DNP-825 Epidemiology Report: Malaria in Children Under Five Analysis

This report examines the vulnerability of infants and children under five to malaria, particularly in Sub-Saharan Africa. It highlights that this population group faces a disproportionately high risk of mortality due to the disease. The report presents statistical data, including death rates and trends from 2001 to 2017, emphasizing the severity of the issue. It identifies key nursing interventions to control malaria, such as insecticide-treated nets (ITNs), indoor residual spraying (IRS), and larval control, and also discusses the importance of stakeholder engagement. Furthermore, it addresses challenges in implementing these interventions, including unilateral implementation, inadequate policy development, and structural problems, proposing solutions for more effective malaria control strategies. The report concludes by reiterating the importance of comprehensive approaches to reduce malaria cases and protect the most vulnerable populations.

Running header: Malaria: Infant and Children Under Five 1
Malaria: Infants and Children Under Five
Name:
Institution:

Malaria 2
There is no doubt some population groups are considerably at a higher risk of contracting
various diseases than others. Notably, Malaria tends to affect various group populations, which
include pregnant women, infant, and children under five, HIV and AIDs patients, and migrants
or mobile populations (WHO, 2018). Malaria is a disease caused by Plasmodium parasite and
transmitted through bites of infect female mosquito (Anopheles); however, the disease is not
only preventable and curable. The WHO (2018) report exhibit that in 2017, 435,000 deaths
across the globe were caused by Malaria; moreover, approximately there were 219 million cases
of Malaria. Notably, Africa reported the highest incidents of Malaria across the world whereby
the continent recorded 91% of the death. Therefore, the following study seeks to exhibit how the
infant and children under five in Africa, especially the Sub-Saharan countries, are the highly
vulnerable population group affected with Malaria.
In Africa, 285,000 infants and children under the age of five tend to face death before
reaching the age of five (WHO, Malaria in children under five, 2018). Notably, there is a strong
relationship between pregnant women and infant. For instance, Malaria during pregnancy
increases the risk of stillbirth, neonatal death, and low birth weight, which result in infant
mortality. Moreover, children born and living in endemic areas are considered vulnerable to
Malaria, particularly when the acquired immunity from the parent begins to wane (WHO,
Malaria in children under five, 2018). Moreover, children tend to face other severe features
associated with Malaria, which include hypoglycemia, cerebral Malaria, and severe anemia. As a
result, the study used data sourced from Our World with Data to show the level of vulnerability
to this population group (Roser & Hannah, 2017). Moreover, the statistical analysis was done
using SPSS statistical package version 21.

Malaria 3
The following tables exhibit the average number, and rates (per 100,000) of deaths
associated with Malaria categorized age group, which include under 5, 5-15, 15-49, 50-69, and
above 70 years in Africa from the year 2001 to 2017.
Descriptive Statistics Number of Deaths
N Minimum Maximum Mean Std. Deviation
Under5sdeaths 17 327762.477 571118.523 476356.767 86752.258
@514yearsolddeaths 17 39321.841 58151.670 50921.381 6800.554
@1549yearsolddeaths 17 89111.323 101821.886 94495.663 4746.21
@5069yearsolddeaths 17 59357.008 65565.527 62113.429 2175.539
@70yearsolddeaths 17 24549.167 29292.871 27174.172 1709.990
Valid N (listwise) 17
Descriptive Statistics Rates of death (per 100,000)
N Minimum Maximum Mean Std. Deviation
Under5sper100000 17 200.613 465.389 346.044 95.731
@514yearsoldper100000 17 14.147 30.977 23.481 6.115
@1549yearsoldper100000 17 18.574 30.783 24.778 4.466
@5069yearsoldper100000 17 77.300 128.131 103.988 18.322
@70yearsoldper100000 17 135.309 231.053 189.544 33.714
Valid N (listwise) 17
As evident, children under 5 recorded the number of deaths in all descriptive statistics
(minimum 327,762, maximum 571,118, and mean 476,356). Moreover, it is exhibited that
infants and children under 5 recorded 200 per 100,000 deaths associated with Malaria.
The graph below exhibits the trend of number of deaths associated with Malaria in Sub-
Saharan Africa whereby it is evident that the despite a decrease in the number of deaths across
the years (2001 to 2017) infants and children under the age of five are more vulnerable compared
to other population groups.

