In this blog post, I will be discussing some key determinants of malaria in Nigeria.
Malaria in Nigeria. as in many other countries, cannot be attributed to a single cause. Numerous determinants, including biological, socio-cultural, economic, and environmental, cause and contribute to this deadly infectious disease in Nigeria. The gender inequality in Nigeria is a social determinant of malaria. Nigerian women are more likely to be poor, uneducated, and without political power compared to Nigerian men due to gender discrimination in the country. Therefore, there is a neglect of women's health and this leads to potential problems in the infant developmental process. Thus, Nigerian women, especially pregnant mothers, are at an increased risk of having untreated malaria due to this gender discrimination. Another social determinant of malaria in Nigeria is the barriers to health care access. This may include lack of money, transportation, and conflicting cultural and religious beliefs. Education is another social determinant of malaria in Nigeria. Only 68% of all Nigerians are educated, implying that many Nigerians are not aware of the implications of malaria and the preventive measures available. Biological determinants of malaria in Nigeria include genetic susceptibility. Many Sub-Saharan Africans lack what is called a Duffy blood factor, which is an important mechanism that can limit parasite growth in the red blood cells. Without this protective mechanism, many Nigerians are not protected against severe diseases such as malaria. Also, the parasites that cause malaria are especially resistant to antibiotics, making treatment very difficult with drugs. An environmental determinant of malaria in Nigeria is warm temperature and high rainfall in the country. Mosquitos tend the thrive in sub-tropical/tropical areas, which makes Nigeria a very good mosquito breeding area. Also, human engineering projects destroys the natural terrain, and this favors increased mosquito breeding by creating new breeding sites. Poverty is an economic determinant of malaria. A striking 70% of Nigerians fall below the poverty line. Therefore, many Nigerians cannot afford the preventive measures such as bednets and insecticide sprays. Malaria is also a cause of economic burden because when a family member catches the disease and falls ill, he or she cannot go to work and make money for the family.
1.http://www.who.int/social_determinants/country_action/NIGERIA%20Dr%20ADETUNJI%20Labiran.pdf
2.http://origem.info/FIC/pdf/Breman%20et%20al%20Ears%20Hippopotamus_AJTMH%2001.pdf
3.http://www.rbm.who.int/cmc_upload/0/000/015/330/415680a_r.pdf
4.http://www.nationsencyclopedia.com/economies/Africa/Nigeria-POVERTY-AND-WEALTH.html
Sunday, November 28, 2010
Friday, November 19, 2010
The Magnitude of Malaria in Nigeria
In this post, I will be addressing the magnitude of the problem my final paper will be on.
Problem Statement (not final): Malaria in Nigeria has caused millions of deaths in the country and has had a enormous toll on the economic and social structures of the country.
Malaria causes around 250,000 deaths in children under five every year in Nigeria. An enormous proportion of the country's hospital resources are devoted to treating malaria and the medical staff work overtime all the time. Among the 151 million people in Nigeria, 110 million are clinically diagnosed with malaria. In Nigeria, malaria causes 11% of maternal deaths, and 60% of out-patient visits and 30% of hospitalizations are malaria related. Around $870 million are used every year for prevention and treatment of malaria in Nigeria and the toll on the country's economy is significant. Therefore, malaria has a great burden on society because it not only affects people physically, it affects people mentally, psychologically, and financially. As a result, the economic and social development of the country will be hindered.
Surveillance is rigorously implemented in assessing malaria in Nigeria. Records from all health facilities in the country are reported to the organizations responsible for data collection. Data is collected using standardized tools and there is a monthly reporting system for malaria in Nigeria. The organizations then analyze the data and decide what types of programs should be implemented in preventing and treating malaria and how the limited resources can be most effectively used.
There are several indicators of malaria in Nigeria. Direct indicators include the fact that Nigeria's under 5 mortality rank is number nine in the world, as described by UNICEF. Also, only 8% of Nigerian households own at least one insecticide treated bednet (ITN), 6% of Nigerian children under age 5 sleep under ITNs and 33% of Nigerian children under age 5 receive anti-malarial drugs, documented by the Department of Health Services. Indirect indicators include a high prevalence rate (3.1) of HIV in Nigerians aged 15-49, documented by the Joint United Nations Program on HIV/AIDS. Other indirect indicators include the fact that only 47% of Nigerians use improved drinking water sources and only 30% use improved sanitation facilities, as studied by a combination of organizations including UNICEF and The World Health Organization.
