MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES
SCHOOL OF NURSING

NURSING RESEARCH (NR 302)
INTRODUCTORY PART OF RESEARCH PROPOSAL
ASSESSMENT OF KNOWLEDGE OF AND PRACTICE TOWARDS MALARIA PREVENTION IN UNDER FIVE CHILDREN OF MOTHERS ATTENDING MAGOMENI RCH CLINIC AT KINONDONI DISTRICT
DAR-ES-SALAAM REGION.

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CANDIDATE: MASHAKA SHITUNGULU
REG: 2015-04-09033
COURSE: BScN
SUPERVISOR: NEEMA MAWI
COORDINATOR: Dr. LILIAN MSELLE
18Th June, 2018
INTRODUCTORY PART OF RESEARCH PROPOSAL
CONTENTS PAGES
Title………………………………………………………………………3
Definition of terms…………………………………………………….…3
Abbreviations……………………………………………………….……4
Introduction and background…………………………………….………5
Problem statement………………………………….…………………….6
Broad objective…………………………………….………………….…7
Specific objectives……………………………….………………………7
Specific research questions……………………….………….……..……7
Hypothesis…………………………………………………….….…….…7
Conceptual framework………………………………………….…..……8
Literature review…………………………………………………….……8
References………………………………………………………….……11
TITLE: ASSESSMENT OF KNOWLEDGE OF AND PRACTICE TOWARDS MALARIA PREVENTION IN UNDER FIVE CHILDREN OF MOTHERS ATTENDING MAGOMENI RCH CLINIC AT KINONDONI DISTRICT
DAR-ES-SALAAM REGION.

KEYWORDS: Knowledge, practice, malaria, prevention, and under five children.

DEFINITION OF TERMS
Knowledge: Is a familiarly with someone or something which can include facts, information, description or skills acquired through experience or education.

Practice: Is the act of rehearsing a behaviour over and over , or or engaging in an activity again and again , for the purpose of improving or mastering it, as in the phrase “Practice makes perfect
Malaria: is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells.

Prevention: To avoid doing, stay away dangerous or risky things.

Under five children: means children below five years (from birth to five years of age).

ABBREVIATIONS
WHO……………………………..World Health Organization
HIV………………………………Human Immunodeficiency Virus
AIDS……………………………..Acquired Immuno Deficiency Syndrome
RCH………………………………Reproductive and Child Health
ITNs……………………………….Insecticide-treated bed nets
THMIS……………………………Tanzania HIV/AIDS Malaria Indicator Survey

INTRODUCTION
Background
Malaria is a life-threatening disease. It’s typically transmitted through the bite of an infected Anopheles mosquito. Infected mosquitoes carry the Plasmodium parasite. It is common in tropical and sub-tropical climates where the parasites can live. Malaria can occur if a mosquito infected with plasmodium parasite bites you. There are four kinds of malaria parasites that can infect humans; P. vivax, P. ovale, P. malariae, and P. falciparum. P. falciparum causes a more severe form of disease. The symptoms of malaria develop within 10 days to 4 weeks following the infection. Common symptoms of malaria include: shaking chills, high fever, profuse sweating, headache, nausea, vomiting, diarrhea, anemia, muscle pain, convulsions, and coma.

