PREVALENCE OF ASYMPTOMATIC MALARIA AND USE OF DIFFERENT CONTROL MEASURES AMONG SCHOOL AGED CHILDREN (6-13YEARS) AT DODOMA URBAN DISTRICT.
MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED
SCIENCES
SCHOOL OF PUBLIC HEALTH AND SOCIAL SCIENCE
DEPARTMENT OF PARASITOLOGY AND MEDICAL
ENTOMOLOGY
RESEARCH REPORT SUBMITTED IN PARTIAL FULFILMET
FOR THE AWARD OF BACHELOR DEGREE OF PARASITOLOGY AND MEDICAL ENTOMOLOGY
TITLE; PREVALENCE OF ASYMPTOMATIC MALARIA AND
USE OF DIFFERENT CONTROL MEASURES AMONG SCHOOL AGED CHILDREN (6-13YEARS) AT
DODOMA URBAN DISTRICT.
AUTHOR;
BEATRICE THADEUS KULWA
DEGREE
PROGRAM; BMLS PE
REGISTRATION
NUMBER; 2018-04-11792
SUPERVISOR;
DR LWIDIKO MHAMILAWA
CERTIFICATION
The undersigned certifies that she has
read and hereby recommend for acceptance by Muhimbili University of Health and
Allied Sciences a research report entitled: Prevalence of asymptomatic Malaria and the use of different control
measures among school aged children (6-13yrs) at Dodoma Urban district in
partial fulfillment of the requirements for the degree of Bachelor of Medical
Laboratory Science in Parasitology and Medical Entomology at Muhimbili
University of Health and Allied Sciences
DECLARATION
I,
Beatrice T. Kulwa, declare that this
research report is my own original work and that it has not been presented and
will not presented to any other university for a similar or any other degree
award.
Signature: .
Date:
.
ACKNOWLEGEMENT
First of all, I would like to thank God
for health and strength. Special thanks of gratitude to my supervisor, Dr.
Lwidiko Mhamilawa for his guidance which helped me toward the completion of
this work. Secondly, I would like to thank MUHAS parasitology staff for the
material and crucial support they provided during the accomplishment of this
work. Last but not least, I would like to express my gratitude to my dearest
family and friends who helped me a lot in finalizing this work within the time
frame.
DEDICATION
I dedicate this work to my lovely family.
Table of Contents
1.3 BURDEN OF
MALARIA IN TANZANIA
PREVALENCE OF ASYMPTOMATIC MALARIA AMONG SCHOOL CHILDREN.
2.3 KNOWLEDGE ON MALARIA AMONG SCHOOL CHILDREN
2.4 MALARIA PREVENTION METHODS FOR SCHOOL AGED CHILDREN.
DATA COLLECTION TECHNIQUE AND PROCEDURES
STUDY LIMITATION AND MITIGATION.
.1. SOCIAL DEMOGRAPHIC CHARACTERISTICS OF SCHOOL CHILDREN.
4.2 PREVALENCE OF ASYMPTOMATIC MALARIA
1.2 LEVEL OF KNOWLEDGE OF SCHOOL CHILDREN
5.0 DISCUSSION, CONCLUSION AND RECOMMENDATIONS
5.1.1 Prevalence of
asymptomatic malaria
5.1.3 Knowledge on
malaria preventive measures and use of different control measures.
Appendix 1: CONSENT FORM ENGLISH VERSION
Appendix II: CONSENT FORM SWAHILI VERSION
Appendix III: QUESTIONNAIRE ENGLISH VERSION
Appendix IV: QUESTIONNAIRE SWAHILI VERSION
LIST
OF ABBREVIATIONS
ACT Artemisinin based Combination
Therapy
ALU Artemether lumefantrine
DC District Council
DEO District Executive Officer
IRS Indoor Residual Spraying
ITN Insecticide Treated Nets
LLINs Long Lasting Insecticide Nets
MUHAS Muhimbili University of Health and
Allied Sciences
NBS National Bureau of Statistics
PCR Polymerase Chain Reaction
RDT Rapid Diagnostic Test
TMIS Tanzania
Malaria Indicator Survey
WHA World Health
Assembly
WHO World Health
Organization
LIST OF TABLES
DEFINITION OF TERMS
Asymptomatic malaria: refers to the presence of malaria parasite in
the blood without symptoms, without illness(1).
Knowledge: refers to the condition or fact of being aware of something(2).
Prevalence: refers to the number of cases of a disease that present in a
particular population at a given period of time(3).
Reservoirs: refers to the population of organism or the specific environment in
which an infectious pathogen naturally lives and reproduces typically without
damaging the host(4) .
‘
ABSTRACT
Background; Malaria prevalence continues to decline in Tanzania following the
results of various intervention strategies which has lowered down the
prevalence of malaria to less than 10%. However, the disease still poses a
public health concern in the country. While symptomatic malaria can be
diagnosed and treated, asymptomatic malaria infections become increasingly
important for interrupting transmission. Following the decline of malaria in
Tanzania, it is not known how much the epidemiology of asymptomatic malaria have
changed in Dodoma Urban district particularly among primary school children.
Therefore, this study was conducted to
determine prevalence of asymptomatic malaria and use of different control
measures among school children in Dodoma Urban district.
Objective: The study aimed to determine the prevalence of asymptomatic malaria
and use of different control measures among of school children in Dodoma Urban
district.
Methodology: A descriptive cross-sectional study was conducted using quantitative
methods of data collection. A simple random sampling method was used to obtain
104 school children required for this study. Finger prick blood sample was
collected for detection of malaria parasite, this was complimented with
questionnaire that was used to determine the risk factors of asymptomatic
malaria and the use of different control methods among school children. Data
was entered into SPSS software version 20 to obtain frequency and their 95%
Confidence interval and significance of 0.03%.
Results: A total of 104
primary school children aged between 6-13years (mean age =11.19years) were
recruited and screened for parasitaemia using the mRDT and the overall
prevalence of malaria was 1.9% for mRDT. School aged children were more affected than those aged. The
proportion for ITNs used was 78.8% while that of Indoor residual spray (IRS)
was 82.7%.
Conclusion: Findings show
the existence of low prevalence of asymptomatic malaria among primary school
children at Dodoma Urban district. Where majority of the children reported
using IRS for malaria control. Therefore, extra push should be used to ensure
effective malaria control measures are implemented by the authorities to reduce
burden of the disease among school-aged children and hence ensure public health
in general by completely eradicating Malaria.
CHAPTER
ONE
1.0
INTRODUCTION
1.1 BACKGROUND
Malaria is a disease
of tropical and sub-tropical regions, which is transmitted by female anopheles
mosquito vector. It is caused by Plasmodium
falciparum, Plasmodium malariae, Plasmodium vivax, Plasmodium knowlesi,
Plasmodium ovale curtisi and Plasmodium
ovale wallikeri. Among the five species of Plasmodium; Plasmodium vivax
and Plasmodium falciparum are
responsible for most malaria attributed morbidity(5).
