COVER PAGE THE PREVALENCE OF MALARIA FEVER DURING PREGNANCY IN TUDUN WADA SOKOTO SOUTH LOCAL GOVERNMENT SOKOTO STATE



IN PARTIAL FULFILMENT OR REQUIREMENT FOR THE AWARD OF DIPLOMA COMMUNITY HEALTH PRACTICE
AUGUST 2019.
APPROVAL PAGE
MRS SERAH MAXWELL
SUPERVISOR                    SIGNATURE                    DATE


MAL.BELLO BUHARI
PROJECT CO-ODINATOR                  SIGNATURE       DATE


MAL.UMAR NAGWARI
HEAD OF DEPARTMENT         SIGNATURE        DATE



EXTERNAL EXAMINER          SIGNATURE         DATE



CERTIFICATION
This is to certify that this project has been read, approved and certified as meeting part of the requirement for the award of national diploma in community health.













ABSTRACT
This study was designed to determine the factors that cause malaria during pregnancy at Tundunwada Sokoto South Local Government. To carry out the study, the research questions were formulated. Based on description, survey design was adopted for the study. A structured questionnaire was used and collected data from 100 respondents which also formed the population of the study. Mean statistics was used about important of immunization, early diagnoses and management regular inspection, and regular supervision in order to identify defaulters recommended as follows.








ACKNOWLEDGEMENT
In the name of Allah (SWT) the most gracious, the most merciful creator, provider all thanks to him who granted me the opportunity of completing this research project, kindness and guidance throughout my stay in school of health and technology Gwadabawa in general would not have been possible without the assistance of Allah (SWT).
My appreciation goes to my project supervisor Mrs Serah Maxwell for her tireless effort in correcting this work, may God reward her abundantly, To my project co-ordinator, Mallam Bello Buhari Gwadabawa and Mallam Umar Nagwari (HOD), and all the Academic staff. Much gratitude is expressed to Director Alhaji Nasiru Abubakar Janga for their patience and prayers.
My special thanks go to my beloved parents. Mr and Mrs Abdullahi, my brothers and sisters namely; Haruna Abudullahi, Isah, Rilwanu, Aziki, Balikisu Muhammed Jega Sallah for their contribution and encouragement, advice, prayers and financial support throughout the period of my training may God reward and bless them all. Lastly, my appreciation goes to my friends, Hussaini Muhammed, Umar Usman, Suleman Muhammed, Usman Umar, Iyasu Yahaya.


DECLARATION
This research work is authentic and it is a product of my own efforts under the supervision of Mrs Serah Maxwell. It has never been submitted as of part of fulfillment for any other certificate authors cited where fully acknowledged.
Student Name: Yusuf Abdullahi Jiga Sallah Aliero
Adm: 0/6/chew/103

…………………………..                              …………………....
       Signature           Date







CHAPTER ONE
INTRODUCTION
1.1 STUDY OF THE BACKGROUND
Malaria is an acute tropical and sub-tropical infectious disease although this has been known for many years. Its only recently that the major public health importance of recurrent malaria infection in pregnancy has been apprehended especially in term of their impact on health of mother.
World health organization (W.H.O) 2008. Estimated that through each year over (300 million people are affected with malaria and (1 million) death occurred worldwide from malaria, is most important of the parasites disease of human being especially for people living in sub-Saharan Africa but 90% of death from malaria occurred in sub-Saharan Africa and (19-24 million) women within region and at risk of malaria and its adverse consequences during pregnancy (Paola M. 2008).
In Nigeria malaria cause on estimation that (300,000) death every year in general population. Malaria was identified as one of the causes of severe anemia in Tudun wadia area in Sokoto south. Sokoto staff during the year 2018 to date, the common cause of mobility and mortality of the state during (618/2017) the vast mortality of infection in pregnancy remains a symptomatically undetected and unwanted. The major impact of malaria in this region is caused by persisting in maternal anemia and reduced birth weight. Early identification of infection pregnancy women and prompt treatment may provide an opportunity to prevent the advice affect of malaria during pregnancy in women are known generally to demonstrate increased susceptibility to and screening of malaria infection probably due to immune suppression of pregnancy, many pregnant women may have (2-3) attack during particular pregnancy especially primigravide and multigrivide been demonstrated to be more common during (7s -24) weeks of question (Apare  Addos H2  2011). Pregnancy had effect on the cause of malaria this week pregnancy tends to lower the humanity acquired in non- pregnant state (the reason has not been well defined during pregnancy through the specific malaria antibodies are not decreased (probably) due to decreased level of cortical level (Opere Addos 2016). This is illustrated by the observation their lymphocytes from pregnant when challenge with malaria antigen show a depressed proliferate lymphocytes.  As a result of those define in immunity pregnant disease (Odol Ats 2015).
Malaria has been recognized as an enormorous public health problem since the beginning of (1988) and its also associate with poverty but also a cause to economic development (Stekett R. 2007).


