Socioeconomic analysis of malaria burden in Gezira and Khartoum States

الموضوعات

اجتماع

الملخص

The overall objective of this study is policy-oriented, socioeconomic analysis of malaria burden in rural communities (Gezira and Gunaid schemes), compared to Mamoura urban community (Khartoum State). The achievement of the objective was attained through testing the hypotheses by exploiting of group’s discussions, questionnaires and interviews of the randomly selected samples. The pilot surveys provided the baseline data and enriched the available knowledge about the surveyed communities. Family lists were updated for sample size determination, using the relevant computer packages. The questionnaire considered the basic family information and the baseline data of the socioeconomics related to perpetuation of malaria infection and its complications. The obtained data were analysed utilising a microcomputer and the related technique of the Statistix statistical packages. The overall prevalence rate of malaria in Gezira was 40% and in Gunaid was 35.4%, while in Mamoura, was 31.1%. In the three areas, the infection rates among the males outnumbered those of the females, 51.1%, 51.1% & 34.5% compared to 30.2%, 24.9% & 27.4% respectively. The surveys ensured that the households’ educational level has significant inverse relationships to the prevalence of malaria infection. In Gezira, the most significantly affected occupants were the farmers (69.6%) and the agricultural labourers (57.1%), while in Gunaid the farmers (65.4%) and merchants (50%). In Mamoura, the most suffering occupants were the labourers (52.9%) and merchants (40.7%). In Mamoura, the prevalence rates increased exponentially with the age classes, while in the agricultural schemes the high rates were observed among the extreme age groups, the younger and the elders. In both Gezira and Mamoura, households with excreta disposal system, electricity and water supply were significantly suffering less than those without. In Gunaid, the conventional method of excreta disposal, water and electricity supply has no influential role in the rates of malaria infection. One-third of the Gezira community and one-half of each of Mamoura and Gunaid community complained that the cost of medical-services is beyond their financial means. Thus, seek the institutional, non-institutional assistance, traditional healers or even ignoring treatment. The ignorant group represents 16.6% in Gezira, 47.8% in Gunaid and 67.3% in Mamoura community. In Gunaid, half of the samples used to keep anti-malaria in home, for emergency usage, where 89.9% of them were infected. In Gunaid, 25% of the samples used to keep anti-malaria in home, where 62.5% of them were infected. The bulk of the Mamoura inhabitants (96.2%) do not keep antimalarial tools in home, where 49% of them were infected. In Gezira, 56.9% not used to look for the drug expiry-date, where 88.% were infected, while in Gunaid, 60.4%, not used to check the expiry-date of the drugs, where 90.5% were infected. In Mamoura, only 43.3% of the community used to look for the drug expiry-date, where their infection rate was 62.7%. In Gezira, 75.9% reassured that they were completely deprived from public-health services, while in Gunaid (66%) and in Mamoura (50%) assured that they enjoy some sort of public-health services. The bulk of the villagers, in the two schemes, know nothing about water-associated diseases, excluding malaria and Bilharzia. In Mamoura, all respondents ensured that only malaria is water-associated disease, where they know nothing about the intestinal worms, dysentery, Giardiasis or even Bilharzia. The infection rates of malaria, in the three communities, were inversely proportional to the awareness level of the households to the disease and its vector. In Gezira (65.5%), Gunaid (43.4%) and Mamoura (31.7%) of the villagers can identify the clinical features and the complications of malaria, where 58.6%, 82.6% and 57.6% experienced long-term impacts of malaria, respectively. In Gezira, 69%, of the respondents avoided malaria infection via “avoiding mosquito bites”, while 5.2% of the villagers used to take “regular prophylactics”. In Gunaid, 66%, of the samples “avoid mosquito bites”, while 3.8% taking “regular prophylactics”. The two surveys ensured that in agricultural communities like Gezira and Gunaid, some tactics were adopted for avoiding mosquito-bites, these include: lubrication by sesame oil, operation of roof-fans, and usage of normal or impregnated bednets. In the two schemes, very few villagers put on some smoke, use screened gates, petroleum-derivatives lubrication, and usage of the local perfumes. In Mamoura community (94.2%) of the responses concentrated on avoiding malaria infection by “avoid mosquito bites”. This could be achieved via insecticides application (34.6%), normal bednets (24%), put some smoke (15.4%), sesame lubrication (3.8%) and screened gates (1.9%). In Mamoura, there is no consistent pattern relating the number of active air conditions to the infection rates of the inhabitants. In Gezira 20.7% , in Gunaid 86.8% and in Mamoura 57.7% of the villagers used to store water at home, where 81.0%, 73.9% & 57.7% used to cover their water containers, respectively. The surveys stressed that some microecological niches inside the house yards enriched the transmission of malaria including the provision of the suitable resting sites for the vectors. In Gezira 69.3% and in Gunaid 57.3% were infected with malaria during the season (August-October), while 26.8% and 31.3% during (May-July) and few during (November-January), 3.9% and 11.4%, respectively. In Mamoura (77.3%) were infected with malaria during August-October, followed by November-January (14.4%), May-July (6.1%) and the least period February-April (2.3%). In Mamoura, 50% of the inhabitants used to work daily for at least 10 hours, where the survey highlighted a significant direct relationship between the number of daily working-hours and the infection rates. In the Gezira (60.4%) and in Gunaid (41.5%) of the farmers used to work daily for less than 6 hours, while (24.1%) and (41.5%) work