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CHAPTER ONE

INTRODUCTION

1.1       Background of the Study

Malaria remains a huge global health burden with more than 90% of fatalities occurs in Africa and about half a million infant mortality each year. Malarial infection is of particular concern as it is a disease that can be both treated and prevented. Nigeria, biggest country by population in Africa, is responsible for about 25% of global health burden. While all local and international efforts aim to implement Nigeria’s current National Strategic Malaria Plan [NMSP 2014-2020] to have Nigeria free of Malaria by 2020, the current healthcare system in Nigeria remains a major system bottleneck to achieving such challenging objective but yet still achievable.

Cerebral malaria, a severe form of malaria caused by Plasmodium falciparum, is a significant cause of childhood morbidity and mortality in sub-Saharan Africa [1–3]. It accounts for 1% to 27% of paediatric admissions with case fatality rates ranging from 15% to 50% in our region [3]. Outcome of the disease is influenced by age of child, severity of symptoms, time of intervention and, quality of treatment received [2, 3]. Naturally caregivers of children play a pivotal role in the provision of care for childhood diseases. Since most children cannot fend for themselves, time of intervention and quality of care received depend on the actions of the caregiver. Understanding the concept and consequences of disease, knowledge of treatment modalities, and the capacity to provide or access care are some of the factors that could influence the health care seeking behavior of caregivers. Thus, appraising caregiver health care seeking behavior is necessary for effective prevention and control of grave childhood diseases such as cerebral malaria.

Malaria continues to be a serious public health problem in sub-Saharan Africa [1] and affects the health and wealth of nations and individuals alike [2]. Children aged less than five years and pregnant women are the people most vulnerable to dying of malaria or suffering serious consequences of the disease, especially in regions where transmission is intense [3, 4]. Children are most vulnerable because they have not yet acquired immunity to the disease, while maternal susceptibility to malaria infection during pregnancy may be related to the physiological immunosuppression that occurs during gestation. In children under five, the adverse effects include convulsions, anaemia, coma, and death. In Ghana, preventing malaria is of prime importance in reducing the rates of morbidity and mortality [5]. Malaria is actually responsible for about 31% of consultations, 44% of hospitalizations, and 18% of deaths occurring in health facilities in the country [5]. In children less than 5 years, 41% of deaths are due to malaria [5]. If malaria is appropriately prevented, the

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