1.2 STATEMENT OF PROBLEM
Low birth weight is a high risk factor premature death and its also correlated with recent study shows malaria may contribute these this find research will soon prevent the malaria during pregnancy.
1.3 OBJECTIVES OF THE STUDY
To describe the impact of malaria during pregnancy.
To create awareness on pregnant women on the danger of malaria during pregnancy.
To decrease malaria during pregnancy
To create awareness on malaria pregnancy. 
1.4 SIGNIFICANCE OF STUDY
To enable other researcher to have the idea on how to carry out their own research on malaria.
To promotes awareness in the community about the prevention of malaria infection workers (CHEW) to have the knowledge to this study to enable them help in educating pregnant mothers about this malaria infection.
To prevent the spread of malaria in the community and the environment.


1.5 RESEARCH QUESTIONS
What is the cause of malaria?
What are the ways malaria affect pregnant women?
What are the ways to create awareness?
1.6   DEFINITION OF TERMS
Malaria: - is a tropical disease caused by one of the genus plasmodium and carried by infected mosquito of the genus.
Pregnancy: - Being with child that is gestation from menstrual period to posturition normally 40weeks.
Prevention: - To stop from happening, or preventing something from happening
Mobility: - The state of having disease
Mortality: - Number of death during pregnancy.
Immunity: - Ability of the body to resist infection.
Parasite: - An organism which spend their lives in another organism
Parataemia: - Parasite in the blood
Epidemic: - Simultaneously affecting many people, outbreak of a disease
Endemic: - Re-occurring of disease commonly found in specified area or place. 
Antigen: - Are protein that are produced in the body as a result of introduction of antibody.
Antibodies: - Are protein formed in the blood in reaction to substance which it then destroys.












CHAPTER TWO
LITERATURE PREVIEW
Malaria is a vector bones infectious disease caused by protozoa parasites or an infectious disease caused by protozoa of the genus plasmodium (snow R.W I 2005). In Nigeria malaria disease is known to affect a high population of people women particularly pregnant women and children age 0.5 ago among the worst bit by mosquito borne ailment. Malaria is said to be cause by a parasite is called plasmodium palciparcum this parasite is transmitted by a particular mosquito known as anopoles mosquito when it bites and secretes this germs into the blood stream of an exposal person.
2.2 HISTORY OF THE MALARIA 
Malaria has infected human for over 50 years and may have human pathogens for the entire history of specimen indeed closed relative of human malaria parasite remain common in champhanzine our close relatives.
The scientific study of malaria made significant advance in 1880 when a French army doctor working in the military hospital of constantive Algeria named Charles Louis nephones loverom observed parasite for the first time inside red blood cell of people suffering from malaria for the purpose that malaria was caused by this protozoa the first time protozoa were identified as cause disease alphonses (2006)
 Plasmodium falciparium
Plasmodium ovali
Plasmodium valvav
                        Mosquito vectors and the plasmodium life cycle
                         Mosquito bite host to take male and female garment

     Host is bitten sporazoite                                     Male and female          gametocytes mute
    Injected into human blood streams

Spar azotes are formed                                                   Ocyst formed in the chest of mosquito


                                   Ocyst moves to adornment of the mosquito
The parasite primary host and transmission vector is female mosquitoes of the anopheite genus. Young mosquitoes first large the malaria parasite feeding on infected human carried and the infected anopheles mosquito become infected when it take this male do not transmit the disease. Only female mosquitoes of an anophelesgenus prefers to feed at night. They usually start searching for meal at dust and will continue throughout the night until taking a meal.
                     Life cycle bitten sporozoite into human blood stream 

Gametocytes in the within one hour it leaves the blood stream to the liver
(RBC) Red Blood Cell


New gametocytes are formed Primary schizoids and primary marozoite      are release into blood stream nophozoite

