The Prevalence of Malaria in Northern Nigeria

The Prevalence of Malaria in Northern Nigeria Epidemiological Overview Generally, malaria is widespread throughout most of the tropics globally. However, according to Bradley (1992), the epidemiology of malaria has been characteristically varied across the globe because of malaria’s largely diverse vectorial capacity (p. 1). Out of the approximately 3.4 billion people who are globally prone to malaria infections annually, about 1.2 billion are at a higher risk. The World Health Organization (2013) reports that in 2012 alone more than 207 million people developed symptomatic malaria. Between 2000 and 2010, the figures released by the WHO report are, to some extent, encouraging as the number of reported annual malaria incidences in 34 malaria-eliminating countries decreased by 85 % from 1.5 million to 232, 000 cases (WHO, 2013). However, from the same report, the global malaria deaths reached a high of 1.82 million in 2004 and considerably fell to 1.24 million in 2010. Among the deaths reported in 2010 were 714,000 children below the age of 5 and 5 24,000 individuals above the age of 5. However, shockingly, the World Health Organization (2013) reports that over 80% of malaria deaths occur in the sub-Saharan Africa. Shockingly, the Nigeria Malaria Indictor Report (2012) reports that Nigeria and the Democratic Republic of Congo account for over 40% of the total malaria deaths globally. This revelation has led to several concerted efforts in the two leading countries aimed at addressing the prevalence of malaria. Malaria Situation in Northern Nigeria Nigeria is ranked as one of the most populous countries in Africa with a population of approximately 170 million according to the 2013 population statistics and an estimated annual growth rate of 2.6% (Malaria Operation Plan, 2013). The 2010 United Nations Development Program Human Development Index ranks Nigeria at position 142 out among 169 countries (WHO, 2013). The country has an estimated under-five mortality rate of 157 per 1000 live births and maternal mortality is estimated at 545 per 100,000 live births according to the 2008 Demographic and Health Survey (Okafor Oko-Ose, 2012). The southern part of Nigeria is significantly advantaged in almost all social and economic indicators. In this regards, both the child mortality and maternal mortality are relatively higher. For instance, Okafor Oko-Ose (2012) illustrate that the under-five mortality rates are about one and a half times higher while the maternal mortality rates are about three times higher as compared to some northe rn parts of Nigeria. Contrastingly, despite the high income attributed to the sales of crude oil, no significant improvement has been recorded and majority of the Nigerians, especially the Northerners live in abject poverty (Malaria Operation Plan, 2013). About 97% of the Nigerian population is at risk of Malaria infection with the majority being those living in Northern Nigeria according to a research conducted by the Nigeria Malaria Index Survey (2010). Specifically, research has found out that incidences of malaria transmissions account for over 60% of outpatient visits and 30% of inpatients in Nigerian healthcare institutions. Incidentally, malaria infection is a primary cause of children mortality and contributes to an estimated 225,000 cases of deaths annually (WHO, 2013). Malaria also contributes to an estimated 11% of maternal mortality and about 105 of low birth weight according to NMCP Strategic Plan 2009-2013. The geographic location of Nigeria makes the climate condition to be ideal for malaria transmission nearly throughout the country. In fact, the remaining 3% of the entire country’s population, who are relatively at a low chance of infection, actually live in the mountainous regions in the southern parts of Nigeria (Jos Plateau State) with an altitude of between 1,200 to 1,400 metres. A series of studies have been conducted to elucidate the effect of seasonal changes on epidemiological index of malaria transmission in Northern Nigeria. Undeniably, the climatic condition of Northern Nigeria is seasonal with rainy seasons in May-October, dry season in December-March and transitional period in April-November (Malaria Operation Plan, 2013). However, studies on the prevalence of malaria in Northern Nigeria have shown that malaria transmission has been predominant during the rainy season and lowest during the dry season. Gender Distribution and Prevalence of Malaria Transmission Generally, studies have shown that Plasmodium infections appear more common in the male than in the females in Northern Nigeria. For, example, a study conducted to ascertain malaria occurrences among children aged six months to eleven years in Benin City presented a shocking result. According to the findings of the research, malaria transmission from 2004 to 2009 in male averaged at 57 % while during the same period under review, the transmission in females was at an average of 43% (Okafor Oko-Ose, 2012). A similar