Malaria 4
As evident, the population group of infants and children under the age of five is
profoundly affected with the disease as compared to other groups, thus it essential to adopt
various nursing interventions to curb this challenge. Three primary nursing interventions aid in
controlling the disease include the adoption of insecticide-treated nets (ITNs), indoor residual
spraying (IRS), and larval control (WHO, World Malaria Report, 2011). The ITNs reduces the
level of Malaria by 35%; thus, it is recommendable for households in areas vulnerable to the
disease should acquire the ITNs. Notably, the ITNs should be provided to the households either
on free charges or subsidized rated. Besides, efficient adoption of ITNs depends on Behavioral
change interventions, which include information, communication, and education workshops and
campaigns, which aid in educating or training the users on proper maintenance and usage of the
nets. Consequently, the nets adopted should be recommended by the WHO evaluation schemes
and assessed by the national malaria control programs.
It is exhibited that Malaria is transmitted to people through bites of infect female
mosquito (Anopheles) thus is essential to use other methods that may control the insect, IRS. IRS

Malaria 5
is a vital nursing intervention used in controlling various epidemics; thus, it will aid in
controlling the disease; however, the mechanism requires efficient spraying equipment and
technique (WHO, World Malaria Report, 2011). Notably, there are 12 insecticides used to
control; hence, various agencies need to guide the households on various efficient and eco-
friendly insecticides. For instance, despite DDT used as an insecticide, it has a higher residual
efficacy (more than six months); thus, the mechanism should be adopted to control similar
products. Moreover, a vital method of reducing the population of this insect is through larval
control whereby the households are trained on various methods destroying the breeding sites,
such as stagnant water.
Notably, the success of the above interventions depends on the collaboration of various
stakeholders and agencies. The engagement of multiple stakeholders aid in various processes,
such as program planning, evaluation, implementation, and sustainability (Ingabire, Kateera,
Hakizimana, & Rulisa, 2016). Therefore, the essential stakeholders for the above interventions
include the government and agencies to fund the programs and aid in policymaking strategies;
moreover, it is essential to incorporate administrative and health institutions to offer training to
the households on various method to prevent the disease. However, there are multiple challenges
that tend to affect the adoption of the interventions, which include unilateral implementation of
interventions, inadequately informed policy development, and structural problems, among others
(Mwendera, et al., 2019). The reduction of the Malaria cases in children under five requires full
adoption of the above strategies rather single strategy (unilateral implementation of
interventions). The above challenge can be resolved through government intervention to fund all
the strategies used to curb Malaria.

Malaria 6
Inadequately informed policy development exhibits that adopt interventions without
public participation, workshops, or training, which leads to the development of top-down
policies. The above challenge is resolved by creating platforms for the policymakers to engage
both the local community and influential personnel (politicians). On the other hand, structured
challenges, include inadequate equipment, such as ITNs and spraying materials, and shortage of
health workforce. The problem is resolved through government and agency intervention to fund
and train more medical personnel.
Conclusion
As evident, Malaria tends to affect various group populations, which include pregnant
women, infant, and children under five, HIV and AIDs patients, and migrants or mobile
populations (WHO, 2018. Notably, Africa reported the highest cases of Malaria across the globe
whereby the continent recorded 91% of the death, whereby 285,000 infants and children under
the age of five tend to face death before reaching the age five. Notably, there is a strong
relationship between pregnant women and infant, whereby children born and living in endemic
areas are considered vulnerable to Malaria, particularly when the acquired immunity from the
parent begins to wane.
It is exhibited that children under 5 recorded the number of deaths in all descriptive
statistics (minimum 327,762, maximum 571,118, and mean 476,356). Moreover, it is exhibited
that infants and children under 5 recorded 200 per 100,000 deaths associated with Malaria. Three
primary nursing interventions aid in controlling the disease, which includes the adoption of
insecticide-treated nets (ITNs), indoor residual spraying (IRS), and larval control. The essential
stakeholders for the above interventions include the government and agencies, and administrative
and health institutions. The various challenges that tend to affect the adoption of the

Malaria 7
interventions include unilateral implementation of interventions, inadequately informed policy
development, and structural problems.
References
Ingabire, C., Kateera, F., Hakizimana, E., & Rulisa, A. (2016). Stakeholder Engagement in
Community-based Malaria Studies in a Defined Setting in the Eastern Province, Rwanda.
Mediterranean Journal of Social Sciences, 188-192. doi:DOI:
10.5901/mjss.2016.v7n2s1p188
Mwendera, C., Jager, C., Longwe, H., Kumwenda, S., Hongoro, C., & Phiri, K. (2019).
Challenges to the implementation of malaria policies in Malawi. BMC Health Services
Research, 194-197.
Roser, M., & Hannah, R. (2017, December). Malaria. Retrieved from Our World in Data:
https://ourworldindata.org/malaria
WHO. (2011). World Malaria Report. World Health Organization.
WHO. (2018). Malaria High-risk groups. Retrieved from World Health Organizatio:
https://www.who.int/malaria/areas/high_risk_groups/en/
WHO. (2018). Malaria in children under five. World Health Organization.