Malaria is a major public health problem in Tanzania causing an enormous burden to health and economy. In Tanzania over 95% of the 45 million people are at risk for Malaria infectionADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Kinung”, “given” : “Safari M”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mashauri”, “given” : “Fabian”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mwanga”, “given” : “Joseph R”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Nnko”, “given” : “Soori E”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Kaatano”, “given” : “Godfrey M”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Malima”, “given” : “Robert”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Kishamawe”, “given” : “Coleman”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Magesa”, “given” : “Stephen”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mboera”, “given” : “Leonard E G”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-1”, “issue” : “10”, “issued” : { “date-parts” : “2010” }, “page” : “1-11”, “title” : “Knowledge , attitudes and practices about malaria among communities : Comparing epidemic and non-epidemic prone communities of Muleba”, “type” : “article-journal”, “volume” : “2010” }, “uris” : “http://www.mendeley.com/documents/?uuid=dbbd2084-e87f-458d-acb2-643476ff62cf” } , “mendeley” : { “formattedCitation” : “(Kinung et al., 2010)”, “plainTextFormattedCitation” : “(Kinung et al., 2010)”, “previouslyFormattedCitation” : “(Kinung et al., 2010)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Kinung et al., 2010). The disease is responsible for more than one-third of deaths among children under the age of 5 years and for up to one-fifth of deaths among pregnant womenADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.4061/2010/794261”, “author” : { “dropping-particle” : “”, “family” : “Mazigo”, “given” : “Humphrey D”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Obasy”, “given” : “Emmanuel”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mauka”, “given” : “Wilhellmus”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Manyiri”, “given” : “Paulina”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Zinga”, “given” : “Maria”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Kweka”, “given” : “Eliningaya J”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mnyone”, “given” : “Ladslaus L”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Heukelbach”, “given” : “Jorg”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-1”, “issue” : “10”, “issued” : { “date-parts” : “2010” }, “page” : “9”, “title” : “Knowledge , Attitudes , and Practices about Malaria and Its Control in Rural Northwest Tanzania”, “type” : “article-journal”, “volume” : “2010” }, “uris” : “http://www.mendeley.com/documents/?uuid=149666a4-a9d2-4741-8903-8ad030388f85” } , “mendeley” : { “formattedCitation” : “(Mazigo et al., 2010)”, “plainTextFormattedCitation” : “(Mazigo et al., 2010)”, “previouslyFormattedCitation” : “(Mazigo et al., 2010)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Mazigo et al., 2010). Malaria contributes to 39.4% and 48% of all outpatients less than 5 years of age and 5 years and above, respectively. In term of hospital admissions, malaria accounts for 33.4% of children under under the age of 5 years and 42.1% in children aged 5 years and aboveADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Kinung”, “given” : “Safari M”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mashauri”, “given” : “Fabian”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mwanga”, “given” : “Joseph R”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Nnko”, “given” : “Soori E”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Kaatano”, “given” : “Godfrey M”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Malima”, “given” : “Robert”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Kishamawe”, “given” : “Coleman”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Magesa”, “given” : “Stephen”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mboera”, “given” : “Leonard E G”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-1”, “issue” : “10”, “issued” : { “date-parts” : “2010” }, “page” : “1-11”, “title” : “Knowledge , attitudes and practices about malaria among communities : Comparing epidemic and non-epidemic prone communities of Muleba”, “type” : “article-journal”, “volume” : “2010” }, “uris” : “http://www.mendeley.com/documents/?uuid=dbbd2084-e87f-458d-acb2-643476ff62cf” }, { “id” : “ITEM-2”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Kimbi”, “given” : “Helen K”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Nkesa”, “given” : “Sarah B”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ndamukong-nyanga”, “given” : “Judith L”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Sumbele”, “given” : “Irene U N”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Atashili”, “given” : “Julius”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Atanga”, “given” : “Mary B S”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-2”, “issue” : “14”, “issued” : { “date-parts” : “2014” }, “page” : “1-9”, “title” : “Knowledge and perceptions towards malaria prevention among vulnerable groups in the Buea Health District , Cameroon”, “type” : “article-journal”, “volume” : “2014” }, “uris” : “http://www.mendeley.com/documents/?uuid=5e3432af-5374-48e9-8ea5-094d54abd049” } , “mendeley” : { “formattedCitation” : “(Kimbi et al., 2014; Kinung et al., 2010)”, “plainTextFormattedCitation” : “(Kimbi et al., 2014; Kinung et al., 2010)”, “previouslyFormattedCitation” : “(Kimbi et al., 2014; Kinung et al., 2010)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Kimbi et al., 2014; Kinung et al., 2010). In Tanzania, most of the malaria attributes cases and deaths occur in rural village.
The main focus of malaria control measures in Tanzania includes case management (early diagnosis and prompt treatment with effective drugs), vector control using ITNs, malaria intermittent treatment in pregnant women, malaria epidemics prevention and control, information, education and communication, and operational research. Despite these strategies, malaria cases and deaths have been increasing in the country, mainly due to injudicious use of ant malarial drugs, delayed health seeking, and reliance on the clinical judgments without laboratory confirmationADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Aderaw”, “given” : “Zewdie”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Gedefaw”, “given” : “Molla”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-1”, “issue” : “5”, “issued” : { “date-parts” : “2013” }, “title” : “Knowledge, Attitude, and Practice of the Community towards”, “type” : “article-journal”, “volume” : “13” }, “uris” : “http://www.mendeley.com/documents/?uuid=63215717-fc45-4555-982d-ea23c6dad485” } , “mendeley” : { “formattedCitation” : “(Aderaw & Gedefaw, 2013)”, “plainTextFormattedCitation” : “(Aderaw & Gedefaw, 2013)”, “previouslyFormattedCitation” : “(Aderaw & Gedefaw, 2013)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Aderaw ; Gedefaw, 2013).