research conducted in the Northern Nigeria’s Ebonyi and Edo States in 2004 made a similar conclusion. This prevalence has been attributed to the fact that males expose their bodies more than females especially when the weather is hot. In that regards, males are more likely to be bitten by mosquitoes. On the other hand, Okafor Oko-Ose (2012) explain that females tend to stay indoors, helping out with normal household chores. This significantly reduces their contact with the mosquito vector. Either, studies have shown that females have relatively better immunity to parasitic diseases due to their hormonal and genetic composition. Age Factor and Malaria Prevalence Based on age, studies have shown that children aged  ½ 2 years have the highest prevalence in malaria transmission (Okafor Oko-Ose, 2012). According to the research conducted in Benin City in Northern Nigeria among children aged  ½ to 11 years, it was realized that children aged  ½ -2 years recorded the highest prevalence of 58.6% followed by the age bracket 3 – 5 years at 30.5% and the least being age group 9-11 years at 2.9%. Basically, we can conclude that children under the age of 5 years are more prone to incidences of malaria transmission. In general, malaria transmission is in a declining trend. A finding carried out in 1999, for instance, in Erunmu in southwest Nigeria reported about 80% malaria parasite prevalence among school children. A similar research conducted in Benin City, according to Okafor Oko-Ose (2012) clearly showed this decline in prevalence. In 2004, the prevalence among children of  ½ 11 years was 47%. By 2009, the prevalence had dropped considerably to 32%. Through the period under consideration, the overall prevalence of malaria was reported at 36.4%. In a nutshell, this decline can be attributed to the effect of some preventive measures against malaria that has been adopted by the Nigerian Government. Health Determinants and their Influence on Malaria Prevalence Many factors combine together to affect the health of individuals and communities in a particular area. The Health Impact Assessment (2014) explains that the environment and the circumstances that people live in extensively determine whether people are healthy or not. To a larger extent, factors such as where an individual lives, the state of the environment, genetics, income, education level and our relationship with friends and families all have significant impact on health. However, on a more specific note, determinants of health include the social and economic environment, the physical environment and the individual’s characteristics and behaviors (The Health Impact Assessment, 2014). This paper will elucidate the impact of socio-economic environment and the physical environment on malaria transmission in Northern Nigeria based on both social economic environment and the physical environment. The Social and Economic Environment Malaria has predominantly been linked with poverty and the reduction of the propensity of malaria has become a major priority for the Nigerian Government for a long period of time. In particular, malaria is a leading cause of both child and maternal mortality and morbidity in Northern Nigeria that is relatively of a lower social and economic rating (WHO, 2013 and Nigeria Malaria Indicator Survey 2010). The economic burden of malaria illness on households accounts for almost 50% of total economic burden of illnesses in the Northern regions of Nigeria. Further, multiple studies have noted that individuals of lower social and economic status bear a disproportionate burden of the parasitic disease and have poor health seeking habits and at times lack necessary health facilities. Generally, research has shown that up to 58% of malaria transmission occurs in the poorest 20% of the world population who, incidentally, receives the worst care and has disastrous consequences from the illness ( WHO, 2013). More specifically, there is a heavy malaria burden on the poor than on the rich as demonstrated by recent studies in Northern Nigeria States and in the cities states. According to this research, individuals with an estimate income of less than N300 per day (earning less than a dollar per day) were less likely to perceive malaria as a preventable disease and subsequently recorded more incidences of malaria per month as compared to those who earned less than N300 per day (Yusuph, 2010). Arguably, the rural dwellers of the Northern Nigeria have a higher risk of infection than their counterpart urban residents. The current statistics indicate that between 6% 28% of the malaria burden may occur in urban areas which comprise only 2% of the entire African surface (Yusuph et al., 2010). There could be a relationship between this predominance to the socio-economic status of people living in both rural and poverty-ridden regions. Evidently, members of lower socio-economic societies live in environments that offer little or no protection against mosquitoes and they are also less likely to afford the insecticide-treated