             The (RBC) the parasite transformed into secondary metrozoite
                                             (erythrocytes stage)
As in the case of twins or triple human pregnancy is the most study of all malaria pregnant patients. Child birth usually occur about 38 weeks from fertilization that approximately 40 weeks from the start of the last menstrual this pregnancy last about nine months. Although in the exact definition of the pregnancy is a subject of controversy.
2.3  CHARACTERISTICS OF PREGNANCY
Pregnancy occurs as a result of the female garment or ocyte (egg) being penetrated male garment spermatozoa in the process medicine as fertilization or more commonly known as conception. The fusion of male and female garment usually occurs throughout the act of sexual intercourse.
The beginning of pregnancy may be detected in a number of ways including various pregnancy test which is generated by the newly form placenta clinical blood and urine test can detect pregnancy soon after implantation which is easily as from (6-8 days) after fertilization.
2.4   PREGNANCY SYMPTOMS
Each future mother should know early symptoms of pregnancy should be available to her.
Defined pregnancy at early stage and address to doctors its necessary that pregnancy pass under attention of the doctors, it will allow to avoid negative the sign and symptoms include absence of menses through it can be sign of some diseases such as endocrine disease or disorder a wrong food as a result of negative emotion sensation of a local strain sometime small pain many women can have in the morning nausea and even vomit which usually are not reflected in appetite and state of health.
Some women start to grow fat they change in mentality (the women can be irritated cry without reason, there comes sleepless night or strong excitability.

2.5   MANAGEMENT
A balance diet is an important aspect of healthy pregnancy adquite perception Foliz acid (also called pelate or vitamin B intake has been moved to limit fetal neural fuse defeat, preventing spring bifida a very serious birth defects. The neud fuse develops during the first 28 days of pregnancy and this explains the necessary to grantee adequate preconception Fopcite intake (Stevenson R.E 2000).
Careful washing of fruit and raw vegetables may remove pathogen, as through looking left-over’s, meat or processed meal. Pregnant women are also prone to catching salmonella infection from eggs and poultry which should be thoroughly cooked. Particularly good hygiene in the kitchen can reduce this risk. (Dubnow-Razy. 2007). Weighting-coloric intake must be increased to ensure proper development of fetus, the amount of weight gained during pregnancy varied between women.
2.6    COMPLICATION OF PREGNANCY
Back pain-: common in advancing pregnancy caused by compression of the inferior vana cave pelvic vien by the uterus leads to increased hydrostatic pressure in lower extremities regurgitation, heart burn and nausea, pelvic girdle pain.


2.7   MALARIA DURING PREGNANCY
Malaria infection during pregnancy can have adverse effect on both mother and Festus. Pregnant women are one of the groups most at risk from malaria.
When a woman is pregnant her immunity is reduced, maki8ng her more vulnerable to malaria with dangerous consequences for the mother and child.
Malaria is a parasite infection that has a serious negative impact on pregnant women and young children on sub Sahara Africa and tropical area. More than 45 million women and 30 million of men in Africa become pregnant in malaria endemic area each year. Malaria during pregnancy can cause maternal anemia and impaired fetal growth both which contribute to low birth weight in new born.
2.8   EFFECT OF MALARIA ON PREGNANT WOMEN IN STABLE TRANSMISSION AREA
In low transmission area, have generally developed no immunity to malaria. Malaria infection is more likely to result in save malaria disease maternal anemia premature delivery or fetal loss. The illustration below shows the effect in low transmission area.



2.9 EFFECT ON MALARIA IN PREGNANCY IN UNSTABLE TRANSMISSION
The break down in the first pregnancy and these multifarious women are vulnerable to severe malaria and their fetuses show more pronounced adverse effect.
2.1.0   PREVENTION OF MALARIA DURING PREGNANCY
Definition of prevention-: According to the 6th edition of advanced learned dictionary defined Prevention as the act of stopping about malaria intermittent prevent treatment (IPT):Al pregnant women in area of stable transmission should receive intermittent preventive treatment (ITP) as routine part of anti-natal preventive treatment anti-natal care. Sulfadoxine pyrimethanic (SP is the current anti-malaria drug of choice for intermittent treatment (IPT). Although a single dose of sulfadoxine pyrimethanic this been shown to be effective in reducing dose during second and third trimester are recommended. Following the of a fever (or recent history of fever) and consideration of the type of region (stable or unstable transmission) in which the women live. Women with severe malaria need emergency care from a skilled provider, care may include stabilization, administration of anti-malaria and iron/folate blood transmission and other life saving measure.


2.1.1   CONCEPT OF ROLE BACK MALARIA IN NIGERIA
This is the programmed designed by directing special attention on prevention measure. it was launched in Abuja on 24th April, 202, it involve the following guideline
Use of insecticide treatment net (ITN)
Eradicating mosquito from all angles for example through effective drainage system, use of insecticides/fumes to kill mosquito
Use of anti-malaria is as prophyllective among children and pregnant women that is intermittent preventive treatment.
Proper treatment of active suppliers.
Improved environmental sanitation
Increased advocacy and community mobilization
Development of affordable malaria tools when coordinating action by the three heirs of government.