Malaria can be of
either symptomatic or asymptomatic. Asymptomatic malaria refers to the presence
of malaria parasites in blood without any clinical symptoms usually
asymptomatic individuals serve as the reservoir for transmission (1). Asymptomatic
malaria can be analyzed and detected by
microscopy, rapid diagnostic test and molecular methods (5). For the case of symptomatic malaria;
infection is accompanied by fever, chills, headache, nausea, vomiting,
diarrhea, and extreme weakness and muscles aches (1). Whether its asymptomatic
or symptomatic malaria, Plasmodium
falciparum accounts for most malaria morbidity and mortality which mainly occur in children
under the age of 5years in sub-Saharan
Africa (5).
Plasmodium species
have complex life cycle that involves transmission between an infected female
anopheles mosquito vector and human host. The life cycle starts when a malaria
infected mosquito inoculates sporozoites into the human host, these sporozoites
invade the liver cells which mature and finally releases merozoites, then
relapses by invading the bloodstream after weeks or even years letter the
parasite undergo multiplication in the erythrocytes. Merozoites infect red
blood cells while some parasites differentiate into sexual erythrocytic stage
which are male and female gametes, both microgametes (male) and macro gametes
(female) are ingested by mosquito
during blood meal, then parasites multiply into mosquito’s stomach. Inoculation
of the sporozoites into a new human host perpetuates the malaria life cycle
(1).
Malaria parasites
can be identified by examining under microscope which is the gold standard for
diagnosis. Other diagnostic techniques include rapid diagnostic test (RDTs) and
Polymerase chain reaction (PCR)(6).
In Tanzania
mainland’s national guidelines for diagnosis and treatment of malaria stipulate
Artemether–lumefantrine (ALu) as the first line treatment for uncomplicated
malaria in both adults and children (7).
1.2
GLOBAL BURDEN OF MALARIA
In the past decades,
intensive malaria interventions have resulted in a dramatic decline in global
malaria morbidity and mortality (7). Between 2015 and 2018, only 31 countries
were still malaria endemic. Due to this ongoing burden of malaria, the global
technical strategy for malaria 2016 - 2030 was endorsed by World Health
Assembly (WHA). The plan aimed for reduction of global incidences and mortality
of malaria by at least 90% by 2030.
The WHO African
region accounted for about 94% of malaria cases and death globally. Although
there were fewer malaria cases in 2000(204million) than in 2019, incidence
reduced from 363 to 225 cases per 1000 population at risk in this period. There
is an increase in malaria cases total of 241 million malaria cases have been
estimated and 627 000 deaths worldwide in 2020(8).This is a clear indication that malaria is
still a problem and its still causing death worldwide.
Asymptomatic malaria is
prevalent in both low and high endemic regions. The asymptomatic carriers play important
role as reservoirs for sustaining malaria transmission because they persist for
long time and harbor gametocytes that are infections to anopheles mosquito (9).
1.3 BURDEN
OF MALARIA IN TANZANIA
Tanzania has the
third largest population at risk of malaria in Africa. Malaria is highest in
the kagera region with prevalence of 8.8% on western shore of Lake Victoria and
lowest in Arusha region which is less than 0.1 %(10).
Malaria prevalence
in Tanzania has decreased by half from 14.4% in 2016 to 7.3% in 2018 said by
National Bureau of Statistics (NBS) the report also showed that new infections
for children under the age 5 have dropped to 7.3% in 2017.
Furthermore, a cross
sectional study was done to investigate the prevalence and correlates of
asymptomatic Malaria and anemia among pregnant women in Southeast, Tanzania
showed that the overall prevalence was 36.4%(11).This is a clear indication that asymptomatic
malaria is still a burden especially in high transmission areas.
In Dodoma Urban district where this study will
be conducted, the prevalence of malaria is 2.5%(12). However not many studies have been done on
the asymptomatic malaria. Therefore, this study aimed to determine the current
prevalence of asymptomatic malaria and use of different control methods among
of school children in Dodoma Urban district.
1.4 PROBLEM STATEMENT
Malaria is still a public health and life-threatening disease in
Tanzania. The vulnerable group being infants, children under 5 years’ age,
pregnancy women and patients with HIV/AIDS. School children are not included as
the one of the vulnerable groups to malaria. However recent studies have showed
that the burden of malaria has shifted from under 5 years age to children
between 7 to 13 years(13)
A study was done to
investigate the prevalence and correlates of asymptomatic Malaria and anemia
among pregnant women in Southeast, Tanzania showed that the overall prevalence
was 36.4%. This a clear indication that asymptomatic malaria is not only a risk
for continued transmission, but also anemia in children and other health issues
(11)
Another study was also done on asymptomatic malaria among school children
in Morogoro Municipality showed that the prevalence of asymptomatic malaria was
5.4%((14). This clearly shows that the high
prevalence is the problem because the asymptomatic carriers will serve as the
reservoir for infection hence continual transmission of malaria. Also the
asymptomatic carrier will pose a challenge in control and elimination of the
malaria hence there is a need to conduct this study in order to investigate the
risk factors that can lead to asymptomatic malaria. Therefore, this study was
conducted to determine prevalence of asymptomatic malaria among school children
in Dodoma Urban District.
1.5 RATIONALE
Finding
from this study provide the current burden of the disease among school-aged
children at Dodoma Urban district which is useful in planning effective
strategies to control malaria in school-aged children. Also provide the
information on the current status of the level of knowledge on malaria
prevention measures and the use of different control measures which help in
emphasizing, planning and improving measures on malaria prevention
interventions and attaining the goal of Malaria eradication.
1.6 RESEARCH
QUESTIONS
1. What is the
prevalence of asymptomatic malaria among primary school age children in Dodoma
urban district?
2. What is the level
of knowledge among of primary school age children on malaria at Dodoma urban
district?
3. What is a
proportion of students using different malaria prevention methods in Dodoma
urban district?
1.7 OBJECTIVES
1.7.1 BROAD OBJECTIVES
The broad objective
was to determine prevalence of asymptomatic malaria among primary school age
children in Dodoma urban district.
1.7 .2 SPECIFIC
OBJECTIVES
- To determine prevalence of asymptomatic malaria among school age
children in Dodoma Urban district.
- To determine the level of knowledge among school age children on
malaria in Dodoma Urban district.
- To determine the proportion of primary school aged children using
different malaria prevention methods in Dodoma Urban district.
CHAPTER TWO
LITERATURE REVIEW
Asymptomatic malaria
refers to an individual who harbor malaria parasites such as Plasmodium falciparum but do not
presents clinical symptoms of the disease (2). In malaria – endemic countries,
a large proportion of P. falciparum
are asymptomatic or sub- clinical (1). Asymptomatic carriers do not seek
treatment for their infection, and therefore constitutes a reservoir parasite
for newly hatched mosquitoes which then confer to transmission of the disease
(3).
Patients with
asymptomatic Plasmodium falciparum
infection, especially children under five and school aged usually experience
increase in morbidity due to anemia and reduced cognitive developments (4). The
detection and treatment of asymptomatic carriers of Plasmodium parasites is one
of the innovative strategies for malaria control and it has been previously
considered and included in the WHO guidelines for treatment of malaria (3).