mosquito nets. Clearly, higher social and economic status groups and urban residents posses more malaria preventive tools and therefore, report few incidences of malaria. In addition, low socio-economic status groups are unlikely to pay either for effective malaria treatment or for transportation to a health facility capable of treating the scourge. The Physical Environment Geographically, malaria is transmitted due to the interaction between the malaria mosquito parasite and the human environments (The Health Impact Assessment, 2014). The geographical location of Northern Nigeria presents a key ingredient to the breeding and existence of the malaria-causative parasite. The Progress Impact Series Country Reports (2012) describes Nigeria’s climate as tropical climate with alternating wet and dry seasons throughout the year which is suitable for malaria transmission. Presence of mangrove swamps, the rain forest, the guinea-savannah, the Sudan-savannah and the Sahel-savanna that extends from the South to the North of Nigeria determine the intensity, seasonality and duration of malaria transmission. On the other hand, apart from the climatic condition, the Northern States of Nigeria have access to inadequate physical facilities, safe water, medical facilities and poor infrastructure that presents a daunting challenge to the prevention or treatment o f malaria infections. Prevention Strategy based on Social and Economic Status This paper has emphasized on the major public health challenges that high prevalence of malaria presents to the people of Northern Nigeria. The most biologically vulnerable group, as have been noted, are the children below the age of five and pregnant women, perhaps due to their comparatively lower immunity status (Mazumdar Guha, 2013). Basically, most of the malaria transmissions occur among the poverty ridden residents of the Northern Nigeria. Social and economic background has been distinctively demonstrated by this paper as a major health determinant in malaria transmission in the northern parts of Nigeria. With the highly perturbing statistical information on malaria transmissions and prevalence in Northern Nigeria, there is a need for an infective and inclusive preventive plan that addresses the most biologically vulnerable group and their social and economic factors that determines their health. Consequently, this papers outlines a four dimensional preventive strategy that is undoubtedly capable of containing the mortality and morbidity among children and expectant women. This preventive strategy summarily focus on management of transmission cases, prevention of malaria with insecticide-treated nets, indoor residual spraying to reduce transmission and finally the use of intermitted preventive treatment and the use of intermittent preventive treatment for pregnant women. Prompt Diagnosis and Treatment This strategy focuses on timely diagnosis and effective treatment of cases of malaria infections by use of relevant anti-malarial drugs. This strategy is aimed at ensuring that up to 80% of the population, mostly children below the age of 5 and the pregnant women, who are at risk of malaria take timely and necessary treatment at the initial stages of infection. Under this strategy, there is need for provision of free necessary anti- malarial drugs like Artmether-Lumefantrine (Mazumdar Guha, 2013). There is also a need for a home based care management system especially for the most vulnerable population, that is, children below the age of five. The complexity of this strategy requires a multidimensional approach and involvement by the public sector, the private sector and the faith based health facilities for effectiveness. Distribution of insecticide-treated nets (ITN) This strategy is intended to prevent malaria transmission to a larger population especially the most vulnerable children under the age of 5 and the pregnant women. Under this strategy, pregnant women and children under the age of five are to be provided with free insecticide treated mosquito nets. These nets should be provided to the expectant women when they attend their ante natal care services in designated health facilities. This scheme also proposes the use of relatively long lasting insecticide nets so as to address the social and economic challenges that bedevils most of the vulnerable groups. Indoor Residual Spraying The Indoor Residual Spraying (IRS) is geared towards curtailing the transmission of malaria in both the pregnant women and children under the age of five. This program requires entomological monitoring and proper management of insecticide resistance especially among the ignorant population that are characteristic of a low social economic majority. It also requires behavior change communication with the target population and technical assistance and training especially to the personnel in the indoor residential spraying exercise. Intermittent Preventive Treatment for Expectant Women This last strategy primarily focuses on regulation of malarial prevalence among