CHAPTER THREE
METHODOLOGY
INTRODUCTION 
The chapter present method used for carrying out this research work and is discussed under the following sub-heading.
3.1   RESEARCH DESIGN
For these types of study, Descriptive survey method is used for the study. Worgh (1991), states that this type of research method systematic manner.
3.2   AREA OF STUDY
The areas choose for this research project in Tudunwada Sokoto South Local Government Sokoto State.
3.3   POPULATION OF STUDY
The population of study is (800,950).
3.4   SAMPLE AND SAMPLING TECHNIQUE
These sample and size comprise the population of (800,750) districts in Tawon. In the Local Government and large population of the town by simple random sampling and how many are used. To present the total population instrument for data collection the instrument that was used were questionnaire, validity and reliability of the instrument, The questionnaire was constructed by the research then corrected by the project supervisor, to eliminate errors and was valid, detected by two expert in the department. A pilot survey has construction by selection and selecting people from one of the town/district of area by Local Government in area to be best the reliability of the instrument test retest method has use and it sized desired result.
3.5    PROCEDURE FOR DATA COLLECTION
The research us3d the service of other health worker in the area of the study to administer and recollect the questionnaires. Total low questionnaires were distributed and only 8% were returned.











CHAPTER FOUR
DATA ANALYSIS AND PRESENTATION
INTRODUCTION
This chapter is designed for the analysis and presentation of data obtained from the research being made. The analysis is presented according to research question that guide the study.
Table 1: Return rate instrument
Number of questionnaire
Respondent
Distribute
Returned
Percentage (100%)

Adult
100
80
80%

Total
100
80
80%

The table above shows that 100 questionnaires were returned representing 80% returned rate
SECTION A                                                                     
Table 2: Research question
 What are the factors responsible for malaria in pregnancy?
                                                                                        RESPONDENT
S|N
Factors responsible for the malaria in pregnancy
4
SA
3
A
2
DA
1
SDA
X
A
Remark

1
Lack of environmental sanitation
50
25
3
2
3.5
agree

2
Lack of anti natal care
40
20
15
5
3.1
agree

3
Sleeping without striated net
20
40
9
19
2.9
agree

4
Social economic factor
55
13
7
5(80)
3.4
Agree

Grand mean 
From the table above shows that the level of respondent agreed with the factors responsible for malaria in pregnancy that is why this table shows the factor responsible for malaria population for the care of malaria in pregnancy
SECTION B
Table 3: What is the danger associated with the malaria fever in pregnancy?
                                                                RESPONDENT
S|N
danger associated with malaria fever during  pregnancy
4

SA
3

A
2

DA
1

SDA
X


REMARK

1
Anemia

50

10
10
10(80)

3.5
Agree

2
Abortion

45
15
5
15
3.2
Agree

3
Shock

40
20
15
5(80)
3.2
Agree

4
Death

50
20
7
3
3.4
Agree


Grand mean 
From the above table shoes that the level of respondent who agree are presenting higher percentage that is why table shown the danger associated with malaria fever in pregnancy the grand mean




Table 4: Strategies for reducing malaria fever in pregnancy
s/no
Strategies for reducing malaria fever in pregnancy
4


SA
3


A
2


DA
1


SDA
x
remark

1
Health Education about the disease
50


20
6
4(80)
3.4
agree

2
Use of treated mosquito net 
40
20
15
5
3.2
agree

3
Regular visit of anti-natal care
45
20
8
7
3.3
Agree

4
Early diagnostic treatment
40
25
10
5
3.2
Agree


Table 4: The above table show the total grand mean which is 3.2 in this table the level of respondent who agree have presenting a higher percentage while disagree presenting non percentage while the sanitary measures and other item 