Distribution of malaria chemoprophylaxis to African school children is
accompanied with lower rates of malaria parasitemia and severe anemia, few
clinical attacks and reduced school absenteeism due to malaria (5).
PREVALENCE OF ASYMPTOMATIC MALARIA AMONG SCHOOL CHILDREN.
The prevalence of
asymptomatic malaria varies in different regions around the global (1). A
community study was conducted in Molyko, Cameroon among 116, 158 school
children recruited in both urban and rural areas to determine the prevalence of
asymptomatic malaria. The prevalence of asymptomatic malaria infection was
42.17% and 40.16% in urban and rural
areas respectively(15). This shows that there was lack of
significant difference in prevalence between the two areas. School age children
harbor malaria parasite of whether they are from rural or urban. Control
measures are therefore, urgently needed to reduce the burden of the disease(15).
Also a study conducted in Ethiopia to
determine the prevalence of asymptomatic malaria among school children and
associated risk factors showed that out of 385 school children recruited, the
prevalence was 22% % in both male and female(16). Furthermore, the prevalence of asymptomatic
malaria decreased with the increase of age group.
A research study was
also done in Morogoro Municipality, Tanzania, and the result indicated that among
317 school aged children the prevalence of asymptomatic malaria was 5.4%(14). This clearly indicates that school aged
children are still at risk of being infected by malaria and their infection go
unnoticed. Thus never getting treated resulting to further complications such
as anemia.
2.3 KNOWLEDGE ON MALARIA AMONG
SCHOOL CHILDREN
Several studies have
been done to investigate level of knowledge on malaria, affordability and
accessibility of ITN (3). Net ownership has also been related to education
level of household members. Education attainment can have the impact on
individual’s ability to understand the role of treated mosquito nets in malaria
prevention (9).
Some survey reveals
a lack of knowledge and many misconceptions about the transmission, treatment
of malaria, control measures and antimalarial therapy as a knowledge gap could
have an advance effect on school children who could be used as change agents
and role models for their siblings and peers in malaria control strategy. Thus,
there is a need to empower teachers with information about the cause of malaria
and preventive strategies (9).
False knowledge and
misconceptions on causes of malaria will continue to increase the incidences
and prevalence of malaria among schoolchildren since they are not able to
implement correct preventive measures of malaria. Therefore, there is a need to
make necessary changes in course based curriculum so that the school aged
children will be able to assimilate correct causes of malaria (17).
However, a study
performed in Morogoro Tanzania revealed that 99% (395) of the recruited
children had knowledge on malaria transmission methods and used protective
measures such as long clothes and ITNs, also mass media and teachers was the
source of knowledge used in more than half of the recruited children. This tell
us that knowledge of school children can be associated with the community
surrounding them(14).
2.4 MALARIA PREVENTION METHODS
FOR SCHOOL AGED CHILDREN.
The practice of
malaria preventive measures has been related to the level of knowledge and
belief of people. The understanding of the possible causes, mode of
transmission and decision about the mode of adoption of preventive and control
measures vary from community to community among individual households (10). The
current emphasis on malaria control is centered on community-based strategies.
In order to prepare for a successful malaria control program, it is necessary
to evaluate the level of knowledge and practice of people living at risk area.
(10). The majority of malaria cases are acquired via a bite from an infected
mosquito, although some very rare cases are acquired trans-placentally or via
transfusion of blood products (18).Generally, to avoid malaria infection, school
age children must avoid being bitten by an infected mosquito. This can be
accomplished by controlling physical environment, blocking mosquito access to
the skin, repelling mosquito from skin(19).
Mosquito bites can
be avoided by use of appropriate environmental control such as closing doors and use of house with screened window
and use of protective clothing that is skin should be covered with clothing
(lightweight for comfort and light-colored to be less attractive to insects),
sleeping children should be surrounded by nets, repellents, and insecticide(20).
Poor practice of
malaria prevention may be linked to various factors as lack of follow up during
sleeping time and parental beliefs that children are becoming older, the same
authors argued that some children are usually sleeping in separate bedrooms
from their parents which cause less usage of Insecticides Treated Nets(21).
Another study
revealed that ITNs used for protection against mosquito bites have proven to be
practical, highly effective and cost –effective intervention against malaria. A
decline in malaria I sub-Saharan Africa is attributed to malaria control
measures, predominately to the use of ITNs, IRS which have been implemented in
high scale(14).
CHAPTER
THREE
METHODOLOGY
STUDY AREA
The
study area was in Dodoma Urban District. Dodoma urban district is one of the
seven districts of Dodoma region of Tanzania. It is bordered to the North by
Dodoma Rural District, to the East by Mpwapwa District, to the South by Iringa
region and to the West by Singida region.
The
climate of Dodoma Urban District is semi-arid, characterized by seasonal
rainfall distribution with long dry and short wet seasons. There are seasonal
rivers, shallow wells and dams in few villages. Dodoma municipality is
administratively divided into one parliamentary constituency, 4 divisions, 41
wards, 18villages,170 streets and hamlets.
The
malaria control initiatives that have been implemented in Dodoma includes
providing citizens with Insecticide treated nets (ITNs), intermittent
preventive treatment of Malaria in pregnant women (IPTp), Indoor residual
spraying (IRS) and vector control.
STUDY DESIGN
To
determine the prevalence of asymptomatic malaria among school aged children a
descriptive crossectional study was conducted at Dodoma Urban District.
STUDY POPULATION
The
study population was school aged children from the age of 6 to 13 years, were
selected from which blood sample was collected by finger prick and taken for
examining of asymptomatic malaria using Rapid Diagnostic Test (RDT)
SAMPLE SIZE ESTIMATION
The
sample size was calculated from the below bio statistical formulae,
N=Z2
P (1-P)
£2
Where,
N=total number of subject requested in sample
Z=standard normal deviation value that
correspond to a level of statistical significance P≤ 0.05 which is 1.96.
P=estimate of proportion of malaria prevalence
among school age children in Dodoma which is 2.5% (12)
£ =Since P<20% which gives the marginal
error of (3%)
N=
1.962× 0.025(1-0.025)/0.032
N=104.0433
The sample size for this study was 104 school age children
SAMPLING TECHNIQUE
The
study used a simple random sampling technique to obtain a sample size required.
At
first, a list of 41 wards was obtained with the assistance of DEO, and then two
wards among of 41 was selected randomly.
Also,
from the selected wards, a list of villages that are found within a selected ward
was obtained. Followed by selecting randomly two villages, finally 2 schools
were randomly selected within the two given villages.
With
the help of the head teacher, students with the age of 6 to 13 years were
selected randomly from each class to participate in the study. Then only the
students that met all the inclusion criteria were taken to the next step. The
selected schoolchildren were given an informed consent that was signed by their teacher. In the end, only the children who consented
were recruited as part of the sample.
ELIGIBILITY CRITERIA
Inclusion
criteria
The
inclusion criteria were:
- School children aged 6 to 13 years.
- Children must be day scholar.
