CHAPTER ONE:

INTRODUCTION

1.1. Background of the study

Microfilaremia is the presence of filaria worm in blood which is a disease caused by thread like nematodes (round worms) of the super family Filarioidea and is transmitted from host to host by blood feeding arthropods mainly black flies and mosquitoes. Eight filaria nematodes are known to use man as their definitive host and are divided in to three groups according to the niche they occupy within the body [1,2]: lymphatic filariasis, subcutaneous filariasis and serous cavity filariasis.

The disease is transmitted from person to person through the bite of an infected mosquito and one must be beaten many times over a long period to develop symptoms of filariasis [1].

Malaria is a disease caused by a blood protozoan of the genus Plasmodium and there are five species; P. falciparum, P. malariae, P vivax, P ovale and P. knowlesi  [3]. Plasmodium specie the infective agent of the disease is transmitted to humans primarily through the bite of an infected female anopheles’ mosquito [4]. Malaria symptoms typically begin within a few weeks of infection and include fever, headache, muscle pain, chills. In severe cases, the disease can lead to complications such as anemia, kidney failure, seizures, cerebral malaria which can result to death [5].The high Prevalence of the disease in many developing countries is due to limited medical care and resources with poverty, poor housing, bushes contributing to the high burden of the disease as well as the increasing resistance of the Plasmodium parasites to antimalarial drugs has made the control of the disease challenging [6].Despite these challenges, significant progress has been made in the control and elimination of this infection in recent years. The world health organization global technical strategy for malaria 2016 have been successful in reducing the global burden of malaria through the implementation of interventions like the use of insecticide treated bed nets, antimalarial drugs and indoor residual spraying. There is however much to be done to achieve the goal of malaria elimination and ensure everyone has access to the resources needed to protect themselves from the infection [7].

Blood donation occurs when a healthy person has blood drawn from his or her body for transfusion which is a life-saving procedure and the demand for blood has increased over the years [4].

1.2. Problem statement

Microfilaremia and malaria are transfusion transmitted infections which pose the recipients at risk especially in the endemic regions of the world such as Sub Saharan Africa. These infections are major problem as they can lead to complications in recipients and even be fatal among the vulnerable group such as immunocompromised recipients, pregnant women, children under five years and serve as a pool of community transmitted infections [8]. Screening of microfilaremia and malaria are not documented in the national donor screening protocol as recommended by the world health organization in endemic areas which is a necessity as shown by the prevalence of 0.1% in the United Kingdom,0.33% in Nepalese donors, [10], 0.6 to 50% in Sub Saharan Africa [9], 62.0% in Nigeria [10] and 6.5% in Cameroon [11].

However, the Prevalence of these parasitic infections is a serious case which needs to be addressed as these parasites constitute a serious threat to the human race due to the complications and fatality it causes [10].

 1.3. Rationale

Microfilaremia and malaria are infections caused by filaria worm and Plasmodium species respectively which are transmitted from person to person through the bite of infected sand flies and mosquito for microfilaremia and infected female anopheles’ mosquito for malaria. They remain major problems as the appropriate measures to eliminate the vectors are not put in place by the population despite all government efforts. Stagnant pools of water, bushes especially in developing countries continue to serve as breeding grounds for the vectors. Also, financial constraints hinder some infected persons from getting treatment as well as lack of health facilities which continues to lead to wide spread of the disease.

1.4. Research questions

1.4.1. Main question

What is the Prevalence of microfilaremia, malaria parasitemia and associated factors among asymptomatic blood donors attending the Regional hospital Bamenda blood bank?

1.4.2. Specific questions

1. What is the Prevalence of microfilaremia among asymptomatic blood donors attending the Regional hospital Bamenda blood bank?
2. What is the Prevalence of malaria parasitemia among asymptomatic blood donors attending the Regional hospital Bamenda blood bank?
3. What are the factors associated to microfilaremia and malaria among asymptomatic blood donors attending the Regional hospital Bamenda blood bank?

1.5. Research objectives

1.5.1. Main objective

The main objective of this study was to determine the prevalence of microfilaremia, malaria parasitemia and associated factors among asymptomatic blood donors attending the Regional hospital Bamenda blood bank.

1.5.2. Specific objectives

1. To determine the prevalence of microfilaremia among asymptomatic blood donors attending the Regional hospital Bamenda blood bank.
2. To determine the prevalence of malaria among asymptomatic blood donors attending the Regional hospital Bamenda blood bank.
3. To determine the factors associated to microfilaremia and malaria parasitemia among asymptomatic blood donors attending the Regional hospital Bamenda blood bank.