expectant women. Statistical data that only 58% of pregnant women by 2008 had access to antenatal care from relevant service providers while 62% of expectant women successfully delivered at home elucidates the extent of socio-economic disparity and the need for effective preventive treatment programs for pregnant women. Ideally, a couple of factors contribute to low utilization of health facilities by expectant women. Primarily, inadequate or poor quality of antenatal services, expensive cost of the services and ignorance on the need to attend antenatal services indisputably discourages expectant women from utilizing antenatal services from relevant health facilities. As a preventive measure to the challenges facing expectant women, this strategy identifies specific drugs that can effectively fight malaria in expectant women. The Intermittent Prevention Therapy (IPT) and Sulphadoxine-Pyrimethamine (SP) ha ve been identified as effective malaria prevention among this vulnerable group. These drugs should be administered freely to the women since majority of them may not be able to afford such drugs. In conclusion, this paper reaffirms the need to address the malaria menace especially in the sub-Sahara Africa and other tropics. The paper lays emphasis on the prevalence of this scourge on children under the age of 5 and pregnant women. The paper also extensively discusses how socio-economic factors and physical environments contribute to the prevalence of malaria infections especially in poor neighborhoods in Africa and Northern Nigeria in specific. This paper presents a preventive strategy that focuses on the most vulnerably group. Reference Bradley, D. J. (1992). Malaria: Old Infections, Changing Epidemiology. London: London School of Hygiene, in Health Transition Review Vol. 2. Supplementary Issue 1992. Health Impact Assessment (2014). The Determinants of Health. WHO. Retrieved from http://www.who.int/hia/evidence/doh/en/ Malaria Indicator Survey (2010). Final Report. Retrieved from http://dhsprogram.com/pubs/pdf/MIS8/MIS8.pdf Malaria Operational Plan FY 2013. President’s Malaria Initiative. Retrieved from www.pmi.gov/countries/mops/fy13/nigeria_mop_fy13.pd Mazumdar S. Guha, P. M. (2013). Prevention and Treatment of Malaria in Nigeria: Differential and Determinants from a Spatial View. Retrieved from http://uaps2007.princeton.edu/papers/70579 Okafor, F. U. Oko-Ose, J. N. (2012). Prevalence of Malaria Infections among Children aged six months to eleven years in Benin City, Nigeria. In The Global Advanced Research Journal and Medical Sciences Vol. 1 (10) p. 273-279, November, 2012. Retrieved from, http://garj.org/garjmms/pdf/2012/november/Okafor and Oko-ose.pdf Progress Impact Series Country Reports, No. 4 (2012). WHO. Retrieved from http://www.rbm.who.int/ProgressImpactSeries/docs/report11-en.pdf Report on Nigeria Malaria Indicator Survey (2010). Retrieved from http://dhsprogram.com/pubs/pdf/MIS8/MIS8.pdf Yusuph, O. B. et al. (2010). Poverty and Fever Vulnerability in Nigeria: A Multilevel Analysis. In Malaria Journal. Retrieved from http://www.malariajournal.com/content/9/1/235 World Health Organization. World Malaria Report (2013). Retrieved from www.who.int/iris//9789241564694_eng.pdf

Colonial Representations of India in Prose Fiction :: Essays Papers

Colonial Representations of India in Prose Fiction As in representations of the other British colonies, India was used by colonial novelists as a tool of displacement of the individual and re-affirmation of the metropolitan whole. There are three methods by which this effect is achieved. The first method displays an unqualified reliance on a culture too remote to be approached except physically: a hero or protagonist in a pre-mutiny novel is at liberty to escape to India at a moment of crisis, rearrange his life to his advantage and return to a happy ending and the establishment of a newly defined metropolitan life. Dobbin of Thackeray's Vanity Fair (1848) and Peter Jenkins of Gaskell's Cranford (1853) exemplify this well. Even the child Bitherstone of Dickens' Dombey and Son (1848) regards India as his salvation. The second method demonstrates the duality of the post-mutiny era. We are told by Patrick Brantlinger that the earliest work of fiction to deal with the mutiny is "The Perils of Certain English Prisoners", a collaboration by Dickens and Wilkie Collins in the Christmas 1857 edition of Household Words . Wilkie Collins's The Moonstone (1868) revolves around the theft and reclamation of the Koh-i-Noor and creates an ambiguous point of antagonism between Brahmin and Englishman. The Brahmins cannot be said to be wholly right or wrong in their dealings with the stone and it is the British Ablewhite who is portrayed in the most one-dimensional manner and who is cast almost as penumbra to the issues redefining the character of the former. However, only eleven years after the Mutiny, Collins's Indians remain at all times a threatening presence subject only to the most tenuous negotiation:- the reader must not forget