- Teacher must sign the informed consent
form for the child to participate in this study.
- Children must be residents of that
particular area.
Exclusion criteria
The exclusion criteria were:
- Sick children.
- Children whose teachers refused to sign consent forms.
- Children who will disagree to give blood sample.
STUDY VARIABLES
Independent
variables
- The independent variables were; Socio
demographic characteristics such as level of education. Knowledge on
causative agent, transmission, treatment, control and prevention of
asymptomatic malaria.
Dependent variables
The dependent
variable was prevalence of asymptomatic malaria.
DATA COLLECTION TECHNIQUE AND
PROCEDURES
Structured interview using
questionnaire
A questionnaire was prepared to collect
information on demographic characteristics and assess knowledge and awareness
on asymptomatic malaria and methods used in malaria prevention and control. The questionnaire consisted two versions, Swahili version
which was used to collect demographic data and knowledge of malaria in primary
school and English version, which was used to translate back Swahili data
obtained from participants. A face to face interview approach was used and the
responses obtained were filled to the questionnaire.
Data collection Procedures.
Blood samples obtained from school children
were screened for Plasmodium parasite carriage using SD Bioline malaria
Ag Pf/Pan (HRP-II/pLDH) Rapid Diagnostic Test (RDT).
All necessary materials were gathered at the testing area which includes RDT
kit (test cassette, buffer, and blood collecting device). Each s child was
explained what the test is for and the procedures. Then the cassette was
removed from the foil package and labeled with particular number (identification
number). All these procedures were done while wearing gloves, the puncture site
was disinfected (the fourth finger of non-dominant hand) with alcohol swab. Along
that, a gentle prick was made toward the bull of the 4th finger and
wipe off the first drop of blood with a dry cotton.
Using the blood pipette, 5micro liters of
blood was collected then transferred to the cassette and then the buffer was
added 3 to 4 drops and finally the cassette was placed for 15 minutes before
interpretation of the results. The interpretation of the results was done as
follow:
- Negative-the presence of only control band
indicates a negative result
- Positive-the
presence of both control and test band indicates the positive result
- Invalid-if
the test doesn’t show the control band even if there is the control band.
Then reporting was
as RDT negative or RDT Positive or RDT invalid. Followed by discarding the
cotton wool, RDT cassette and gloves into the box for
infection waste
DATA
PROCESSING ANALYSIS.
Data collected was coded, entered, cleaned,
and analyzed by using Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics was done to obtain
the frequencies of variables of interest.
Objective 1: Prevalence of asymptomatic malaria was
presented as overall prevalence, but also in frequency and proportion according
social demographic characteristics.
Objective 2: Knowledge of each question is presented
in frequency and proportional. Knowledge level is presented in frequency and
proportion as high level knowledge, moderate level knowledge and low level
knowledge. Then knowledge
score scale was used whereby score was given to both correct and incorrect
responses, a total of 12 questions were prepared and given to schoolchildren to
answer them after a good instruction, and the correct score was given 1 and an
incorrect score will be given 0 (22).Then scores will be categorized to the low,
moderate and high level of knowledge as follows
- 0-3 points =High level of knowledge
- 4-7 points= Moderate level of knowledge
- 8-12points= Low level of knowledge
Finally, all the responses were added to find
the mean score for all the recruited children.
Objective
3:
Proportion of School children using different Malaria control measures were
analyzed in both frequency and proportion.
ETHICAL
CONSIDERATIONS.
Before conducting the study, ethical
consideration was requested from Muhimbili University of Health and Allied
Sciences Institutional Review Board then permission to conduct this study in
Dodoma Urban District was requested from the Regional Administration Officer,
then to District Administration officer and other permission was requested from
District Education Officer (DEO). Then the written consent forms was distributed
to each participant in order to be given to their teacher and request them to
read and sign if they allow their students to participate in this study.
STUDY
LIMITATION AND MITIGATION.
Poor
participation which was caused by some of the school age children refusing to
answer the asked questions and was mitigated by explaining the advantages of
the study to them.
Response bias also occurred in this study and
was mitigated by telling them to be truthful to all asked questions.
Also, recall bias was one of the limitations,
which was mitigated by repetitively asking the same question to the same
schoolchild and by giving enough time to remember.
CHAPTER
FOUR
4.0 RESULTS
.1.
SOCIAL DEMOGRAPHIC CHARACTERISTICS OF SCHOOL CHILDREN.
A total of 104 primary school children
from three primary schools were recruited in this study. Out of 104 school-aged
children who participated in this study, male were 53 (51%) and female were
51(49%). The majority of primary school children participated in this study
aged 10 to 13 years (90.4%) and the mean age was 11.19. Standard seven occupied
the most (28.8%) of all primary school children enrolled in this study.
Table
1: Social demographic characteristics of participants (n=104)
|
Variable |
N
(104) |
%
|
|
Sex Males Females |
53 51 |
51 49 |
|
|
|
|
|
Age
group 6-9 10-13 |
10 94 |
9.6 90.4 |
|
Class Standard three Standard four Standard five Standard six Standard seven |
10 17 24 23 30 |
9.6 16.3 23.1 22.1 28.8 |
|
|
|
|
4.2 PREVALENCE OF ASYMPTOMATIC
MALARIA
The
overall prevalence of asymptomatic malaria among 104 primary school children
enrolled in this study was 1.9%. The
prevalence of asymptomatic malaria among females was greater (3.9%) than in
male, where none of the male students appeared to be infected. Asymptomatic
malaria appeared to affect mostly primary school children of age 10 to 13years
(2.1%) of standard four and seven compared to other age group. (Table 2).
Table 2: Prevalence of asymptomatic malaria according to the social
demographic characteristics of the study participants (n=104)
|
|
MRDT
result |
||||
|
Positive |
Negative |
||||
|
N |
% |
N |
% |
||
|
Age group |
6-9 |
0 |
0.0% |
10 |
100.0% |
|
10-13 |
2 |
2.1% |
92 |
97.9% |
|
|
Sex |
Male |
0 |
0.0% |
53 |
100.0% |
|
Female |
2 |
3.9% |
49 |
96.1% |
|
PROPORTIONAL OF CHILDREN USING MALARIA
PREVENTIVE METHODS
School children were assessed by asking them
questions based on methods used for malaria prevention techniques. Majority of
respondents 82(78.8%) slept under mosquito nets. Furthermore, about 86(82.7%)
children said they use IRS as preventive method for malaria transmission and 18(17.3%)
children mentioned cleaning around their home as a method of malaria prevention
as shown in Table 3.
Table
3: Proportional of children using malaria preventive methods (n=104)
Variable n
(%)
Do you use IRS at your home?
Yes
86(82.7)
No
18(17.3)
Do you sleep under ITNs?
Yes
82(78.8)
No
22(21.2)
What other methods do you use to prevent
malaria?
