A study on malaria control measures among community members in Lusaka urban

Abstract

Malaria is an illness caused by Plasmodium of the falciparum, maiariae, vivax and ovale species. 90% to 95% of the malaria cases occurring in Zambia are due to Plasmodium falciparum. The malaria parasites are transmitted by the vector mosquito. The important malaria vectors in Zambia are Anopheles gamibiae, anopheles Arabiensis and Anopheles funestus, all these are fresh water breeders (Bransby - Williams, 1979). Approximately 500 million cases occur worldwide per year. 90% of these happen in Sub-Saharan Africa. On the Zambian scene, the disease has been identified as one of the leading cause of both morbidity and mortality. By 1999 the incidence rate for malaria was 308.4 per 1,000 people. While the fatality rate among those admitted to health centres and hospitals was 51.3 per 1,000. Malaria has also been documented as the most common cause of both outpatient attendance and hospital admission in all age groups. Figures for 1999 show that 35.1% of total health centre admissions were due to malaria. The disease affects all age groups but is mot serious among younger children and pregnant women.It has been suggested that community involvement and their full participation would provide a solution to bringing the vexing problem down. The questions therefore are, what does the community l<now about malaria prevention and control? What is the community actually doing to malaria? And what is the potential of the community to participate and contribute to the malaria control programme? This study aims at answering these questions in other words it aims at assessing the knowledge attitudes and practices in malaria control measures among community members. To initiate a community based programme it is necessary to have adequate and focused information regarding the community visa-a-vis the given problem. Hence this study would be useful in the planning and implementation of partnership based malaria control activities. The study would be useful especially now when there is new vigour to control malaria under the Roll Back Malaria initiative.This was a cross sectional survey targeting randomly sampled household. The sample was drawn from 3 residential clusters.(a)Low cost high density (b)Medium cost medium density and;(c)High cost low density areasA representative sample of 10% of the households was drawn from the three residential areas. Specifically the areas were Olympia, Libala Stage II and Old Kanyama.

The major findings were that people generally found definitions of things like what is malaria or what is malaria prevention, cumbersome. However upon probing they came up with more or less the correct answers. It was also found that people in Lusaka urban appreciated the severity of malaria (69%) as well as recognized the importance of taking preventive measures (61%) (However practice of control measures were low at 48% x^=3.2, P < 0.05). What could be near a fresh finding is the discovery of a very strong association of high temperature and fever to malaria. 55% of the respondents across the education strata and residential areas defined as high temperature and fever. On the other hand clinicians also heavily rely on temperature and fever to diagnose the disease. The argument that arises is could there be an exaggeration in our estimation of malaria incidence in view of the fact that high temperature and fever could be brought about by a myriad of other causes?