College of Natural & Life Sciences Malaria Mortality and Morbidity in Under-Five Year Old Children in Nigeria - A Literature Review. Presented by Lawrence Ndupu (B.Pharm, MPH) College of Natural & Life Sciences INTRODUCTION RESULTS CAUSES DISCUSSIONS Under-fives Mortality Rates   Causes of under-fives mortality in Nigeria in 2008   The findings of this study have shown significant reductions in: The prevalence rates of under-fives mortality between 1990 and 2012, in Nigeria (from 21.3% to 12.4%), Gambia (from 17.0% to 7.3%) and Senegal (from 14.2% to 6.0%).  Under-fives mortality in Nigeria (42% reduction from 213 to 124 per 1,000 live births), Gambia (57% reduction from 170 to 73 per 1,000 live births) and Senegal (58% reduction from 142 to 60 per 1,000 live births) within the same study period. These findings also showed that the under-fives mortality rates were significantly greater in Nigeria compared to Senegal (p<.05), but no difference compared to Gambia (p>.05) and no difference between Gambia and Senegal (p>.05). Malaria was the 2nd main cause of under-5s mortality in Nigeria (25%), Gambia (27%) & Senegal (19%), while neonatal factors was the 1st in all 3 countries DEMOGRAPHY LOCATION: Nigeria covers a surface area of 923, 708 km² and situated on the west coastline of Africa. It shares borders with Niger, Chad, Cameroon, and the Atlantic Ocean  POPULATION: 177 M (approximately 2.46% of the world’s population with population density of 193 p/km². BACKGROUND Malaria is a preventable and treatable but very deadly disease that : Affects 350 - 500million people annually and 1 million of the cases leading to death. Prevalent in more than 100 countries where 40% of the world population resides, thus killing over 800, 000 African children annually. African regions accounts for about 86% of an estimated 247 million malaria cases globally and 91% of deaths due to malaria . Malaria significantly contributes to anaemia in expectant mothers and young children. One child dies every minute . Nigeria suffers the world’s largest malaria burden with almost 51 million cases and 207,000 deaths annually, 30% of which are under the ages of five, with about 1 in 20 of these children dying due to malaria-associated illnesses and 1 in every 8 Nigerian children not surviving their 5th birthday. Malaria is the 3rd prominent cause of death in the under-5s globally, after pneumonia and diarrhoea. In Africa, after neonatal infections, malaria infection was the 2nd highest cause of mortality. Approximately 1 out of every 5 under-5s (20%) mortality is attributable to malaria. Nigeria was significantly higher than Gambia & Senegal throughout study period. Senegal was likely to meet MDGs target of 2/3 reduction in under-5 mortality (reduction to 46/1,000 live births by 2015; Gambia & Nigeria was still far from the target reduction of 51/1,000 & 71/1,000 live births respectively.   Causes of under-fives mortality in Gambia in 2008   Prevalence rates of mortality in Under-fives   CONCLUSIONS Overall, the study suggests that malaria prevalence and under-fives mortality in Nigeria is still very high. Declining mortality rates in the under-fives observed during the study period was encouraging but cannot be accurately ascertained or generalised to the population. Further research could be carried out into the long-term impact of potential malaria interventions on under-fives morbidity and mortality in Nigeria in the next five years.   Prevalence Rates (PR)= under-5s mortality ÷ Country’s population x 100 PR decreased in all 3 countries between 1990 & 2012 (significantly lower in Nigeria followed by Gambia & then Senegal). Senegal had the highest reduction. Senegal was the only country likely to meet the MDGs target by 2015 (PR in Senegal dropped to 6% in 2012, while Nigeria was still high at 12% and Gambia at 7.3%. SPSS Tests Lavene’s test for homogeneity– Sample variance do not differ significantly (p>.05) ANOVA-(F(2,15) =4.93, p<.05 show significant main effect Post-Hoc Bonferroni Test– Shows that under-5s mortality was greater in Nigeria vs Senegal (p<.05); no significant difference between Nigeria vs Gambia (p>.05) & Senegal vs Gambia (p>.05).   Causes of under-fives mortality in Senegal in 2008 BIBLIOGRAPHY Mendez, C., Fleming, A.F., Alonso., PL. (2000) Malaria-related anaemia. Parasitology Today (Personal ed.), 16(11), pp. 469-476. World Health Organization (2015) World Malaria Report 2014 [Internet]. Available from: http://www.who.int/malaria/publications/world_malaria_report_2014/wmr-2014-no-profiles.pdf?ua=1[Accessed: 13 May 2015]. Sachs, J.D. (2001) Macroeconomics and Health: Investing in Health for Economic Development [Internet]. Available from: http://whqlibdoc.who.int/publications/2001/924154550X.pdf[Accessed: 17 April 2015].