CHAPTER FIVE
SUMMARY, CONCLUSION, RECOMMENDATION AND SUGGESTION
Re-statement of the problem
The low birth weight is a high risk factor for prenatal death and its also causes mobility and mortality in pregnancy. A present study shown malaria may contributed this five research will prevent the malaria fever in pregnancy
5.1 SUMMARY
The questionnaires are (100) questionnaire were distributed to the respondent but only 80 were returned.
Table 3: shows that the level of respondent who agree are representing high percentage that is why table show the danger associate with malaria fever in pregnancy grand mean= 3.2
Table 4: Shows the total grand mean which is 3.2 in this table of respondent who agree representing non percentage a higher percentage which disagree presenting non percentage non on the table will be strategies reducing the rate of malaria fever in pregnancy.
Same on the table another have highlighted the important of proper handling of malaria fever in pregnancy and suggested implementation of meaningful to give care result.
To safe this for the main aim of this study is to further encourage the public on the prevention of malaria fever in pregnancy so that it can be cured in community also the study will help to provide health education on prevention of malaria in pregnancy.
To where they have the knowledge on malaria in pregnancy is to provide death knowledge on malaria treatment administered locally before compared to the scientific treatment, the finding will further show which of it has successful great achievement.
Malaria fever is a disease that commonly affect the pregnant women which is characterized by fever, headache, nausea and vomiting and sometimes cause many disease like anemia.
The appropriate ways of prevention of malaria is the use of mosquitoes net and environment sanitation and use of insecticide treatment of mosquitoes e.t.c  therefore considering the expectation of the public on what roles the hospital excelling for pregnant women the disease the finding of the study will be enhanced better result in the advocacy programmed of provide adequate mosquito net in the community and basic sanitation.


5.2 CONCLUSION
It hoped that the three arms of government will continue to give more attention on mass education such as good nutrition mass campaign on adequate mosquito net and basic sanitation to avoid and maintain cleanness of environment and personal hygiene.
5.3   RECOMMENDATION
Based on the finding from the questionnaire interview made the writer to tell on both state area and local government to provide the study area with the following.
The following were recommended-:
More health facility to be built in the study area
Health education the mass on causes and prevention of malaria during pregnancy
Control of communication disease
Enlightening the community about the effect of malaria during pregnant emphasis should be lead on the important of good nutrition and because deep for the people in the community.



5.4 SUGGESTION
In the virtue of this, I therefore suggest that the government and health worker should find solution to this problem that is coursing high mortality and mobility   rate causing by malaria in pregnancy government of the day should increase the health workers with knowledge and should give orientation on how to prevent this disease.














REFERENCE


C Lucas and H.M Gills (2003) short for textbook of public Health Medicine for the tropics 4th edition
Evelyn Frarce (1971) General Textbook of nursing 18th edition Fabu and Fabep.
Ealnest R. Hicgard (1962) Introduction to malarial 3rd edition Half Richard and wintson company New York
Hppt://wwwcdc.gov/malerial.travel/drugs pregnant public ht
Victoria Ajayi (1982) An Aspect of midwifery practice in developing countries 2nd edition











Table of Contents
COVER PAGE…………………………………….………………………………………………………………….............i
APPROVAL PAGE……….……………………………………………………………………………………………………ii
CERTIFICATION………………………..…………………………………………………………………………………….iii
ABSTACT…………………………..……………………………………………………………………………………………iv
ACKNOWLEDGEMENT……………..……………………………………………………………………………………..v
DECLARATION…………………………….………………………………………………………………………………...vi
TABLE OF CONTENTS………………………………..…………………………………………………………………..vii
CHAPTER ONE 1
INTRODUCTION 1
1.1 STUDY OF THE BACKGROUND 1
1.2          STATEMENT OF PROBLEM 3
1.3          OBJECTIVES OF THE STUDY 3
1.4          SIGNIFICANCE OF STUDY 3
1.5     RESEARCH QUESTIONS 4
1.6          DEFINITION OF TERMS 4
CHAPTER TWO 6
LITERATURE PREVIEW 6
2.2    HISTORY OF THE MALARIA 6
2.3         CHARACTERISTICS OF PREGNANCY 8
2.4         PREGNANCY SYMPTOMS 9
2.5         MANAGEMENT 10
2.7         MALARIA DURING PREGNANCY 11
2.8         EFFECT OF MALARIA ON PREGNANT WOMEN IN STABLE TRANSMISSION AREA11
2.9         EFFECT ON MALARIA IN PREGNANCY IN UNSTABLE TRANSMISSION 12
2.1.0      PREVENTION OF MALARIA DURING PREGNANCY 12
2.1.1      CONCEPT OF ROLE BACK MALARIA IN NIGERIA 13
CHAPTER THREE 14
METHODOLOGY 14
INTRODUCTION 14
3.1             RESEARCH DESIGN 14
3.2             AREA OF STUDY 14
3.3             POPULATION OF STUDY 14
3.4             SAMPLE AND SAMPLING TECHNIQUE 14
3.5             PROCEDURE FOR DATA COLLECTION 15
CHAPTER FOUR 16
DATA ANALYSIS AND PRESENTATION 16
INTRODUCTION 16
CHAPTER FIVE 19
5.1      SUMMARY 19
5.2      CONCLUSION 21
5.3           RECOMMENDATION 21
5.4      SUGGESTION 22
REFERENCE 23

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