IRS
70(67.3)
Cleaning home
18(17.3)
Never taught
8(7.7)
Ensure window have wire meshes 7(6.7)
Closing
windows 1(1)
1.2 LEVEL
OF KNOWLEDGE OF SCHOOL CHILDREN
It was found that 78(75%) had high level of
knowledge on Malaria and its methods of prevention, 25(24%) had moderate level
of knowledge and only 1 student (1%) had low level of knowledge as shown in
Table 4
Table
4: Level of knowledge on malaria preventive measures among study participants
(n=104)
|
Variable |
|
Frequency (%) |
CI |
|
High |
|
78(75%) |
8-12 |
|
|
|
|
|
|
Moderate |
|
25(24%) |
4-7 |
|
|
|
|
|
|
Low |
|
1(1%) |
0-3 |
Despite the general high level of
knowledge score, there was still a big number of students 82(78.9%) who had
misconception on malaria transmitting agent. About 93 (89.4%) students were
aware that malaria is transmitted through mosquito biting however some other
participants still mentioned other means such as drinking contaminated water
3(2.9%) and eating without washing hands 8(7.7%). Use of ITN and IRS were
malaria preventive measure that primary school children mentioned, The majority
being ITN 79(76%) followed by IRS 14(13.5%).
The
majority of the participants had proper knowledge on the health care seeking
and taking medication ACTs 80(76.9%), instead of self-medication at home with
traditional remedies. Participants also
mentioned, fever as a malaria symptom they knew was mostly mentioned symptom 90
(86%) followed by general body weakness 9 (8.7%)
Table 4: Knowledge on malaria preventive
measures(n=104)
|
Variable |
Frequency N (%) |
|
|
|
||||
|
Malaria transmission agent Mosquitoes Worms Fleas Plasmodium
parasite |
70(67.3) 11(10.6) 1(1) 22(21.2) |
|
|
||||
|
Advantage of children sleeping in nets Reduce
burden of Malaria 77(74.0) Children
sleep better
8(7.7) Just
for luxuriousity
9(8.7) When
I sleep under netnothing 7(6.7) bothers
me Others
3(2.9) |
|
|
|||||
|
Malaria preventive measures Use
of ITN
79(76.0) Going
to school daily
3(2.9) Closing
doors and windows at night 8(7.7) Use
IRS
14(13.5) Common symptoms of Malaria General
body weakness 9(8.7) Sweating
5(4.8) Fever 90(86.5) Precaution taken first against malaria
episode Taking
ACTs
13(12.5) Informing
parents 15(14.4) Giving
information to teachers 2(1.9) Sleeping
under nets 74(71.2) How is malaria transmitted Bitting
of mosquitoes
93(89.4) Drinking
contaminated water 3(2.9) Eating
without washing hands 8(7.7) Malaria treatment Going
to the hospital
7(6.7) Drinking
water regulary 4(3.8) Eating
balanced diet
13(12.5) Using
ACT
80(76.9) |
|
|
|||||
CHAPTER FIVE
5.0 DISCUSSION, CONCLUSION AND RECOMMENDATIONS
5.1 DISCUSSION
This study assessed the prevalence of asymptomatic
malaria and knowledge-based factors that determine the likelihood of malaria
infection among primary school children aged 6 years to 13 years at, Dodoma
urban district.
5.1.1 Prevalence of asymptomatic malaria
Malaria
diagnostic methods using malaria rapid diagnostic test (mRDT) was used to
detect malaria infection. Overall prevalence of asymptomatic malaria among
primary school children was 1.9% for mRDT, which is lower compared to the study
done in Bagamoyo, Kiwanga Pwani region in 2017 that reported prevalence of 14%
by mRDT and 8% by LM(20).
It’s also lower compared to the study done in Morogoro in 2015 that
reported prevalence of 5.4% by mRDT (21). Prevalence was lower than
prevalence of asymptomatic malaria among school-aged children obtained from
studies done in Northwest Ethiopia that reported prevalence of 6.8% (4), and Yemen that reported
prevalence of 12.8%(16). This reflects low burden of the
disease in the study area, which necessitates explicit shift in emphasis from
control alone and includes a progression from control to elimination and
eventual eradication through the appropriate actions to be taken by the
authorities to intervene this problem, as these asymptomatic carrier acts as
reservoir of the infection.
Female
children were found to have a higher prevalence than male children. Several studies
also reported similar findings. Study done in Morogoro reported female children
to be more infected than male children (21). However other studies reported
different findings where male children were found with higher prevalence than
female. Study done in Kenya to assess Prevalence and associated determinants of
malaria parasites among Kenyan children, and study done in Rufiji district (22) reported the similar findings. So,
there are variations in findings on the association between prevalence of
malaria and the sex, more studies need to be done to come with general
conclusion on this.
5.1.3 Knowledge
on malaria preventive measures and use of different control measures.
Findings of this study revealed that,
majority of the participants 78(75%) had high knowledge on the malaria
preventive measures. Also, majority of participants (89.4%) mentioned mosquito
as bitting as a method of malaria transmission, indicating the high knowledge
of the relationship between malaria and mosquito. These finding are higher
compared to study done in Western Ethiopia, which reported only 29.9%(24).
Our study found that 78.8% use of ITN as
primary source for protection against malaria. These findings are supported by
study done in Bagamoyo, which reported the same findings (17).
This reflect the high knowledge on the malaria preventive measures, indicating
that if efforts made to supply preventive measures they will be utilized properly.
Also, our study indicates that majority of
primary school children in the study area have knowledge on symptoms of
malaria, treatment seeking, ITN and IRS use. These finding are similar with
study done in Bagamoyo(17).
These findings are higher compared to study done in Western Ethiopia which,
reported lower proportion(24).
The majority of the respondents (76.9%)
reported to take ACT to treat malaria infection from healthcare. Study done in rural Geita
district reported the same findings (21).
Better knowledge about malaria
transmission and benefits of using available effective preventive and control
measures by the individual households and the community could contribute much
to the overall reduction of the malaria burden(24).
5.2 CONCLUSION
The findings from this study concluded
that, prevalence of asymptomatic malaria among primary school children is low
at Dodoma Urban district. The findings of this study indicated that primary
school children at Dodoma urban district have high knowledge on malaria
transmission, symptoms, and preventive measures. ITNs and IRS are still good choice for malaria
preventions, the
use of bed nets is widespread which makes its intensive use viable for malaria
control. Although more education on the emphasis of using nets should be
provided so as to increase number of people who use mosquito nets.
Also, there is need to have program for
malaria screening among primary school children as intervention on malaria
prevention and eradication in malaria at Dodoma Urban district.
Also due to lower asymptomatic malaria
prevalence, there is need to initiate effective use of IRS program in the study
area as one of preventive measure to reduce malaria incidences so as to ensure
elimination of malaria.
5.3 RECOMMENDATIONS
1. There is need for a strong collaboration among major
stakeholders including Government and non-government organization to mobilize
and sensitize community on malaria as disease and develop effective method for
prevention and control of the diseases.
2. As government implemented SST (Single Screening and Treatment)
for pregnant women, it needs also to initiate the same approach to primary
school children as these asymptomatic individuals become the great challenge
toward malaria eradication because thy acts as reservoir of the infection.