There are several strengths and weaknesses of the above indicators. Bednets are very effective and cost-effective in preventing malaria so the use of bednets and the prevalence of malaria are directly but not exclusively related. Malaria has an enormous toll on children and the high ranking Nigeria received in its under 5 mortality rate means that malaria is widespread in this country. The high prevalence rate of HIV resembles a link to a high prevalence rate of malaria because the two diseases are mutually cohesive. Also, improved sanitation and a cleaner water source decreases the spread of malaria, as studies have shown. The weakness of the above indicators is that most of them were all conducted as surveys of Nigerians. Surveys bring up all kinds of voluntary response bias and are not the best type of data collection.
sources:
1. http://www.unicef.org/infobycountry/nigeria_49472.html
2. http://mobileactive.org/malaria-kills-getting-63-million-bednets-nigerians-rapidsms
3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1890276/
4. http://nmcpnigeria.org/?p=m-and-e
5. http://www.unicef.org/infobycountry/nigeria_statistics.html
Problem Statement (not final): Malaria in Nigeria has caused millions of deaths in the country and has had a enormous toll on the economic and social structures of the country.
Malaria causes around 250,000 deaths in children under five every year in Nigeria. An enormous proportion of the country's hospital resources are devoted to treating malaria and the medical staff work overtime all the time. Among the 151 million people in Nigeria, 110 million are clinically diagnosed with malaria. In Nigeria, malaria causes 11% of maternal deaths, and 60% of out-patient visits and 30% of hospitalizations are malaria related. Around $870 million are used every year for prevention and treatment of malaria in Nigeria and the toll on the country's economy is significant. Therefore, malaria has a great burden on society because it not only affects people physically, it affects people mentally, psychologically, and financially. As a result, the economic and social development of the country will be hindered.
Surveillance is rigorously implemented in assessing malaria in Nigeria. Records from all health facilities in the country are reported to the organizations responsible for data collection. Data is collected using standardized tools and there is a monthly reporting system for malaria in Nigeria. The organizations then analyze the data and decide what types of programs should be implemented in preventing and treating malaria and how the limited resources can be most effectively used.
There are several indicators of malaria in Nigeria. Direct indicators include the fact that Nigeria's under 5 mortality rank is number nine in the world, as described by UNICEF. Also, only 8% of Nigerian households own at least one insecticide treated bednet (ITN), 6% of Nigerian children under age 5 sleep under ITNs and 33% of Nigerian children under age 5 receive anti-malarial drugs, documented by the Department of Health Services. Indirect indicators include a high prevalence rate (3.1) of HIV in Nigerians aged 15-49, documented by the Joint United Nations Program on HIV/AIDS. Other indirect indicators include the fact that only 47% of Nigerians use improved drinking water sources and only 30% use improved sanitation facilities, as studied by a combination of organizations including UNICEF and The World Health Organization.
There are several strengths and weaknesses of the above indicators. Bednets are very effective and cost-effective in preventing malaria so the use of bednets and the prevalence of malaria are directly but not exclusively related. Malaria has an enormous toll on children and the high ranking Nigeria received in its under 5 mortality rate means that malaria is widespread in this country. The high prevalence rate of HIV resembles a link to a high prevalence rate of malaria because the two diseases are mutually cohesive. Also, improved sanitation and a cleaner water source decreases the spread of malaria, as studies have shown. The weakness of the above indicators is that most of them were all conducted as surveys of Nigerians. Surveys bring up all kinds of voluntary response bias and are not the best type of data collection.
sources:
1. http://www.unicef.org/infobycountry/nigeria_49472.html
2. http://mobileactive.org/malaria-kills-getting-63-million-bednets-nigerians-rapidsms
3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1890276/
4. http://nmcpnigeria.org/?p=m-and-e
5. http://www.unicef.org/infobycountry/nigeria_statistics.html
Friday, November 12, 2010
Malaria in Sub-Saharan Africa
In this blog post, I will address what my final paper topic is on and give background information on it and why I am interested in the topic.
For my final paper, I plan on addressing malaria in Sub-Saharan Africa. Malaria is a disease that is caused by a parasite that uses mosquitos as its vector to humans. Victims of malaria experience flu-like symptoms and if left untreated, they will die. Malaria is especially prevalent in temperate areas such as Sub-Saharan Africa. According to the CDC, in 2008, there were 190-311 million cases of malaria worldwide and 700 thousand to one million deaths, most occurring in Sub-Saharan Africa (http://www.cdc.gov/MALARIA/). Malaria can also be spread from a pregnant mother to her infant child. There are many reasons why malaria is especially prevalent in Sub-Saharan Africa. Sub-Saharan Africa is home to the deadly species of mosquitos that transmit malaria and since this place is very temperate, these mosquitos thrive in this region. Also, many Sub-Saharan Africa countries lack the medical and public health infrastructure and resources to deal with malaria prevention. Furthermore, the disease has shown increasing drug resistance to past antibiotics and has mutated in even dangerous forms. The problem is complicated by the fact that money donated to malaria prevention campaigns by the World Health Organization (WHO) usually ends up in the hands of African military and political groups seeking for personal benefit due to the lack of infrastructure and the confusion when it comes to distribution of resources. Malaria is such a big problem in Sub-Saharan Africa because it causes the economic system to be unstable. When people are infected, they are unable to go to work and thus, become poor because they are receiving no wages, which is bad for both the person and the company/place he or she works for.
