HEALTH ASSESSMENT ON MALARIA AND INTESTINAL PARASITE CO-INFECTION AMONG INTERNALLY DISPLACED PERSONS(IDP REFUGEES)

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HEALTH ASSESSMENT ON MALARIA AND INTESTINAL PARASITE CO-INFECTION AMONG INTERNALLY DISPLACED PERSONS(IDP REFUGEES)

CHAPTER ONE

INTRODUCTION

Background of the study

Malaria and Neglected Tropical Diseases (NTDs), including intestinal parasitic infections (IPIs) and schistosomiasis, are highly endemic in developing nations of the world and remain a serious public health issue in sub-Saharan Africa, especially in impoverished and poor sanitary settings, with tremendous consequences for development (Yamey, 2002; Tchuenté et al., 2013; Kwenti et al., 2016). About 3.3 billion people worldwide are at risk of being infected with malaria and developing disease (Abossie et al., 2017). In 2018, about 228 million malaria cases and 405,000 deaths globally were recorded (WHO, 2019a). The burden is heaviest in the sub-Saharan African Region, with more than 80% of all malaria deaths, and children ages 1–4 years account for 78% of all deaths (Murray et al., 2012; WHO, 2019a; Naß and Efferth, 2019).

Plasmodium falciparum, out of the five human malaria parasites, is the most virulent and prevalent species in Africa where it was responsible for about 214 million clinical cases and 438,000 deaths recorded all over the world in the year 2015 (WHO, 2015; Bhatt et al., 2015). Primarily IPIs are caused by helminths (Ascaris lumbricoides, Trichuris trichiura and hookworm), protozoans (Entamoeba histolytica, Giardia duodenalis and Balantidium coli) or both (Harhay et al., 2010; Odo et al., 2016). The severity of intestinal parasitic infections (IPIs) is more pronounced in areas in Asian, Latin American and sub-Sahara African countries lacking potable water supply, good personal and environmental hygiene, and have rapid growth in human population (Mohammed et al., 2015). These infections predominate in children and 12% of the global disease burden is reported among children within 5–14 years of age in developing countries (Awasthi et al., 2003).

Ascaris lumbricoides causes about 1.2 billion infections worldwide and T. trichiura and hookworm disease accounts for 795 million and 740 million (Alum et al., 2010). High prevalence of IPIs has been observed among school-going children in sub-Saharan African countries including: 84.6% in Nigeria (Awi-Waadu, 2008), 90% in Central Sudan (Ahmed et al., 2010), 50.0% in Rwanda (Emile et al., 2013), 48.7% in Tanzania (Speich et al., 2013) and 84.7% in Burkina Faso (Erismann et al., 2016). Malaria coinfection with IPIs predominates in sub-Saharan African countries due to their overlapping distribution (Hotez et al., 2009).

Human schistosomiasis or bilharziasis is a freshwater snail-transmitted intravascular debilitating disease caused by blood-dwelling parasitic dimorphic Schistosoma trematode worms (Gryseels et al., 2006; Chen et al., 2020). Essentially, the disease is grouped into two: urogenital schistosomiasis and intestinal schistosomiasis based on the organs affected (Njunda et al., 2017). Basically, six major species infect man—Schistosoma haematobium (etiological agent of urogenital schistosomiasis), S. intercalatum, S. mekongi, S. japonicum, S. mansoni and S. guineensis (etiological agents of intestinal schistosomiasis)— however, S. haematobium, S. japonicum and S. mansoni are most pathogenic (Steinmann et al., 2006; Chuah et al., 2019). Not less than 240 million people are affected by schistosomiasis globally and about 200,000 deaths recorded yearly (Thétiot-Laurent et al., 2013; Hotez et al., 2014; WHO, 2019b). Approximately 90% of the cases occur in Africa of which nearly two-thirds are caused by S. haematobium (Hotez and Kamath, 2009; Vos et al., 2012). Nigeria has the highest prevalence among the 75 countries in which the disease is endemic (Uchendu et al., 2017; WHO, 2019b). In Nigeria, a prevalence of 9.5% was reported by the Federal Ministry of Health (2015). Other studies conducted in Maiduguri and Anambra, Nigeria, reported prevalence of 14.5% and 15.7% respectively (Joseph et al., 2010; Ugochukwu et al., 2013).

Evaluating the endemic level of parasitic infections in populations exposed to the disease is of utmost necessity in order to formulate specific and appropriate intervention programmes. There is dearth of empirical estimates of parasitic infections in the camp therefore; this research sought to determine the prevalence of malaria with NTD coinfection in children in IDP camp, Benin City, Nigeria. The outcome of this research will help the management of the camp in appropriate intervention programmes to tackle these diseases.

Statement of the problem

There may have been previous researches in this subject. This work gives further explanations and analysis in health assessment on malaria and intestinal parasite co-infection among internally displaced persons(idprefugees)

Objectives of the study
To understand the impact of health assessment on malaria and intestinal parasite co-infection among internally displaced persons(idprefugees)
To understand the relationship between health assessment and malaria and intestinal parasite co-infection among internally displaced persons(idprefugees)

Research questions
To understand the impact of health assessment on malaria and intestinal parasite co-infection among internally displaced persons(idprefugees)
To understand the relationship between health assessment and malaria and intestinal parasite co-infection among internally displaced persons(idprefugees)
1. Research hypothesis

H0: There is no relationship between health assessment and malaria and intestinal parasite co-infection among internally displaced persons(idprefugees)

H1: There is a relationship between health assessment and malaria and intestinal parasite co-infection among internally displaced persons(idprefugees)

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