THE USE OF TRADITIONAL MEDICINE IN THE TREATMENT OF MALARIA AMONG PREGNANT WOMEN

1.1 Introduction

Malaria symptoms usually occur between seven and fifteen days after a mosquito inoculation. Signs and symptoms related to malaria infection are varied, but the majority of patients have fever. It is generally characterized by recurrent attacks with moderate to severe shaking chills, high-fever, profuse sweating during the fall of body temperature, general feeling of unease and discomfort (malaise). Other signs and symptoms are headache, nausea, vomiting and diarrhea. Malaria should be suspected in every febrile patient who lives or has traveled to an endemic area and in the differential diagnosis of patients who have fever of unknown origin, malaria should also be considered. Any patient with an untreated P. falciparum infection can rapidly progress to coma, renal failure, pulmonary edema, and death (MMWR, 2004).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.

1.2 Background of Study

Malaria is a life threatening parasitic disease transmitted by female Anopheles mosquitoes. In Nigeria, malaria is responsible for around 60% of the out-patient visits to health facilities, 30% of childhood death, 25% of death in children under one year and 11% of maternal deaths (National Population Commission, 2008; Noland et al., 2014). Similarly, about 70% of pregnant women suffer from malaria, which contributes to maternal anemia, low birth weight, still births, abortions and other pregnancy-related complications (Federal Ministry of Health Abuja, 2005).

Presently, malaria remains one of the worst menaces of tropical countries of the world. It is a killer and debilitating disease that affects the physical and economic well-being of people living in endemic areas of Africa (WHO, 2008). Pregnant women are among those in the higher risk group (Okwa, 2003). Recent global estimate shows that there are between 300 - 500million clinical cases of malaria and between 1.50 — 2.70million deaths attributed to malaria annually (Greenwood, 2005). Pregnant women are at immense risk of malaria due to natural immune depression in pregnancy (Fievet, 2008). Hence, it is one of the most important health issues affecting pregnant women as it has a risk of jeopardizing the life of the woman or the fetus (WHO, 2010).

Traditional herbal medicine could be described as “herbs, herbal materials, herbal preparations and finished herbal products whose content includes active ingredients parts of plants, or other plant materials, or combinations”. Herbal medicines can be in the form of liquids, powder, capsules, tablets or ointments. Some are pre-packaged while others are prepared when needed and are used not only to cure illness but to maintain or boost one's health (WHO, 2002). In Africa, reliance on herbal medicines is relatively high and the global use of herbal medicine is growing. Most pregnant women believe that these medicines are ‘natural’ and ‘safe’ compared to modern drugs. Besides, traditional medicine is believed to treat medical problems and improve health status during pregnancy, birth and postpartum care in many rural areas (Khadivzadeh and Ghabel, 2012).

Erhun, Agbani and Adesanya, (2004) opted that many pregnant women that are involved in such practice acquire the knowledge from relatives, neighbours, friends, traditional medicine dealers and sometimes media (Shah, 2004). The situation is predominant due to the limited antenatal health delivery centers and defective functional health institutions (Rohra, 2008); poor medical services and attitude of medical staff; lack of professional control of pharmaceutical products (Abrahams and Jewkes, 2002) as well as high illiteracy level and cost of synthetic malaria medicine over traditional orthodox ones (Dossou-Yov, 2001).

In addition, several factors such as; socioeconomic status of the women, poverty issues, cultural perception, age, sex, income level, religion and belief of certain diseases’ entity and their perceived responses to indigenous medications have been widely reported as indicators that influences their attitude (WHO, 2002); Hence, herbal traditional medication for curing malaria has become a norm and is widely practiced and patronized by pregnant women owing to general ease of access, social and cultural influences, perceived efficacy and beliefs about its safety (Langloid-Klassen, 2007).

Kyomuhendo (2005) noted that pregnant women decisions regarding health and antenatal care attendance are influenced by the patriarchal system of society that gives men control over resources to the disadvantage of women.

This study therefore, aims at examining the use of traditional medicine in the treatment of malaria among pregnant women in Abraka, Delta State, Nigeria.

1.3 Statement of Problems

Investigation revealed that malaria infection during pregnancy is a major public health problem in tropical and subtropical regions throughout the world and Nigeria in Particular. The burden of malaria infection during pregnancy is caused mainly by Plasmodium falciparum, the most common malaria species in Africa (WHO, 2010). Pregnant women and the unborn children are particularly vulnerable to malaria, which is a major cause of prenatal mortality, low birth weight, and maternal anaemia (Greenwood, 2007). Malaria during pregnancy compounds or provokes anaemia, which, when severe, increases the risk of maternal death (estimated at around 10,000 deaths annually), low birth weight (linked to around 100,000 annual infant deaths in Africa), pre-term delivery, congenital infection and reproductive loss of overwhelming morbidity and mortality (Fakeye, 2009).

There have been a considerable number of reports about poor knowledge, attitudes, and practices among pregnant women relating to malaria and its control from different parts of Africa. The disease remains the world's most important tropical health challenge. Access to medical care is limited in many malaria-endemic areas and where medical services exist, they commonly lack facilities for laboratory diagnosis, and treatment option. This forces these pregnant women to use various forms of substances and traditional herbs for curing malaria.

1.4 Aim and Objectives of Study

The aim of the study is to examine the use of traditional medicine in the treatment of malaria among pregnant women in Abraka, Delta State. In achieving this aim, the following specific objectives were laid out as follows:

1. To find out the extent to which the level of education of pregnant women determine the use of traditional herbs for the treatment of malaria;
2. To determine influence of socio-economic status on the use of traditional herbs in the treatment of malaria among pregnant women;
3. To find out the extent to which the age of pregnant women determine the use of traditional herbs for the treatment of malaria; and
4. To examine the extent to which the locality of pregnant women determine the use of locally made herbs for treatment of malaria.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• What is the difference in socio-economic status on the use of traditional herbs in the treatment of malaria among pregnant women?
• What is the difference in the ages of pregnant women on the use of traditional herbs for the treatment of malaria?
• What is the difference in the level of educational background of pregnant women in the use of traditional herbs for the treatment of malaria?
• What is the difference in the locality of pregnant women in the use of traditional herbs for the treatment of malaria?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

• H₀1: There is no significant difference between the socioeconomic status in use of traditional medicine for the treatment of malaria among pregnant women in Abraka.
• H₀2: There is no significant difference between the age groups in the use of traditional medicine for the treatment of malaria by of pregnant women in Abraka.
• H₀3: There is no significant difference between the levels of Education in the use of traditional medicine for the treatment of malaria among pregnant women in Abraka.
• H₀4: There is no significant difference between Urban and Rural areas in the use of traditional medicine for the treatment of malaria by pregnant women in Abraka

1.7 Significance of Study

The findings in this study will be important to the government because it elucidates the need for government to provide an effective waste management and control scheme. This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

1.8 Scope of Study

The scope of the research is focused on the Use of Traditional Medicine in the Treatment of Malaria among Pregnant Women. The study will cover only pregnant women from Abraka district in Delta State, Nigeria.

1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
4. Lack of Initial Cooperation from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.