Different studies reported about knowledge, attitudes, and practices relating to malaria and its control from different part of the World. These reports concluded that, misconceptions concerning malaria still exist and that practices for the controls of malaria have been unsatisfactory. Thus, an advanced knowledge of the community beliefs and practices with respect to disease is required to obtain and maintain its participation in surveillance and control activitiesADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Access”, “given” : “Open”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-1”, “issue” : “13”, “issued” : { “date-parts” : “2013” }, “page” : “1-8”, “title” : “Community knowledge , attitude and practice about malaria in a low endemic setting of Shewa Robit Town , northeastern Ethiopia”, “type” : “article-journal”, “volume” : “2013” }, “uris” : “http://www.mendeley.com/documents/?uuid=c693a8e6-c165-4ad6-853d-5f85fef21ff2” }, { “id” : “ITEM-2”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Kimbi”, “given” : “Helen K”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Nkesa”, “given” : “Sarah B”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ndamukong-nyanga”, “given” : “Judith L”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Sumbele”, “given” : “Irene U N”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Atashili”, “given” : “Julius”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Atanga”, “given” : “Mary B S”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-2”, “issue” : “14”, “issued” : { “date-parts” : “2014” }, “page” : “1-9”, “title” : “Knowledge and perceptions towards malaria prevention among vulnerable groups in the Buea Health District , Cameroon”, “type” : “article-journal”, “volume” : “2014” }, “uris” : “http://www.mendeley.com/documents/?uuid=5e3432af-5374-48e9-8ea5-094d54abd049” } , “mendeley” : { “formattedCitation” : “(Access, 2013; Kimbi et al., 2014)”, “plainTextFormattedCitation” : “(Access, 2013; Kimbi et al., 2014)”, “previouslyFormattedCitation” : “(Access, 2013; Kimbi et al., 2014)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Access, 2013; Kimbi et al., 2014).

In Tanzania, support for malaria control at both the national, district, and private sector levels have increased over the past fewer years. Example of collaboration in fighting against malaria are between the public sector, the Geita district council (District health department), and private organization (Geita Gold Mines, Anglo Ashanti Gold Mines Tanzania)ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Ruberto”, “given” : “Irene”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Camara”, “given” : “Seydouba”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Banek”, “given” : “Kristin”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Loua”, “given” : “Marcel Kovana”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-1”, “issue” : “June”, “issued” : { “date-parts” : “2014” }, “page” : “119-127”, “title” : “Knowledge , attitudes and practices of malaria control among communities from the health district of Foru00e9cariah in the Republic of Guinea , West Africa”, “type” : “article-journal”, “volume” : “2014” }, “uris” : “http://www.mendeley.com/documents/?uuid=b3fcdef0-b325-43b3-9ffb-f4d93b560c30” } , “mendeley” : { “formattedCitation” : “(Ruberto, Camara, Banek, & Loua, 2014)”, “plainTextFormattedCitation” : “(Ruberto, Camara, Banek, & Loua, 2014)”, “previouslyFormattedCitation” : “(Ruberto, Camara, Banek, & Loua, 2014)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Ruberto, Camara, Banek, ; Loua, 2014).

Tanzania has the third largest population at risk of malaria in Africa. Over 90% of population lives in areas where there is malaria. Each year, 10 to 12 million people contract malaria in Tanzania and 80,000 die from the disease; most of them are children below age of 5 years. Malaria risk is highest in the Kagera region on the western shore of Lake Victoria and lowest in the Arusha region. Fortunately, malaria cases have dropped significantly over the last decade. In the last years, the number of children dying from malaria has halvedADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1186/s12936-015-0755-7”, “ISSN” : “1475-2875”, “author” : { “dropping-particle” : “”, “family” : “Fuge”, “given” : “Terefe G”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ayanto”, “given” : “Samuel Y”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Gurmamo”, “given” : “Fiseha L”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Malaria Journal”, “id” : “ITEM-1”, “issue” : “14”, “issued” : { “date-parts” : “2015” }, “page” : “1-9”, “publisher” : “Malaria Journal”, “title” : “Assessment of knowledge , attitude and practice about malaria and ITNs utilization among pregnant women in Shashogo”, “type” : “article-journal”, “volume” : “2015” }, “uris” : “http://www.mendeley.com/documents/?uuid=4087c097-2bdb-4ca5-bbd4-65bdc7fdbe52” } , “mendeley” : { “formattedCitation” : “(Fuge, Ayanto, & Gurmamo, 2015)”, “plainTextFormattedCitation” : “(Fuge, Ayanto, & Gurmamo, 2015)”, “previouslyFormattedCitation” : “(Fuge, Ayanto, & Gurmamo, 2015)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Fuge, Ayanto, ; Gurmamo, 2015).