Malaria prevention includes bed nets, indoor insecticide sprayings, vaccines, and DDT. Bed nets are the most probable and cost efficient among these. However, it is difficult to ensure that all Africans are properly using bed nets. Indoor insecticide sprayings are very effective but they cause toxic and smelly odors. Vaccines are obviously the most effective prevention measure and in recent years, there has been a lot of research done on developing a malaria curing vaccine. However, all the vaccines that have been introduced so far have not had great success and the anti-drug resistant nature of the malaria causing parasite makes it difficult for researchers to develop such a vaccine. Also, vaccines are expensive, so it will not be available to the general Sub-Saharan Africa public. DDT is another very effective prevention measure but it has caused a lot of controversy over the use of it when dealing with malaria. DDT itself introduces many other dangerous side effects and depending on the individual, it can cause many unpleasant reactions.
I am interested in malaria because I am surprised by its pervasiveness and its effect on the economies of Sub-Saharan African countries. I am amazed by how such a disease can make the economies of 20 or so countries suffer so much. Also, the nature of the disease is very interesting to research on because of its uniqueness. Furthermore, the issue of malaria not only involves public health preventions and medicinal cures, but also involves governments of other countries seeking power in the region by getting involved, numerous global organizations trying to provide help, and military regimes within the Sub-Saharan African countries trying to seek personal empowerment. The issue covers public health, medicine, politics, warfare, and international relations, and that is what interests me the most.
For my final paper, I plan on addressing malaria in Sub-Saharan Africa. Malaria is a disease that is caused by a parasite that uses mosquitos as its vector to humans. Victims of malaria experience flu-like symptoms and if left untreated, they will die. Malaria is especially prevalent in temperate areas such as Sub-Saharan Africa. According to the CDC, in 2008, there were 190-311 million cases of malaria worldwide and 700 thousand to one million deaths, most occurring in Sub-Saharan Africa (http://www.cdc.gov/MALARIA/). Malaria can also be spread from a pregnant mother to her infant child. There are many reasons why malaria is especially prevalent in Sub-Saharan Africa. Sub-Saharan Africa is home to the deadly species of mosquitos that transmit malaria and since this place is very temperate, these mosquitos thrive in this region. Also, many Sub-Saharan Africa countries lack the medical and public health infrastructure and resources to deal with malaria prevention. Furthermore, the disease has shown increasing drug resistance to past antibiotics and has mutated in even dangerous forms. The problem is complicated by the fact that money donated to malaria prevention campaigns by the World Health Organization (WHO) usually ends up in the hands of African military and political groups seeking for personal benefit due to the lack of infrastructure and the confusion when it comes to distribution of resources. Malaria is such a big problem in Sub-Saharan Africa because it causes the economic system to be unstable. When people are infected, they are unable to go to work and thus, become poor because they are receiving no wages, which is bad for both the person and the company/place he or she works for.
Malaria prevention includes bed nets, indoor insecticide sprayings, vaccines, and DDT. Bed nets are the most probable and cost efficient among these. However, it is difficult to ensure that all Africans are properly using bed nets. Indoor insecticide sprayings are very effective but they cause toxic and smelly odors. Vaccines are obviously the most effective prevention measure and in recent years, there has been a lot of research done on developing a malaria curing vaccine. However, all the vaccines that have been introduced so far have not had great success and the anti-drug resistant nature of the malaria causing parasite makes it difficult for researchers to develop such a vaccine. Also, vaccines are expensive, so it will not be available to the general Sub-Saharan Africa public. DDT is another very effective prevention measure but it has caused a lot of controversy over the use of it when dealing with malaria. DDT itself introduces many other dangerous side effects and depending on the individual, it can cause many unpleasant reactions.
I am interested in malaria because I am surprised by its pervasiveness and its effect on the economies of Sub-Saharan African countries. I am amazed by how such a disease can make the economies of 20 or so countries suffer so much. Also, the nature of the disease is very interesting to research on because of its uniqueness. Furthermore, the issue of malaria not only involves public health preventions and medicinal cures, but also involves governments of other countries seeking power in the region by getting involved, numerous global organizations trying to provide help, and military regimes within the Sub-Saharan African countries trying to seek personal empowerment. The issue covers public health, medicine, politics, warfare, and international relations, and that is what interests me the most.