for 6-10 hours and only (15.5%) and (17%), respectively, work for more than 10 hours a day. In the two schemes, the infection rates of malaria were significantly inversed the number of the working hours. In Gezira (84.5%) and in Gunaid (100%) of the farmers accompanied their family members in all steps of supervising the farm activities. In Gezira (86.2%) and in Gunaid (79.2%) of the household reassured that there was a shortage in agricultural labourers, at least during the harvest activities. From Gezira (66.7%) and from Gunaid (63.6%) compensate the shortage by renting labourers and (23.3% and 18.2%), by “Nafeir” system, respectively. In Gezira (84.5%) and in Gunaid (90.6%) of the farmers rely on the manual preparation of the land sowing, where they significantly suffering the infection. In Gezira only (12.1%) and in Gunaid (90.3%) need to absent themselves from work, when infected, for more than three days. In Gezira (27.6%) and in Gunaid (10%) of the households used to accompany their family members for nursing when infected. Concerning the school children, all of them, in the three areas, were obligated to take at least 3 days before resuming their academic activities. In Gezira and Gunaid, the absenteeism from work constituted (46.2% and 70.4%), while the school children scored (37.3% and 26.7%) and those for accompanying the hospital admission (13.6% and 2.9%), respectively. In Mamoura, the absenteeism from work constituted (76.3%), while school children scored (19.9%), and those for accompanying the hospitalized admission represented only (3.8%). In the three study areas, the total cost of infection had considered the expenses of the medical consultancy, laboratory diagnosis and the treatment costs. In Gezira (56.9%), Gunaid (73.6%) and Mamoura (57.7%) of the households used to consult medical officers (1000 Sudanese Dinars, SD), while 13.8%, 1.9% & 39.4%, respectively, encysted to consult only the specialized physicians (> 2000 SD). Regarding the cost of the laboratory diagnosis, in Gezira (77.6%), Gunaid (86.8%) and Mamoura (89.4%) reported (200-500 SD), while 20.7%, 11.3% and 10.6% respectively, ensured the cost is more than 500 SD. Concerning the costs of the treatment, in Gezira (60.3%) and in Gunaid (83%) reported a range between (500-2000 SD). In Mamoura, 71.2% reported less than 500 SD, while 21.2% stressed that the costs ranged between (500-2000 SD). Concerning the history of residence, 72% of the Gezira and 65.1% of the Gunaid villagers were resident since (1990-1995), who were the least suffering malaria infection, 28.4% and 22.4%, respectively. The relatively new comers, 1996-2000, 17.2% in Gezira and 21.2% in Gunaid, where 62.1% and 42.1% of them were infected, respectively. The very recent comers (2001- 2005) represents 10.8% in Gezira and 13.7% in Gunaid, where 82.9% and 87.1% of them were infected, respectively. Like Gezira and Gunaid, (39.9%) of Mamoura population were resident since 1990 – 1995, with the least infection rates, 11.6%. The new arrivals (1996- 2000) like the above proportion, 38.6%, where 37.3% of them were infected. Concerning the recent arrivals (2001- 2005) to the Mamoura represents more than one-fifth the population, 21.5% of the total population, but unfortunately 56.4% were infected. The investigation stressed that 77.6% of Gezira and 79.2% of Gunaid have moderate monthly income, 25,000-100,000 SD. It also ensued that 10.3% and 5.7% have a relatively high income (> 100,000 SD), while only 12.1% and 15.1%, respectively, have a low income (< 25,000 SD). The analysis of the three surveys recapitulated that there was a significant negative relationship between the monthly income of the households and the infection rates of malaria. The Gezira findings stressed that the production of both sorghum and peanut was directly related to that of cotton. In this way, the revenue from these agricultural products is used to finance the cotton production that gives the positive coefficient, as suggested by regression analysis. On the other side, the regression analysis of the Gunaid findings ensured that many factors influentially affect the sugar production. These include: the educational level, labour type and shortage and its replacement, the number of episodes and the type of Hawasha possession. In Mamoura, the regression analysis pointed out that the containers uncoverage, vegetation cover, accommodation type and dosage incompletion have negative effect on malaria infection. The findings were linked to those obtained from some African countries, where a final conclusion was drawn \\\\\\\"the cost-effective malaria interventions can not be made by stroke of a pen or a magic pullet\\\\\\\". It relies on a concrete baseline data on micro-epidemiological and socioeconomical foundations, thus, real and meaningful interventions should be adapted to the specific local ecological, epidemiological and socioeconomic conditions. The vital role of the integration between biomedical and socioeconomic sciences to eliminate ill-health and transmitted diseases from the community, was stressed. The villager\\\\\\\'s KAP that assist in transmission of the disease was analyzed considering the interdisciplinary approach for the cost-effective control of malaria. Finally - based on the findings of the investigation, some effective measures for combating the disease were recommended

روابط وملفات

التعريف والنوع

رقم الوثيقة

0e6c20df-2b96-4964-8ce2-57d155c0fbea

رقم العقد

0

نوع الوسائط

Crawler

نوع المحتوى

الرسائل العلمية

صيغة المصدر

رسائل دكتوراة

نوع الملف

pdf text

أسماء الملفات

1632286_1.pdf

بيانات النشر

ألقاب المؤلفين

[{"name_ar":"Lammyaa Ali El Tash","title_ar":"اعداد","title_en":"Preparation"},{"name_ar":"Mohamed Hashim Awad","title_ar":"اشراف","title_en":"Supervision"},{"name_ar":"Moneif Abd el Bagi","title_ar":"اشراف","title_en":"Supervision"}]

اللغة

English

المصدر والدورية

اسم المصدر

Socioeconomic analysis of malaria burden in Gezira and Khartoum States

المحتوى والصفحات

عدد الصفحات

0

إشراف وإعداد

الإشراف

Mohamed Hashim Awad, Moneif Abd el Bagi

الإعداد

Lammyaa Ali El Tash

الاقتباسات الببليوغرافية