PROBLEM STATEMENT
According to World Malaria Report 2015, there were 212 million new cases of malaria worldwide in 2015 (range 148-304). The WHO African Region accounted for most global cases of malaria (90%), followed by the South-East Asia Region (7%) and the Eastern Mediterranean Region (2%). In 2015, there were an estimated 429000 malaria deaths (range 235000-639000) worldwide. Most of these deaths occurred in Africa (92%) followed by the South-East Asia Region (6%) and the Eastern Mediterranean Region (2%). Between 2010 and 2015, malaria incidence rates fell by 21% globally and in the Africa Region. During this same period, malaria mortality rates fell by an estimated 29% globally and by 31% in the Africa Region.

Malaria is the leading public health problem in Tanzania. The disease contributes between 39.4% and 48% of all outpatient children under the age of five years and among those aged five years and above, respectively. Malaria is the major cause of hospital admissions accounting for 33.4% in children under the age of five years and 42.1% in those aged five years and aboveADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1056/NEJMoa1214482”, “author” : { “dropping-particle” : “”, “family” : “Acremont”, “given” : “D”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Acremont”, “given” : “D”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Malaria”, “given” : “Beyond”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Tanzanian”, “given” : “Outpatient”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Acremont”, “given” : “Valu00e9rie D”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ph”, “given” : “D”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Kilowoko”, “given” : “Mary”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Kyungu”, “given” : “Esther”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-1”, “issue” : “9”, “issued” : { “date-parts” : “2014” }, “page” : “809-817”, “title” : “Article Beyond Malaria u2014 Causes of Fever in Outpatient Tanzanian Children Beyond Malaria u2014 Causes of Fever in Outpatient Tanzanian Children”, “type” : “article-journal”, “volume” : “370” }, “uris” : “http://www.mendeley.com/documents/?uuid=c0cb918f-6f41-4fc8-84fb-72edc028d1b6” } , “mendeley” : { “formattedCitation” : “(Acremont et al., 2014)”, “plainTextFormattedCitation” : “(Acremont et al., 2014)”, “previouslyFormattedCitation” : “(Acremont et al., 2014)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Acremont et al., 2014). The disease is responsible for more than one-third of deaths in children under the age of five years.

Previous studies covered large area i.e district, region, district and region hospital, and country wise. This study will focus in the community directly (Magomeni Health Centre) by looking the mother’s understanding on malaria transmission, their recognition signs and symptoms, community preventive measures and practices. Aim is to investigate that if the study carried in district, region and country wise correlate with the information which will be obtained in this study.

BROAD OBJECTIVES
To explore knowledge and practice of mothers towards Malaria prevention to their children who are under five years.

SPECIFIC OBJECTIVES
To assess knowledge of mothers towards Malaria prevention in their under five children.

To assess Malaria prevention practice of mother in their under five children.

SPECIFIC RESEARCH QUESTIONS
What do mother know about Malaria?
Which methods are used to prevent Malaria in their under five children?
HYPOTHESIS
Mothers of knowledge about Malaria are more likely to practice on Malaria prevention in their under five children.

CONCEPTUAL FRAMEWORK
Independent variable Dependent variable
Demographic characteristics
(Age and Education level)

Practices related to malaria prevention and control

Knowledge about malaria (causes, transmission, symptoms, and prevention)

Figure 1: Conceptual framework indicating factors relating to Malaria prevention and control
EXPLANATION OF CONCEPTUAL FRAMEWORK TO MY STUDY
The illustration above shows the relationship between the dependent and independent variables. It shows the factors that affect adoption of malaria preventive practices. These factors include demographic characteristics, community’s knowledge about malaria and their practices towards preventive and control strategies. Other studies have also associated gender, age, education, and poverty level to practices towards malaria prevention and control.