Sunday, November 7, 2010
Reflection on first half of course
In this blog post, I will be reflecting on the first half of the Intro to Public Health class and my thoughts and impressions so far.
I believe this class has been very interesting so far. The lectures are enjoyable because they are all taught by various faculty selected from the Bloomberg School of Public Health and they all are very knowledgable about their respective topics. The online course readings have been entertaining to read and although the textbook may be boring to read sometimes, it still presents some interesting things such as giving case studies and historic examples of public health problems and their respective solutions. I feel like my knowledge of public health has vastly expanded and I would like to continue to learn more about this broad area of study.
Personally, I found that the area of infectious diseases and bioterrorism were interesting to me. I feel like these two areas relate to my interest in biology and are topics that combine public health and biology. I also like history, so learning about the history of infectious diseases and their various historic examples are of particular interest to me. Bioterrorism is a interesting topic because of the psychological impact it has. Even though anthrax and other bioterrorism mechanisms have not killed many people, the psychological impact that it penetrates into society is huge. I would like to take further courses related to infectious diseases and/or bioterrorism later on in my college experience.
To me, the most surprising thing is that chronic diseases are now more pervasive than infectious diseases. I had no prior knowledge of public health so as a child, I thought that infectious diseases are the most dangerous and probably the most widespread types of diseases in the world in part due to the inherent "danger" in its name. However, I found out in this course that chronic diseases are actually the most pervasive type of disease and it is also becoming the most widespread disease in developing countries. It makes sense because as countries develop and industrialize, the risk factors for chronic diseases will increase and risk factors for infectious diseases can be prevented through advanced research on the causes of the infectious diseases.
Initially, I took this class because I wanted to know what public health does and how it relates to medicine. Throughout my childhood, I witnessed many public health disasters and I wanted to know what public health does in these types of situations and their powers and limitations. Many things have certainly changed since my first blog post. Now, I have a general understanding of all the areas of public health. I know that it covers many more areas of study than I initially thought it did and I now know that public health is intertwined with medicine, law, and politics. After taking more than two months of this class, I feel like I definitely have more respect for public health because it deals with saving the maximum number of lives as possible and the issues and problems that public health officials face are almost always as difficult if not more difficult than those that doctors face in the field of medicine. My public health interest has definitely increased as a result of taking this course because I am now aware to the numerous aspects of public health that are available for study. I definitely plan to take more upper level public health classes and pursue a major in this area of study.
I believe this class has been very interesting so far. The lectures are enjoyable because they are all taught by various faculty selected from the Bloomberg School of Public Health and they all are very knowledgable about their respective topics. The online course readings have been entertaining to read and although the textbook may be boring to read sometimes, it still presents some interesting things such as giving case studies and historic examples of public health problems and their respective solutions. I feel like my knowledge of public health has vastly expanded and I would like to continue to learn more about this broad area of study.
Personally, I found that the area of infectious diseases and bioterrorism were interesting to me. I feel like these two areas relate to my interest in biology and are topics that combine public health and biology. I also like history, so learning about the history of infectious diseases and their various historic examples are of particular interest to me. Bioterrorism is a interesting topic because of the psychological impact it has. Even though anthrax and other bioterrorism mechanisms have not killed many people, the psychological impact that it penetrates into society is huge. I would like to take further courses related to infectious diseases and/or bioterrorism later on in my college experience.
To me, the most surprising thing is that chronic diseases are now more pervasive than infectious diseases. I had no prior knowledge of public health so as a child, I thought that infectious diseases are the most dangerous and probably the most widespread types of diseases in the world in part due to the inherent "danger" in its name. However, I found out in this course that chronic diseases are actually the most pervasive type of disease and it is also becoming the most widespread disease in developing countries. It makes sense because as countries develop and industrialize, the risk factors for chronic diseases will increase and risk factors for infectious diseases can be prevented through advanced research on the causes of the infectious diseases.
Initially, I took this class because I wanted to know what public health does and how it relates to medicine. Throughout my childhood, I witnessed many public health disasters and I wanted to know what public health does in these types of situations and their powers and limitations. Many things have certainly changed since my first blog post. Now, I have a general understanding of all the areas of public health. I know that it covers many more areas of study than I initially thought it did and I now know that public health is intertwined with medicine, law, and politics. After taking more than two months of this class, I feel like I definitely have more respect for public health because it deals with saving the maximum number of lives as possible and the issues and problems that public health officials face are almost always as difficult if not more difficult than those that doctors face in the field of medicine. My public health interest has definitely increased as a result of taking this course because I am now aware to the numerous aspects of public health that are available for study. I definitely plan to take more upper level public health classes and pursue a major in this area of study.
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