Malaria Epidemiology in Ghana - Assignment Example

Malaria Epidemiology Malaria Epidemiology Malaria is endemic in Ghana and accounts for close to 50% of outpatient attendance inall public hospitals. Additionally, it accounts for 14 % of the total hospital deaths and 23% of the total mortality among children below the age of five years. The study analyzed malaria as the main cause of mortality among children with the use of a logistic regression model. It also assessed the effect of interaction between the treatment of malaria and age. Secondary data was obtained from the outpatient mortality and morbidity returns at the hospital from January to December 2008. According to the findings, risk factors including age, distance, length of stay on admissions, and the referral status were significant predictors of malaria mortality (World Bank, 2008, Pg. 56). Malaria in Ghana threatens the lives of up to three billion people in the world while this leads to up to one million deaths in a year. In Ghana, malaria is the leading cause adult morbidity as well as the significant cause of many workdays lost to sickness. Therefore, malaria is hyper-endemic in this country and presents a serious health problem (off brand, 2011, Pg. 89). It records a crude parasite rate of 10 to 70% as well as a plasmodium falciparum that is the main malaria parasite. Malaria takes up, up to 15% of the overall mortality in Ghana. However, 40-45% of the total deaths occur among children of five years and below. According to the United Nations classification of childhood diseases, Ghana ranks the third in Africa. According to the statistics obtained, on the other hand, malaria is a leading cause of workday loss in the country. It accounts for four ill days in every month, two workdays absent for workers and a 7% loss of potential income. Additionally, the disease is also responsible for 11% of all healthy life lost from other diseases. This makes it the chief cause of the total lost days of health in Ghana (Gregory and Andropoulos, 2012, Pg. 123). The World Health Organization (WHO) initiated some measures for the eradication of malaria in Ghana. They came up with the “Roll Back Malaria” project whose attempt was to expand the availability of the insecticide treated mosquito nets (Calder, 2002, Pg. 23). As a result, the health ministry developed a policy on insecticide treated nets, and adopted the nets as a control measure to uphold the project. In some parts of the country, despite the many years of control and prevention measures, malaria has remained a national health problem. In the water logged and the low-lying areas, malaria is found to be a serious problem. According to the Tamale Hospital, half the total number of patients admitted suffered from malaria. Most of these patients are said to inhabitants of the swampiest and the low-lying areas of the country (World Bank, 2005, Pg. 10). Tamale metropolis, a district that is located in the north, has generally been classified as malaria endemic. It has a total population of 2.5 million people. The Tamale hospital is the area’s main hospital and has about three hundred and eighty patient beds. This makes it the largest facility in the metropolis. It serves as the first consultation point for patients as well as the referral center for many other primary health centers. Therefore, this study used data from the primary diagnosis of malaria from the hospital wards including the Registers in the hospitals that included patients’ details such as the dates of admission, sex, and age as well as the referral status and the type of treatment given (Shetty, 2008, Pg. 11; Howson, 1996, Pg. 8; Ardayfio Schandorf and Kwafo-Akoto, 1990, Pg. 24). The following variables were coded from the data obtained from the hospital (Semba and Bloem, 2008, Pg. 37): 1. Outcome (1 patient = dead while alive = 0 patients); 2. Season of the year when admitted was found to be 1 admitted during the wet season from April to October and 0 admitted during the dry season from November to March; 3. The type of treatment given was that, 1 = artesunate amodiaquine while 0 = quinine, the total distance to the hospital was recorded as 1 =distance > 5 km while 0 = distance ≤ 5 km. The distance of five kilometers was chosen to reveal travel time of one hour on foot and the length of stay in the hospital was used. Moreover, it is worth noting the variable referral was defined. These data sets indicated that children who used the hospital as a first point of consultation were given a code 0 while those who referred to the district hospital from peripheral health facilities in the metropolis were given the code 1 (Knobler and Pray, 2002, Pg. 29). More research on the effects of malaria with respect to the hospital records showed that, out of three thousand administered malaria patients, 5% died upon admission. At the same time, 94% of the total patients administered in the hospital are children. Less than ten percent of the total number was referred from other peripheral health facilities around the metropolis. Among these children, forty percent are found to be female children while sixty percent are their male counterparts. The mean age of the