ANALYSIS OF MALARIOMETRIC VARIABLES AND DRUG USAGE PATTERN IN ABRAKA, DELTA STATE, NIGERIA, 2013-2019
Introduction: Despite concerted efforts to eliminate malaria, the disease, still poses the most severe public health problems worldwide, particularly in sub-Saharan Africa, where Nigeria has the highest number of cases. Increasing incidence of malaria has been reported in the Northern, Southwest, Southeast and North Central parts of Nigeria in recent times, but information from the South-South region is scarcely available. Therefore, this study, investigates the trends of malariometric variables (morbidity, mortality and drug use pattern) in Abraka, South-South Nigeria, between 2013 and 2019.
Methods: Medical records of twenty three (90%) health institutions in Abraka were reviewed after obtaining permission, and a total of 188,945 clinical malaria cases, documented from 2013 to 2019 were examined from January to March 2020. Data were then, analyzed using Microsoft Excel to generate graphs, while the Epi Info version 7 was used to evaluate Chi-square trends for significance.
Results: Data obtained indicate that malaria morbidity increased by 67% from 2013 to 2019 at rates of 180/1,000 population at risk in 2013 to 301 in 2019. The increase among males was 77% (95-168), while among the females was 58% (85-134). The average rates 142 vs 121 were, however, not significantly different (p>0.05). Morbidity among children (0-12 years), teenagers (13-19 years), young adults (20-49 years) and older adults (≥50 years), respectively, increased by 91% (110-210, average 182), 5% (40-42, average 43), 106% (18-37, average 27) and 0% (13-13, average 13). Children had the highest average rate, calculated to be significantly different (p<0.05). The average mortality rate/1,000 clinical cases was also highest (p<0.05) among children at 0.57 and then, 0.26, 0.03 and 0.00 for the rest age classes, accordingly.
Drug use complied substantially with WHO’s ACT recommendation for first line treatment of uncomplicated malaria in endemic areas. About 89% of regimen were ACT-based.
Conclusion: Malaria cases stably increased in Abraka from 2013 to 2019, in spite of the strong compliance to WHO treatment guidelines; indicating that the well-articulated National Malarial Strategic Plan 2014-2020, aimed at reducing malaria burden to pre-elimination levels and bringing malaria-related mortality to zero by 2020 was not fully supported and funded by agencies concerned. Therefore, there is need for fiscal commitment and advocacy in order to achieve the objectives for which the National Malaria Elimination Programme, NMEP was established.
Key words: Abraka, ACTs, Children, Control, Endemic, Malaria, Morbidity, Nigeria, Disease, Mortality