3. Other studies need to be done in Dodoma Urban district to
assess the burden of the disease on other groups especially secondary school
students and community as well, as up to now the burden assess among primary
school children and pregnant women only.
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Mlugu EM, Minzi O, Kamuhabwa AAR,
Aklillu E. Prevalence and correlates of asymptomatic malaria and anemia on
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TACAIDS. Tanzania- 2011-12 HIV/AIDS
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2013;16.
13.
Carneiro I, Roca-Feltrer A, Griffin
JT, Smith L, Tanner M, Schellenberg JA, et al. Age-patterns of malaria vary
with severity, transmission intensity and seasonality in sub-Saharan Africa: A
systematic review and pooled analysis. PLoS ONE. 2010.
14.
Nzobo BJ, Ngasala BE, Kihamia CM. Prevalence
of asymptomatic malaria infection and use of different malaria control measures
among primary school children in Morogoro Municipality, Tanzania. Malar J.
2015;14(1):1–7.
15.
Kimbi HK, Nformi D, Ndamukong KJN.
Prevalence of asymptomatic malaria among school children in an urban and rural
area in the Mount Cameroon region. Cent Afr J Med. 2005;
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Mohanna MAB, Ghouth ASB, Raja’a YA.
Malaria signs and infection rate among asymptomatic schoolchildren in Hajr
valley, Yemen. East Mediterr Heal J. 2007;13(1):35–40.
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Sumari D, Dillip A, Ndume V, Mugasa J, Gwakisa
P. Knowledge, Attitudes and Practices on Malaria in Relation to its
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Velasco E, Gomez-Barroso D, Varela C,
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Strickman D, Gaffigan T, Wirtz RA,
Benedict MQ, Rafferty CS, Barwick RS, et al. Mosquito collections following
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Castle S, Scott R, Mariko S. Malaria
prevention and treatment for children under five in Mali: further analysis of
the 2012-13 Demographic and Health Survey. DHS Furth Anal Rep. 2014;
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Nzobo BJ, Ngasala BE, Kihamia CM.
Prevalence of asymptomatic malaria infection and use of different malaria
control measures among primary school children in Morogoro Municipality,
Tanzania. Vol. 14, Malaria Journal. 2015.
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Khatib RA, Chaki PP, Wang DQ, Mlacha
YP, Mihayo MG, Gavana T, et al. Epidemiological characterization of malaria in
rural southern Tanzania following China-Tanzania pilot joint malaria control
baseline survey. Vol. 17, Malaria Journal. 2018.
23.
Survey MI. Malaria Indicator Survey
2017. 2017;
24.
Legesse Y, Tegegn A, Belachew T,
Tushune K. Knowledge, Attitude and Practice about Malaria Transmission and Its
Preventive Measures among Households in Urban Areas of Assosa Zone, Western
Ethiopia. Vol. 21, Ethiopian Journal of Health Development. 2007.
APPENDICES
Appendix 1: CONSENT FORM ENGLISH VERSION
MUHIMBILI
UNIVERSITY OF HEALTH AND ALLIED SCIENCES
DIRECTORATE
OF RESEARCH AND PUBLICATION
INFORMED
CONSENT FORM
ID-NO
Consent
to participate in the research study
Greetings!
My name is Beatrice Thadeus Kulwa
from MUHIMBILI UNIVERSITY OF HEALTH AND
ALLIED SCIENCES (MUHAS), BMLS PE candidate. I am conducting a research
project with the aim to determine prevalence of asymptomatic malaria and the
use of different control measures among of school age children in Dodoma Urban
district.
Study purpose
The
study is aimed to determine the prevalence of asymptomatic malaria among of
school age children, assessing level of knowledge of school age children on
malaria and determining the portion of students using malaria prevention
methods.
What participation involves
The
study will involve school age children ranging from 6 to 13 years who will be
required to answer questions during interview and to provide finger prick blood
sample for malaria.
Confidentiality
All
collected information will be entered into computer with only study
identification number without involving their names and unauthorized person
will have no access to the data collected.
Benefits
If you agree your child to participate in this
study, he /she will benefit directly or indirectly. Directly, any child who
will found with malaria will be referred to the nearest health facility for
management. Indirectly, the information she/he will provide will help to
understand the knowledge of children on malaria controls and level of
asymptomatic malaria among of school children in Dodoma Urban district. These
findings will help the policymakers to address the problem.
Potential risks
I
assure you that no any harm will be expected to happen to your child because of
participation in this study however during finger prick one may feel some pain.
Right to withdraw and alternatives
Participation
in this study is completely your choice. You can stop your child participation
in this study at any time even if you have already given your consent. Refusal
to participant or withdraw from the study will not involve any penalty.
Contacts.
If
you ever have questions about this study. You may contact the following
address.
MUHAS
Head, Department of Parasitology and Medical
Entomology
P.O.BOX 65001
School of Medicine.
OR
MUHAS
Director of
Research and Publication
+255-022-2152489
If
you have understood and ready to participate, please give the sign below.
Signatures:
1.
Participant ……………......
2.
Researcher………………...
Appendix II: CONSENT FORM SWAHILI VERSION
CHUO KIKUU CHA AFYA NA SAYANSI SHIRIKISHI
MUHIMBILI
|
KURUGENZI
YA UTAFITI NA UCHAPISHAJI MUHIMBILI
FOMU
YA RIDHAA
NAMBA
YA UTAMBULISHO..................
Ridhaa ya kushiriki katika utafiti
Salamu! Jina langu
ni Beatrice Thadeus Kulwa kutoka CHUO KIKUU CHA AFYA NA SAYANSI SHIRIKISHI
MUHIMBILI (MUHAS), Mwanafunzi wa shahada ya kwanza ya sayansi ya maabara za
binadamu. Ninafanya utafiti kwa madhumuni ya kuchunguza” Kuenea kwa malaria isiyo na dalili na matumizi ya hatua tofauti za
udhibiti kati ya watoto wennye umri wa shule(miaka 6-13) katika wilaya ya
Dodoma Mjini ,Tanzania.
Kusudi la utafiti
Utafiti huu
unakusudiwa kufahamu kiwango cha maambukizi
ya malaria isiyoonyesha dalili kwa watoto wa shule ya msingi, kukusanya
taarifa juu ya sababu zinazopelekea kuongezeka kwa malaria isiyo onyesha dalili za ugonjwa kati
ya watoto wa umri wa shule ya msingi, kiwango cha maarifa ya watoto wa umri wa
shule ya msingi juu ya ugonjwa wa malaria na kuweza kufahamu sehemu ya
wanafunzi wanaotumia njia za kuzuia malaria.
Ushiriki utahusisha nini
Utafiti huo
utahusisha watoto wa umri wa kwenda shule kuanzia miaka 6 hadi 14 ambao
watalazimika kujibu maswali katika dodoso na kutoa sampuli ya damu ya kidole
kwa ugonjwa wa malaria.
Usiri
Taarifa yoyote
iliyokusanywa itaingizwa kwenye kinakilishi na nambari ya kitambulisho cha
kusoma tu bila kuwashirikisha majina yao na mtu ambaye hajatambuliwa hataweza
kupata tarifa iliyokusanywa.