that they belong to the realm of the non-rational. Collins' Brahmins, unaware that they are observed, participate in magical rites and his Hindus, en masse, typify Romantic notions of Man's ideal union with Nature. As re-affirmation, they reconfirm the relationship between the central characters. The third method again demonstrates the duality of the post-mutiny era but with more emphasis on reconciliation. Later novels such as Rudyard Kipling's Kim (1901) or E. M. Forster's Passage to India (1924) attempt to remove either the Indian character from the confines of previous stereotype or the Anglo-Indian character from the confines of automatic moral superiority. Colonial Representations of India in Prose Fiction :: Essays Papers Colonial Representations of India in Prose Fiction As in representations of the other British colonies, India was used by colonial novelists as a tool of displacement of the individual and re-affirmation of the metropolitan whole. There are three methods by which this effect is achieved. The first method displays an unqualified reliance on a culture too remote to be approached except physically: a hero or protagonist in a pre-mutiny novel is at liberty to escape to India at a moment of crisis, rearrange his life to his advantage and return to a happy ending and the establishment of a newly defined metropolitan life. Dobbin of Thackeray's Vanity Fair (1848) and Peter Jenkins of Gaskell's Cranford (1853) exemplify this well. Even the child Bitherstone of Dickens' Dombey and Son (1848) regards India as his salvation. The second method demonstrates the duality of the post-mutiny era. We are told by Patrick Brantlinger that the earliest work of fiction to deal with the mutiny is "The Perils of Certain English Prisoners", a collaboration by Dickens and Wilkie Collins in the Christmas 1857 edition of Household Words . Wilkie Collins's The Moonstone (1868) revolves around the theft and reclamation of the Koh-i-Noor and creates an ambiguous point of antagonism between Brahmin and Englishman. The Brahmins cannot be said to be wholly right or wrong in their dealings with the stone and it is the British Ablewhite who is portrayed in the most one-dimensional manner and who is cast almost as penumbra to the issues redefining the character of the former. However, only eleven years after the Mutiny, Collins's Indians remain at all times a threatening presence subject only to the most tenuous negotiation:- the reader must not forget that they belong to the realm of the non-rational. Collins' Brahmins, unaware that they are observed, participate in magical rites and his Hindus, en masse, typify Romantic notions of Man's ideal union with Nature. As re-affirmation, they reconfirm the relationship between the central characters. The third method again demonstrates the duality of the post-mutiny era but with more emphasis on reconciliation. Later novels such as Rudyard Kipling's Kim (1901) or E. M. Forster's Passage to India (1924) attempt to remove either the Indian character from the confines of previous stereotype or the Anglo-Indian character from the confines of automatic moral superiority.

Cultural Insularity

River Faller developed near the Indus river In the middle east Mesopotamia= developed between the Tells and Euphrates River Elms and Chapin= both help develop the Mayans and the Incas Empire Pastoralist: Primarily the tending of animals= provided food and hides provided clothes and shelter â€Å"Nomads†= herding the animals from one place to another Helped spread ideas= would trade with nearby civilizations/settlements The Peopling of the Earth: Europe= one of the beginning areas to start populating Asia= the next area to be populatedSouth & Central America= the final area to be peopled through the Bearing land bridge Art: Venus Figurines- used for the worshipping of women: belief In fertility oracle Bones- where questions were written on them in which they were used to receive answers from deities in Sang dynasty Code of Hamburg= law codes to help control civilians in Mesopotamia Other Names: NONE Accurate time span: 500 B. C. E to ACE Top five Monotheistic religion a. Judais m- Major In the Mediterranean; Jesus was Jewish, Jesus† dad was god, therefore they worshipped god. They worshipped one god. A god. THE god.Yaw b. Zoroastrian – Major in The Persian Empire. It was a quasi monotheistic religion, however, there were other gods that they believed had a little amount of power that are bad. But they mostly worshiped ONE god. C. Christianity – Major in the Roman Empire, it persisted in Roman empire despite resistance by Romans Empires Roman- large empire with borders which stretch across different ethnicities/beliefs. Han- attempted centralized gobo with heavy dependency on silk road. Collapsed due to the inability to prevent the development of factions in government in court that reverted a centralized gobo.Persia- state organized in satrapies, religiously tolerant (Cyrus the Great). Great transportation and communication Murrain- fighting BTW regional