Prevalence rate of chloroquine-resistant malaria and its associated factors in some boarding schools in the Eastern Province of Zambia
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Malaria continues to be a major public health problem in many endemic countries of sub-Saharan African of morbidity affecting all age groups. Malaria incidence rates have tripled over the past 23 years from 1976 to 1999 (National Malaria situation analysis - Zambia 2000). As if this is not bad enough, the emergence of chloroquine -resistance has brought more devastating and more fatal consequences of malaria infections in the twenty first century. In Zambia, 95% of malaria infections are due to P. falciparum which is mostly associated with chloroquine - resistant and severe malaria.The main objective of this study was to estimate the prevalence rate of chloroquine-resistant malaria with its associated factors. The study design was a descriptive cross sectional study of two boarding schools in the eastern province of Zambia which was carried out between January and May 2002.The results indicated that the prevalence of chloroquine resistant malaria was 9.5% and was divided as follows:- early treatment failure 5.2 % and late treatment failure 4.3 %, giving a total treatment failure of 9.5 %. The pupils found with Parasiteamia were infected with P. falciparum, the parasite commonly associated with chloroquine resistance and severe malaria. All respondents had knowledge of at least two signs and symptoms of malaria. This indicated that they knew when to suspect malaria, when to seek treatment and when to suspect that chroloquine had not worked. All pupils in both secondary schools indicated that they had malaria several times before. Sixty one percent of the respondents indicated that either physical or laboratory examinations were done on them to confirm the diagnosis of malaria when they were sick and went to seek medical care. Sixty percent indicated that medical personnel at the clinic made diagnosis only when chloroquine treatment failed. All respondents confirmed that the school provided only chloroquine for treatment of malaria. Ninety percent of respondents indicated that they used mosquito nets when they went to bed to reduce the risk of repeated mosquito bites which may lead to infections. Fifty five percent of the respondents indicated that no spraying had ever been done in the dormitories while 45% said spraying was done only once since they entered school. Sixty percent responded that they closed windows while 40% said they did not close windows even at night because they were over crowded and they needed fresh air. Seventy six percent responded that they put on protective clothing as they went for prep at night to protect themselves from mosquito bites. The high usage of mosquito nets is attributed to the fact that in 2000, 'POWERNET company donated mosquito nets to the two schools.In this study a prevalence rate of 9.5 % of chloroquine - resistant malaria was found among the pupils of two boarding schools in the eastern province of Zambia. Therefore, continued use of chloroquine as first line drug for malaria treatment is recommend in this population where chloroquine resistance has not yet become a public health problem. This is in line with WHO recommendation that first line drug can be changed if resistance prevalence is 25% or above.Prevention and prompt treatment of chloroquine - resistant malaria will ensure healthier lives for the pupils and hence prevent interruption in their education.
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