Faida za kushiriki katika utafiti huo
Ikiwa unakubali
mtoto wako kushiriki katika utafiti huu, atafaidika moja kwa moja au zisizo
moja kwa moja. Moja kwa moja, mtoto yeyote atakayepatikana na ugonjwa wa
malaria atapelekwa kwenye kituo cha afya cha karibu na shule kwa
usimamizi. Zisizo Moja kwa moja, tarifa
zitakazopatikana ziitasaidia kuelewa ufahamu wa watoto juu ya udhibiti wa
ugonjwa wa malaria na kiwango cha ugonjwa huu miongoni mwa watoto wa shule ya
msingi wilayani Bagamoyo. Matokeo haya yatasaidia watunga sera kushughulikia
tatizo hili.
Hatari zinazowezekana kutokea
Nakuhakikishia
kwamba hakuna madhara yoyote yanayotarajiwa kutokea kwa mtoto wako kwa sababu
ya kushiriki katika utafiti huu, pengine anaweza kuhisi maumivu kidogo tu
kutokana na kuchoma kidole cha mkononi wakati wa kutoa damu.
Haki ya kujiondoa na mbadala
Ushiriki katika
utafiti huu ni hiari yako kabisa. Unaweza kusimamisha Ushiriki wa mtoto wako
kwenye utafiti huu wakati wowote hata ikiwa umeshampa idhini yako. Kukataa
kuhusika au kujiondoa kwenye utafiti hautahusisha adhabu yoyote.
Anwani
Ikiwa utakuwa na
maswali juu ya utafiti huu. Unaweza kuwasiliana na anwani ifuatayo.
MUHAS
Mkuu wa Idara ya
vimelea na matibabu
P.O.BOX 65001
Shule ya Tiba
AU
MUHAS
Mkurugenzi wa
Utafiti na Uchapishaji
+255-022-2152489
Ikiwa umeelewa na
tayari kumuruhusu mtoto wako kushiriki, tafadhali Saini hapa chini.
Saini:
1. Mshiriki
……………......
2. Mtafiti ………………….
Appendix III: QUESTIONNAIRE ENGLISH VERSION
Questionnaire No.......................
PREVALENCE
OF ASYMPTOMATIC MALARIA AND USE OF
DIFFERENT CONTROL MEASURES AMONG SCHOOL CHILDREN IN DISTRICT, TANZANIA.
Name
of the ward………
Name
of the village……...
Name
of the school……….
Identification
number of the interviewee…………………….
PART
A: Demographic Data
1. Sex
1. Male
2. Female [ ]
2. What is your age in
years...................?
3. Which class are you………………….?
PART
B: ASSESSMENT ON THE USE OF DIFFERENT
MALARIA CONTROL METHODS
1. Do you sleep under ITNs?
a. Yes [ }
b. No (if no go to number 2)
2. What are reasons for not using ITNs at
home?
a. ITNs are not effective in preventing malaria
b. Used for other purpose (mention the purpose)
c. Weather
d. Not available
e. Others (mention) ……………
[ ]
3. What is the structure of your sleeping
room?
a. No space for
hanging nets
b. The room is open
c. There is enough
space in the room
d. Nets are not
easily available
e.
Others (mention the structures) ……………………….
4. What do you think are the advantages of
children sleeping in the nets?
a.
Reduce
the burden of malaria on them
b.
Children
sleep better
c.
Just for
luxuriously
d.
When I
sleep under net. Nothing bothers me.
e.
Others
(mention)………………………….
[ ]
- Do you use IRS at your home? If no go to question 6
a. Yes
b. No
6. What is the reason of not using IRS at your
home?
a. IRS has bad smell
b. We use ITNs hence no reason of using IRS
c. Not easily available
d. Our windows have wire mesh
e. Others (mention)…………………………….
[ ]
7. What is the structure of your home?
a. The room has Screened window
b. Open windowed
c. The door is open at night
d. Windows have wire meshes [ ]
e. Others (mention)…………………….
8. How many ITNs do you have in the household?
a. Two
b. Five
c. More than five
d. None
e. Mention (others)……………………..
9. Are you using insecticide treated nets? If
Yes go to question 10.
a. Yes
b. No
c. I don’t know
10. How did you get your ITNs at home?
a. Parents brought
b. Free from the government
c. Voucher system
d. I don’t know
e. Hospital
f. Others (mention)……………………………………..
11. Which of the following are the methods to
prevent malaria infections apart from insecticide treated nets
a. IRS
b. Cleaning around home
c. Never taught
d. Insuring widows have wire mashes
e. Closing windows
f. Others (mention)……………………….
PART
C: KNOWLEDGE ON MALARIA
1. Have you ever heard of malaria (If yes go to question 2)
a. yes
b. no
2. Where did you get information about
malaria?
a. Media
b. Health facility
[ ]
c. School
d. Home
e. Others (mention)
3. What is the causative agent of
malaria.......?
- Pasmodium
parasites
- Mosquitoes
- Chicken
[ ]
- Worms
- Fleas
4. How is malaria
transmitted..............?
- Through inhalation
- Through Biting by mosquitoes
[ ]
- Through Drinking contaminated water
- Through Eating without washing hands
- others (mention)
5. What are the common symptoms for
malaria.........? circle all the possible answers
a. General body weakness
[ ]
b. Feeling well
c. Joint strongest
d. Ability to eat
e. Sweating
f. fever
g. Others (mention)…………………………..
6. How can you treat malaria? Circle all the
possible answers
- Going to hospital
- Going to traditional healer
- Drinking water regularly
- Eating balanced diet
- Using ACTs
- Others (mention)………...
7 What are the methods which can be used to
control and prevent malaria? Circle all the possible answers
- Sleeping under ITNs
- Sleeping while watching TV
- Not sleeping the whole night [ ]
- Going to school daily
- Closing doors and window at night
- Using IRS
- Others (mention)
8. When you get malaria episode, what
precaution do you normally use first?
- Taking ACTs
- Informing parents
[ ]
- Giving information to teachers
- Sleeping continuously under nets
- Others
9. Which age group is at a higher risk of
acquiring malaria?
a. People of any age
b. Under-five children [ ]
c. Only elders
d. Only primary school children
e. People of any age group
10. Where should children with malaria seek
treatment?
a. In the community
b. Through traditional healers
c. During clinical medicine
d. They should ask their parents
e. Children should ask their teachers
f. Others [
mention ]……………………
11. What is the single most important practice
to reduce malaria infections?
a. Hand washing
b. Cleaning environment around home
c. Eating balance diet
d. Sleeping with mother
e. Use of ITNS
f. Others (mention) …………….
[ ]
12. What are the behaviors associated when
using bed net when sleeping at night which can cause you to be bitten by mosquitoes
?
a. Bed sharing
b. Bed net not compliant
c. Sleeping patterns like limb hanging outside of
the net
d. We sleep well enveloped by bed net
e. Mention (others) [ ]
Appendix IV: QUESTIONNAIRE SWAHILI VERSION
DODOSO Namba ya
dodoso ………………………
KUENEA KWA MALARIA ISIYO NA DALILI NA MATUMIZI
YA HATUA TOFAUTI ZA UDHIBITI KATI YA WATOTO WENNYE UMRI WA SHULE(MIAKA 6-13)
KATIKA WILAYA YA DODOMA MJINI ,TANZANIA.
