. This is a threat to human capital formation, which constitutes a key factor in economic development. The debilitating effects of malaria on adult victims are very disturbing. In addition to the time and money spent on preventing and treating malaria, it causes considerable pain and weakness among its victims, thereby affecting their ability to work. The adverse impact of the disease on household production and gross domestic product can be substantial. Malaria therefore is not only a public health problem but also a developmental problem.
At the national level, apart from the negative effect of lost productivity on the major sectors of the economy, malaria has negative effects on the growth of tourism, investment and trade, especially in endemic regions.
It constitutes a major socio-economic challenge to African countries since they are the region most affected by the disease. This challenge must be faced with resolve since good health is not only a basic human need but also a fundamental human right and a prerequisite for economic growth (Streeten, 1981).
The malaria burden is a challenge to human development. It is both a cause and consequence of under-development. As has been observed elsewhere, the disease is not homogeneous and uniform in Nigeria. It is a localized problem with great differences from place to place. Prevalence shows diversities and variations to the extent that neighbouring communities can display complete difference in transmission patterns. This is due to a combination of factors: meteorological and ecology of both human host and the vectors and proximity between human habitat and the breeding places. The peak period of malaria transmission occurs during the rainy season and often coincides with the peak period of agricultural activities such as planting and harvesting. Parasite strains appear to be including an increasing human tool with services on productivity. There is some reduction during the dry season.
The malaria burden is a challenge to human development. It is both a cause and consequence of under-development. In Nigeria, malaria is the number one cause of morbidity, accounting for 40 to 60% of outpatient visits. It is also the leading cause of mortality in children under 5 years of age, a significant cause of adult morbidity, and the leading cause of workdays lost to illness.
Despite the devastating effects of the disease, the importance of a malaria-free environment in promoting economic development and poverty reduction has not been fully appreciated in Nigeria. Perhaps the impact of malaria has not been demonstrated in quantitative terms that might convince politicians, policy makers, programme managers and development partners to devote the needed attention and resources to combating this dreadful disease. This study is an attempt to fill this gap with appropriate information.
1.3 Objectives of the Study
The objectives of the study are to:
(i) provide us clues about the behaviour of the time series data
(ii) develop a statistical model that will aid in forecasting the incidence of the disease in the
state.
1.4 Scope
The study is confined to the morbidity of malaria cases reported at the University of nigeria teaching hospital in the Enugu State. The project is seeking information on monthly outpatient morbidity returns for ten (10) consecutive years (2001-2010) of the disease.
1.5 Justification of the Research
Several programmes have been initiated in this country to combat this disease of the poor people but its prevalent rate is still high and accounts for 40% out of the 70% communicable disease in Nigeria in 2008. The National Malaria Control Programme (NMCP) is the mother agent for controlling the disease in this country. Other companies like Zoomlion Company Limited and
AngloGold Ashanti have also joined in the fight against the disease.
Considering the concomitant loss of lives, cost in the medication and loss of productive hours, it requires renewed commitment from the government, non-governmental organizations and all and sundry to fight for complete eradication of the disease. Since the cost of treatment of the disease is directly proportional to the size of the potential benefits to be derived for the country, for a successful malaria control programme, this study will try to identify areas of high prevalence of malaria in the state. Indeed, very few research studies have been carried out on the incidence of malaria in the Nigeriaian context to date. In particular, very little is known in the state concerning this very important subject. Based on available empirical evidence, it is necessary to furnish decision makers and other stakeholders with vital information regarding the incidence of malaria in the state for possible policy interventions. Additionally, it is important to contribute to knowledge on the incidence of malaria with a view to, among other things, stimulate further research.
1.5 Limitation of the Study
This project has successfully been accomplished not withstanding constraints encountered. Inadequate logistical arrangement to facilitate collection and storing information constituted a major drawback. Officers of the statistical department of the hospital had to search through bulk documents for the needed information. This made it a hard task for me in obtaining the required data. Time allotted to carry out the study wasn‟t sufficient enough to cover a broader scope like the whole of Ashanti Region or country wide. The high cost of gathering and collection of data also prevented me form covering a wider scope to achieve a desirable and representative result.
1.6 Thesis Organization
Chapter 1 is the introduction which comprises the background to the problem, statement of the problem, objectives of the study, justification of the research, methodology and limitation.
Chapter 2 basically deals with the review of literature on malaria and time series modelling.
Chapter 3 deals with the methods used in the analysis. It comprises of the introduction, describing basic statistics, method and concept of time series and Box-Jenkins methodology.
The data used in the study and characteristics of the study area, data analysis and results are considered in Chapter 4.
The summary and conclusions including a discussion of the policy implications of the study are presented in Chapter 5.
Item Type: Project Material | Size: 97 pages | Chapters: 1-5
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