children was found to be three and a half years (Aryeete et al. 2000, Pg. 6). According to the study, it is evident that a number of other accompanying factors catalyze malaria mortality rate in Ghana especially among children of ages fourteen and below. With malaria being the key factor, distance from the hospital also contributes to the rate of mortality caused by malaria. Distant villages with ill resourced hospitals suggest that the problem include the access to an adequate health care. The study shows that patients who came from around the hospitals were less likely to die than the patients who went beyond five kilometers from the hospital premises (Maxwell, 2000, Pg. 156). This reflected the fact that nearness to the hospital enabled an early access to care and reduced the risk of malaria mortality. Referral children are at a high risk of dying in hospital after the adjustment of the distance. Many small health care centers were found to miss the adequate treatment facilities for malaria; therefore, referred patients to the Tamale hospital. Malaria in this region has greatly hiked the mortality rate because of lack of the required medical facilities in the small health care centers (Ibrd, 2005, Pg. 81). Although it is believed that the transmission of malaria is more intense during the wet season than during the dry season, the study revealed that there were 57 % cases during the dry season and 47% in the wet season. It has been realized that with the increased number of malaria patients in Ghana, children of five years and below (Chao, 1999, Pg. 10) take up a larger percent. Other factors including distance, referral status, and the treatment type significantly contribute to the malaria mortality of patients and more especially on infants admitted as malaria patients in the hospitals in Ghana (United states, communicable disease center (u.s.); national communicable disease center (U.S.), & center for disease control, 1952, Pg. 251). Factors Increasing the Prevalence of Malaria The study investigated some environmental factors on the prevalence of malaria in Ghana. The population of study comprised of 1500 subjects of ages between 0 and sixty years. According to the findings, malaria parasite prevalence was found to be higher during the rainy season than during the dry season (Allen and Caballero, 2013, Pg. 61). There was also quite a significant difference in the mean density of parasite between the seasons. Individuals of below fifteen years old had higher malaria parasite prevalence than individuals of above fifteen years old (Oliver, 1995, Pg. 98). This showed that young individuals were at a great risk of dying from malaria infection than for the older persons. According to the report presented in the tamale hospital on the number of deaths recorded, children of below five years were represented in a higher percentage than individuals of fifteen years and above. The representation of the collected data in a graph was as below: Below 15years Above 15years Rainy season Dry season 678,876 200,765 75,874 23,654 On the other hand, malaria parasite prevalence and the density opt parasite was higher among the individuals who lived in the wooden plank houses while it was less among people who lived in cement brick houses (Benefo and Schultz, 1994, Pg. 56). Malaria parasite would easily reach individuals in the wooden plank houses than it would happen to individuals in the cement brick houses. Additionally, individuals living in houses surrounded by garbage heaps or bushes and swamps or stagnant waters were faced with a higher malaria parasite densities and prevalence compared with houses from clean environments (Moore, 1995, Pg. 42). Female anopheles mosquito and funestus were up to 63.8 % and 32.4 % respectively, associated with persistent transmission of malaria. In this case, poor environmental sanitation and untidy housing may be significant factors for the malaria parasite burden in Ghana. The Burden of Malaria Malaria is a killer disease caused by the plasmodium parasite and transmitted to individuals through bites of infected mosquitoes. The World Health Organization (WHO) estimated that close to three hundred million cases of malaria and infections and an estimated number of eight hundred thousand deaths in the world. Most of the deaths occurred among children living in the African region (Kehoe et al., 2010, Pg. 87). As the incidence of malaria increases, morbidity and mortality rates increase as well. Malaria is endemic in Ghana while the population at highest risk includes pregnant women, children and the non-immune leading to great economic loses. Economic and social consequences have a direct relationship with the severity of the increases malaria mortality. This has made children to spend days away from school while adults lose many workdays. On the other hand, age distribution has a great effect on the burden of malaria. In the high endemic areas, the older people develop some immunity to malaria which makes the severity of malaria attack is less. In an area of more young population, the risk of malaria attack is high (Bendich and Deckelbaum, 2005, Pg. 15). 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