SEHEMU A: TAKWIMU ZA KIDEMOGRAFIA
1jinsia
a.
Mwanaume
b.
Mwanamke [ ]
3. Una umri gani……..?
4. Uko darasa la ngap……….i?
SEHEMU B: UTUMIAJI WA NJIA TOFAUTI ZA
KUDHIBITI UGONJWA WA MALARIA
1.
Je,
unalala ndani ya chandarua? kama ni hapana nenda namba 2
a.
Ndiyo
b.
.Hapana
2 Sababu zipi zinakufanya usitumie chandarua
chenye dawa
a.
Chandarua
chenye dawa siyo njia halisi ya kuzuia malaria
b.
Zinatumika
kwa matumizi mengine *(Taja………….)
c.
Hali ya
hewa
d.
Zingine
,(taja)……………………
3. Je, hali ya chumba unacholala ikoje?
a. Hakuna nafasi ya kuweka chandarua
b. Chumba kina uwazi mzuri
c.Chumba kina nafasi ya kutosha
d. Chandarua hakipatikani kwa urahisi
e.Vingine (taja)……………………………….
e.
4. Je unafikiri ni faida zipi za kutumia
chandarua
a.
Kupunguza
maambukizi ya malaria
b.
Watoto
hulala vizuri ndani ya chandarua
c.
Kwa
ajili ya raha tu
d.
Nikilala
kwenye chandarua sipati shida yoyote
e.
Menginyo
taja…….
5. Je mnatumia dawa ya kupulizia kuua mbu
a. Ndiyo
b. Hapana, kama hapana nenda swali namba
6. Zipi sababu zinawafanya msitumie dawa ya kupulizia kuua mbu?
a.
Dawa ya
kupulizia ina harufu mbaya
b.
Tunatumia
chandarua, hivyo hakuna umuhimu kutumia dawa ya kupulizia kuua mbu
c.
Dawa
hizi hazipatikani kirahisi
d.
Madirisha
yetu yana nyavu hivyo hazipitishi mbu
e.
Zingine (taja)
7. Upi ni mwonekano wa nyumba yenu
a.
Chumba kimefunikwa na mapazia
b.
Madirisha
yamefunguliwa
c.
Milango ipo wazi wakati wa usiku.
d.
Madirisha yamezungushiwa nyavu
e.
mengineyo,
taja……..
8. Je mna jumla ya vyandarua vingapi vyenye dawa nyumbani?
a. Viwili
b. Vitano
c.Zaidi ya vitano
d. Hatuna
e. Taja idadi nyingine……………………….
9. Je chandarua chako kina dawa?
a. Ndiyo
b. Hapana
c. Sijui
10. Je mlipataje hicho chandaraua?
a. Wazazi walinunua
b. Tuligawiwa bure na serikali
c. Sifahamu
d. Hospitalini
e. Pengine (taja)
11. Zipi ni njia zingine zinazofahamika kuzuia malaria unazozifahamu
mbali n chandarua chenye dawa?
a. Njia ya kupulizia dawa
b. Kusafisha mazingira yanayotuzunguka
c. Sijawahi kufundishwa
d. Kufunga madirisha
e. Zingine ( taja)
SEHEMU C: UFAHAMU JUU YA MALARIA
1. Je unafahamu kuhusu uonjwa wa malaria
a. Ndiyo
b. Hapana. Kama ni ndiyo nenda swali la 2
2. Je! habari kuhusu ugonjwa wa malaria
ulipata wapi?
a. Vyombo vya habari
b. Kituo cha afya [ ]
c. Shule
d. Nyumbani
e. Pengine ... (Taja)…………………….
3. Malaria
husababishwa na nini?
a. Kidubini cha Plasmodium
b. Mbu
c. Kuku [ ]
d. minyoo
e. viroboto
4. .Malaria
huambukizwa kwa njia zipi ???
a. Kuvuta pumuzi
b. Kuumwa na mbu
[ ]
c. Kunywa maji machafu
d. Kula bila kunawa mikono
5. Zipi ni dalili za ugonjwa wa malaria?
a.
Maumivu
ya mwili mzima
b.
Kujiskia
vizuri
c.
Uimara
wa viungo
d.
Uwezo wa
kula
e.
Mwili
kupata jasho
f.
Zingine
..
6. Je ni zipi kati ya njia zifuatazo
hutumika kama tiba juu ya maambukizi ya malaria? Zungushia majibu yote ambayo
ni sahihi
a.
kwenda hospitalini
b.
kwenda kwa wagnga wa kienyeji
c.
kunywa maji mara kwa mara
d.
.kula chakula chenye mlo kamili
e.
matumizi ya dawa mseto
f.
.mengineyo
7. Njia ifuatayo inayotumiwa kudhibiti na
kuzuia ugonjwa wa malaria? Zungushia majibu yote ambayo ni sahihi
a.
Kulala
ndani ya chandarua chenye dawa
b.
Kulala
ukitazama TV
c.
Usilale
usiku kucha [ ]
d.
Kuenda
shuleni kila siku
e.
Kufunga milango na madirisha wakatia wa usiku
f.
Zingine
( taja)
8. Je, ni kipi cha kwanza kunafanya kama
matibabu unapougua malaria
a.
Natumia
dawa mseto
b.
Natoa
taarifa kwa wazazi [ ]
c.
Nawapa
tarifa walimu
d.
Nalala
mara kwa mara
e.
Kingine....
9. Ni watu wa umri gani wapo kwenye hatari ya
kuambukizwa na ugonjwa wa Malaria?
a.
Watu wa
umri wowote
b.
Watoto
wenye umri chini ya miaka mitano [ ]
c.
Wazee
d.
Watoto
wa shule ya msingi tu
e.
Umri
wowote
10. Wapi utapata tiba ukiugua malaria?
a.
Katika
jamii
b.
Kwa
waganga wa kienyeji
c.
Kwa
watalaamu wa afya
d.
Wawaulize
Wazazi wao
e.
Wawaulize
walimu
f.
PenginePO
(Taja)…….
11. Ipi ni njia bora ya kujikinga na malaria
- Kunawa
mikono
- Kusafisha
mazingira ya nyumbani
- Kuchelewa
Kulala
- Kulala na mama
- Taja zingine…….
12. Zipi ni tabia hujitokeza pindi unapo lala
kwenye chandarua wakati wa usiku ambazo zinaweza sababisha kuumwa na mbu?
a.
Kuchangia
kitanda
b.
Chandarua
kukosa ubora mfano uchafu
c. Kulala miguu nje ya chandarua
d. Tunalala vizuri ndani ya chandarua
Zingine .....
DATA SHEET
Table 3:
Data sheet
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PARTICIPANTS |
AGE |
SEX |
mRDTs
RESULTS |
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