kingdoms,united by Marry dynasty(Osaka) Guppy-After the Marry,fell to white Hung,re gional governors Long distance trade Silk Road- Located in East Asia traded spices, porcelain and other goods along trade routes Indian Ocean Basin- Connected all of the Mediterranean countries with India and South East Asia Trans- Sahara Trade- connected all of the Sahara AfricaPersian Royal roads and post office Prone to governmental decline Patriarchal society China -footslogging in China- showed the female dependency on men Confucius roles of women: India -Inhabitant, Ramadan: portrayed women as weak-willed and emotional; exalted women who served their husbands devotedly Rome – Pater Familial: roman law that invested authority in the head of the household. Constantinople -Women withdrawn from public festivities; fear of compromise of honor Islamic Empire – Women increasingly covered; couldn't leave house without male attendant of the family.An Age of Cross Cultural Interaction Post Classical Era Time pennon: 600 CE to 1450 -rope 5 List: BOB trade systems Spread tec hnology such as gunpowder, paper and the printing press Allowed the formation of economies based mostly on trade, instead of agriculture Spread cultural traditions such as Islam, Buddhism and Christianity Byzantium Schism- Roman Catholic/Eastern Orthodox Constantinople: major center of trade and silk production Suffered the fate of most empires: got too big and eventually disintegrated Islam Started in Arabia spread to Mesopotamia, Africa, Mediterranean.Muslim Merchants/ Suffix spread Islam all over the world reaching lands such as India, Anatolia Mongols Pox Mongolia: After their conquests were over, they integrated the world into a single empire and encouraged trade so that cultural interaction spread exponentially. Because of their culturally integrated empire and the peace they spread, the Bubonic plague spread quickly and was drastic towards the world's population Emphasized religious tolerance Cultural Flourishing Renaissance: in Western Europe, a period of cultural flourishin g and revival of Greece-Roman tradition Islam: a boom in artwork, medicine, mathematics, humanities, science and logic as well as the translation of Greek literature/philosophy Tang Golden Age Early Modern Era Other Name: The Origins of Global Interdependence Accurate time-span: 1500-1800 1 . Religious Controversy – Protestant/ Catholic Reformations – Schism in Russian church – Spanish Inquisition 2. Scientific Revolution/ Enlightenment – New ideas on the interpretation of the world- Galileo, Isaac Newton – Adam Smith's introduction of capitalism – Theory of Progress 3.Nations becoming closed off to outside influences (Cultural Insularity) – Borrowed technology, but weren't open to political or cultural influences – Only exception is Russia; westernizes under Peter & Catherine the Great – Ottomans, Japan 4. State Building – Unification of Japan under Outgas Baku – Europeans attempt to revive the Carolingian empire with the Holy Roman Empire – Islamic Empires– Ottomans, Savvied & Mussels 5. Trans-oceanic voyages – James Cook exploration of New Zealand, Australia & Hawaii – Christopher Columbus – Columbian Exchange

Movie Review The Rundown - 783 Words

The Rundown After viewing the movie, The Rundown, the main stars of the movie are Dwayne Johnson as Beck, Seann Williams Scott as Travis, Rosario Dawson as Mariana, Christopher Walken as Hatcher, Edwen Bremner as Declan, Stephen Bishop as Quarterback, and Jeff Chase as Kambui. I would recommend this movie to people who like action- adventure movies. It was a very good movie with lots of action and it was a funny. Beck is my favorite character in the movie because he is generous and an excellent fighter without being armed. However, Hatcher is my least favorite, he’s cruel and greedy. Beck is a highly paid retriever of vital missing things like jewelry, weapons, and people. Beck requests to open his own restaurant, because he is in huge debt, he takes the bounty hunter job. Becks last job is to find a mobster son, Travis Walker, a Stanford failure living in the Amazon. If Beck transports Travis home, he will receive two hundred-fifty thousand dollars. He could stop bounty hunting and open his restaurant with the money. Travis went to Brazil to look for El Gato Diablo, which is a well-known idol, which he could sell for millions if he found it. Beck hires a small plane which the pilot is named Declan. As Declan is flying in the Amazon he shouts some verses from the bible. Declan informs Beck about the rebels in the jungle who are cruel. The rebels hide out in the jungle. A small tavern in the Amazon, Travis ask Mariana a bartender if he could borrow her unclesShow MoreRelatedThe Shawshank Redemption Is A Legend Of The 1990s1232 Words   |  5 Pagesacclaimed as the best prison movie to this date according to IMDb (Stenberg). Many movies following The Shawshank Redemption have tried and failed in their attempts to recreate this behemoth of a movie. 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