ABSTRACT
Hypoglycaemia among Plasmodium falciparum infected women attending clinics in Nsukka Local Government Area of Enugu , Nigeria was undertaken. The study objective was to assess the prevalence of hypoglycaemia and P. falciparum infection among women in the study area.
A cross-sectional epidemiological survey was conducted among the pregnant women, who attended antenatal clinics in the study Local Government Area between January and September, 2015. A total of 375 randomly selected pregnant women were assessed for P. falciparum infection and hypoglycaemia from the centres in the study area.
Plasmodium falciparum malaria infection was determined using Malaria Pf antigen detection kit. The blood glucose levels of the subjects were estimated using One Touch UltraSmart Blood Glucose Monitoring System. The obstetric, demographic, clinical and management data of the pregnant women were also determined using a well-structured questionnaire.
Results obtained showed that 292 (77.9%) pregnant women had primary diagnosis of P. falciparum infection and 39 (13.4%) of the infected pregnant women were hypoglycaemic. The highest prevalence for P. falciparum was observed among age group 30-34 years old, primigravidae and second trimester pregnancy.
TABLE OF CONTENTS
Title page – – – – – – – – – – – i
Approval page- – – – – – – – – – – ii
Dedication – – – – – – – – – – – iii
Acknowledgement – – – – – – – – – – iv
Table of contents – – – – – – – – – – v
List of tables – – – – – – – – – – – viii
List of figures – – – – – – – – – – – ix
Abstract – – – – – – – – – – – x
CHAPTER ONE: INTRODUCTION AND LITERATURE REVIEW
1.1 Introduction – – – – – – – – – – 1
1.1.1 Study Justification – – – – – – – – – 5
1.1.2 Study Significance – – – – – – – – – 5
1.1.3 Objectives of the Study – – – – – – – – 5
1.2 Literature Review – – – – – – – – – 6
1.2.1 Malaria Burden- – – – – – – – – – 9
1.2.2 Hypoglycaemia Burden – – – – – – – – 14
1.2.3 Glucose and Malaria – – – – – – – – – 16
1.2.4 Malaria and Pregnancy – – – – – – – – 17
1.2.5 Hypoglycaemia and Pregnancy – – – – – – – 19
1.2.6 Antenatal Services Knowledge and Attitude – – – – – – 20
CHAPTER TWO: MATERIALS AND METHODS
2.1 Study Area – – – – – – – – – – 22
2.2 Ethical Clearance – – – – – – – – – 26
2.3 Study Design – – – – – – – – – – 26
2.4 Collection of Blood for Malaria and Glucose Test – – – – – 27
2.5 Statistical Analysis – – – – – – – – – 28
CHAPTER THREE: RESULTS
3.1 Obstetric and Demographic Characteristics of the Study Population- – – 29
3.2 General Prevalence of Blood Glucose Levels and P. falciparum Infection among
Pregnant Women in the Study Area – – – – – – – 31
3.3 Prevalence of Blood Glucose Levels and P. falciparum Infection among Pregnant
Women in Nsukka Central – – – – – – – – 33
3.4 Prevalence of Blood Glucose Levels and P. falciparum Infection among Pregnant
Women in Nsukka East – – – – – – – – 35
3.5 Prevalence of Blood Glucose Levels and P. falciparum Infection among Pregnant
Women in Nsukka West – – – – – – – – 37
3.6 Prevalence of Blood Glucose Levels among P.falciparum Infected Pregnant
Women in the Study Area Stratified by Location – – – – – 39
3.7 Prevalence of Blood Glucose Levels among P. falciparum Non-infected
Pregnant Women in the Study Area Stratified by Location – – – – 41
3.8 General Prevalence of Blood Glucose Levels and P. falciparum Infection among
Pregnant Women in the Study Area Stratified by Age – – – – 43
3.9 General Prevalence of Blood Glucose Levels and P. falciparum Infection among
Pregnant Women in the Study Area Stratified by Trimester – – – – 45
3.10 General Prevalence of Blood Glucose Levels and P. falciparum Infection among
Pregnant Women in the Study Area Stratified by Parity – – – – 47
3.11 General Prevalence of Blood Glucose Levels and P. falciparum Infection among
Pregnant Women in the Study Area Stratified by Educational Level – – 49
3.12 General Prevalence of Blood Glucose Levels and P. falciparum Infection among
Pregnant Women in the Study Area Stratified by Occupation – – – 51
3.13 General Prevalence of Blood Glucose Levels and P. falciparum Infection among
Pregnant Women in the Study Area Stratified by Residence – – – – 53
3.14 Unhealthy Predisposing Factors to Hypoglycaemia and P. falciparum Infection
among the Pregnant Women in the Study Area – – – – – 55
3.15 Correlation between Blood Glucose Levels and P. falciparum Infection among
Pregnant Women in the Study Area – – – – – – – 57
3.16 Ethno-management Practices on Hypoglycaemia and P. falciparum Infection
among the Pregnant Women in the Study Area – – – – – 59
3.17 Knowledge and Attitude of the Pregnant Women towards Antenatal Services
in the Study Area – – – – – – – – – 61
CHAPTER FOUR: DISCUSSION AND CONCLUSION
4.1 Discussion – – – – – – – – – – 63
4.2 Conclusion and Recommendation – – – – – – – 68
REFERENCES
APPENDICES
INTRODUCTION
Malaria is an old disease whose name is derived from the Italian (mal-aria) or “bad air” and it was also known as Roman fever, ague, marsh fever, periodic fever, paludism (Martin, 2003). There were numerous, sometimes bizarre theories on how malaria was transmitted until 1898 when Dr Ronald Ross discovered that the female Anopheles mosquito was actually responsible for transmitting malaria parasite.
This discovery revolutionized malaria control, which had hitherto often been haphazard or based purely on treating the patient by killing the malaria parasites (Phillips, 2001; Cheesbrough, 2006). Malaria probably originated in Africa and accompanied human migration to the Mediterranean shores, India and Southeast Asia. In the past it used to be common in the marshy areas around Rome.
As malaria is a disease mostly of tropical and subtropical areas, it is particularly prevalent in sub-Saharan Africa, but also common throughout other tropical regions of China, India, Southeast Asia, South and Central America (Cheesbrough, 2006). Nigeria’s quest for effective control of malaria began well before the WHO global malaria eradication period between 1955 and 1968 (Gilles et al., 2007).
From 1955, however, a more focused egalitarian attempt at evolving strategic plans and interventions resulted in pre-eradication pilot studies such as the Kankiya District Project and the establishment of a division in Ministry of Health to deal with the mosquito and malaria problem. The National Malaria Control Committee (NMCC) was set up in 1975 with the set mandate to reduce the malaria burden by 25%.
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