RELATIONSHIP BETWEEN TYPE OF HOUSING ANDMALARIA INCIDENCE IN CHILDREN UNDER 5

YEARS OLD IN MUMIAS TOWN.

A RESEARCH PROPOSAL SUBMITTED IN PARTIALFULFILLMENT OF THE REQUIREMENT FOR THE

AWARD OF THE DEGREE OF BACHELOR OFSCIENCE IN NURSING, OF THE UNIVERSITY OF

NAIROBI.

BY:

OSUNDWAJULIANA-H32/2612/03SUPERVISED BY: MRS. CHEGE.

TABLE OF CONTENTS

Table of Contents II

Table of Contents III

Declaration IV

Certificate of Approval V

Acknowledgement VI

List Of Abbreviation VII

Operational Definitions VIII

Executive Summary IX

CHAPTER I1.0 Introduction 11.1 Statement of the problem 21.2 Justification of the Study 21.3 Research questions 31.4 Hypothesis 31.5 Main objective 31.6 Specific objective 31.7 Expected benefits of the study 3

CHAPTER II: LITEREATURE REVIEW

2.0 Introduction 42.1 Malaria in under Fives 52.2 Risk factor for increased malaria preference in Kenya 52.3 Housing and Malaria 6

II

CHAPTER III: METHODS AND MATERIALS

3.0 Study Design 8

3.1 Study area 8

3.2 Study population 9

3.3 Study Variables 9

3.4 Sampling 9

3.4.0 Sample size determination 9

3.4.1 Sampling method 10

3.4.2 Inclusion and exclusion criteria 10

3.4.3 Selection and training of research assistants 10

3.5 Data Collection Tools 10

3.5.0 Pre-testing the tool 10

3.6 Data cleaning, entry and analysis 10

3.7 Data Presentation 11

3.9 Control of biases and errors 11

3.10 Ethical considerations 11

3.11 Study Limitations 11

3.12 References 12

APPENDICES

Questionnaire / Checklist 15

Letter for seeking authority to conduct a research study 17

Consent Explanation 18

Respondent consent form 19

Financial budget of the study 20

Schedule of activities 21

III

DECLARATION

I, Osundwa Juliana, declare that this research has not been presentedfor award of degree or diploma in any university.

Signature: ~.' .

Date : ~f (1) (O}

IV

CERTIFICATE OF APPROVAL

This research proposal has been presented for examination for theUniversity of Nairobi with my approval as University supervisor.

M.N. CHEGE

Signature:~·r .

31!~OtDate:

v

ACKNOWLEDGEMENTI do wish to acknowledge my lecturers at the school of Nursing sciences,college of health sciences, University of Nairobi for the effort they haveput I helping me in developing my academic career. If it was not forthem, this work could not have been possible with the relative ease Ifound when I was going through it. You are all great!

I would also like to acknowledge my supervisor Mrs. Chege for keepingme on toes and always guiding me throughout the compilation of thisproposal.

Last but not least I wish to acknowledge my parents Wyc1iffeandGaudenzia Marunga for their encouragement and help which theywillingly offered me in terms of proof reading and financing the typing ofthe original script.

May God bless you all.

VI

List of Abbreviations

GOK Government of Kenya

HIVjAids Human Immunodeficiency Virusj AcquiredImmunodeficiency Syndrome

KMIS Kenya Malaria Information Centre

MDGs Millennium Development Goals

MOHjDOMC- Ministry of Health Division of Malaria Control

UON University of Nairobi

US United States

VII

Operational Definitions

Malaria Presence of plasmodium parasites in blood samples

Under Five - Any child who was born in the year 2003 and afterDrug resistance- Is the reduction in effectiveness of a drug in curing a

diseases or improving a patients symptoms.

Secundigravidae- A woman experiencing her second pregnancy

Primigravidae -Awoman experiencing her first pregnancyCerebral Malaria- Any disturbance of the CNS in a malaria infection

Adult Any man or woman 18 years and above in age and cangive consent for the study.

Guardian Anyone 18 years and above in age living with ortaking care of a child/ children below fiveyears of age.Also means anyone who is living with or taking care ofa parent who is a minor.

Instruments- Questionnaires and checklists for collectinginformation from the participants.

Parents who are minors- Any man or woman below the age of 18years who is a parent and cannot give consentfor the student.

Participant Any parent or guardian with children under fiveyears of age and has been accepted to take partin the study.

Prevalence Refers to the proportion of individuals in apopulation having a disease. Is the number ofcases of a disease present in a particularpopulation at a given time.

Well constructed house-A house completely plastered, brick walls, tiledor corrugated iron roofing, no cracks and notdamp.

Poorly constructed house- A house with incomplete and/ or mudwall, with grass roof. with cracks and isdamp.

Endemic Countries Countries in which malaria is present atall times.

An aspect of personal behavior of lifestyle, anenvironmental exposure or an inborn orinherited characteristic which is known to beassociated with health - related conditions.

Risk Factor

VIII

EXECUTIVE SUMMARY

This is a descriptive analytical study on prevalence of malaria in relationto type of housing in Mumias Town. Malaria is a major killer amongunder fives in Mumias town and this study will seek to determine thetype of housing in relationship to Malaria. The study will be done in twoestates Muslim Estate and NHC estate, among 322 study participantswho will be selected using random sampling. Data will be collected by myresearch assistants and I using the checklist as a tool.

Data will be analyzed using SPSS, and after publishing, findings will bemade available to all stakeholders in the health sector, including theMinistry of Health-Kenya, (MOH-GOK).People living in Mumias town andother stakeholders in the health sector.

IX

CHAPTER I

1.0 INTRODUCTION

Malaria is a febrile disease caused by infection of red blood cells byprotozoal organism of genus plasmodium. Infection causes acute andchronic types of fever, anemia and spleen enlargement and sometimescauses severe disorders of the brain, kidneys, liver and other parts of thebody (1)

About 60% of the cases of malaria worldwide occur in sub-SaharanAfrica with plasmodium falciparum causing majority of the infections. Insub-Saharan Africa malaria is also known to cause 118 % of the deathsin children under 5 years. (2)

Malaria is also a major cause of anemia in pregnant women, resulting inlow birth weight babies, premature births and increased infant mortality.In endemic African countries, Malaria accounts for 25-35 % of alloutpatient visits, 20-45 % of all hospital admissions and 15-35 % of allhospital deaths imposing a greater burden on already fragile health caresystems. (2)

In Kenya approximately 20 million people are exposed to stable malariatransmission with regular parasite exposure every year.major public health problem in Kenya with malariatransmission patterns varying across the country.epidemiological zones have been mapped out;

Malaria is aburden andFour major

I. Perennial high transmission near Lake Victoria and SouthCoast.

II. High transmission with seasonal fluctuation adjacent to theareas with perennial transmission

III. Stable transmission with seasonal peeks in most of the semi-arid and western highland regions.

IV. Lowtransmission risk in the arid and mountainous regions. (3)

The worldwide variation seen in the burden of malaria between differentregions of the world is driven by several factors one of which IS

differences in levels of socio-economic development; determinants ofsocio-economic development include; general poverty, quality ofinfrastructure, quality of health services and quality of housing. (2)

Financial support from the developed world for malaria andcommunicable disease control in developing nations is often short term

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