Perceptions, threat, and susceptibility are believed to have an influence on practices adopted by the community to prevent and control malariaADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Kimbi”, “given” : “Helen K”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Nkesa”, “given” : “Sarah B”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ndamukong-nyanga”, “given” : “Judith L”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Sumbele”, “given” : “Irene U N”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Atashili”, “given” : “Julius”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Atanga”, “given” : “Mary B S”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-1”, “issue” : “14”, “issued” : { “date-parts” : “2014” }, “page” : “1-9”, “title” : “Knowledge and perceptions towards malaria prevention among vulnerable groups in the Buea Health District , Cameroon”, “type” : “article-journal”, “volume” : “2014” }, “uris” : “http://www.mendeley.com/documents/?uuid=5e3432af-5374-48e9-8ea5-094d54abd049” } , “mendeley” : { “formattedCitation” : “(Kimbi et al., 2014)”, “plainTextFormattedCitation” : “(Kimbi et al., 2014)”, “previouslyFormattedCitation” : “(Kimbi et al., 2014)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Kimbi et al., 2014).

LITERATURE REVIEW
Approximately half of the world’s population live in areas where malaria is transmitted (approximately 100 countries in parts of Africa, Asia, the Middle East, Eastern Europe, Central and South America, the Caribbean, and Oceania) (World Malaria Report, 2015). Before the 1950s, malaria was endemic throughout the south-eastern United States; an estimated 600,000 cases occurred in 1914.

Worldwide, an estimated 216 million clinical cases and 655,000 deaths were reported in 2010, mostly in children aged < 5 years living in Africa Region (World malaria Report, 2015). Global malaria deaths increased from 995 000 (95% uncertainty interval 711 000—1 412 000) in 1980 to a peak of 1 817 000 in 2004, decreasing to 1 238 000 in 2015 (WHO, 2015).
According to the World Health Organization’s 2013, the countries with the five highest numbers of reported malaria deaths for 2010 are: Kenya (26,017 deaths), Democratic Republic of Congo (23,476), Tanzania (15,867), and Burkina Faso (9,02and Uganda (8,431) (WHO, 2013).
In Africa, malaria deaths increased from 493 000 in 1980 to 1 613 000 in 2004, decreasing by about 30% to 1 133 000 in 2010. Outside of Africa, malaria deaths have steadily decreased from 502 000 in 1980 to 104 000 in 2010 (WHO, 2010).
Over 90% of the deaths from malaria occur in Africa Region, and in children under the age of five. However, it is important to note that this indicates the number of reported deaths that were confirmed as malaria; there are other countries in Africa which may have similar levels of malaria mortality but insufficient health infrastructure for accurate diagnosis of cause of death or reporting (WHO, 2013).

The study done in Nigeria concerning Knowledge Perception and practice of care givers on childhood malaria and treatment shows that 65% of respondent had not heard of Insecticide treated nets and of the 32% who were aware of these nets only 7% used them at home and 2% treated their netsADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Akaba”, “given” : “G O”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Otubu”, “given” : “J A M”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Agida”, “given” : “E T”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Onafowokan”, “given” : “O”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-1”, “issue” : “2”, “issued” : { “date-parts” : “2013” }, “page” : “201-206”, “title” : “Knowledge and utilization of malaria preventive measures among pregnant women at a tertiary hospital in Nigeria u2019 s federal capital territory”, “type” : “article-journal”, “volume” : “16” }, “uris” : “http://www.mendeley.com/documents/?uuid=19626c6f-e7b1-42d0-adea-c7726039fee3” } , “mendeley” : { “formattedCitation” : “(Akaba, Otubu, Agida, & Onafowokan, 2013)”, “plainTextFormattedCitation” : “(Akaba, Otubu, Agida, & Onafowokan, 2013)”, “previouslyFormattedCitation” : “(Akaba, Otubu, Agida, & Onafowokan, 2013)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Akaba, Otubu, Agida, ; Onafowokan, 2013).
The study done in Cameroon concerning Knowledge Perception and practice about malaria transmission and preventive measures among households shows that about 48% of study participants’ were aware that malaria can be transmitted by mosquito bites. The study also showed that knowledge of the role of mosquitoes in malaria transmission and comprehensive knowledge about malaria prevention strategies among the study population were observed to be lower than 50% .Therefore it is still a gap. Comprehensive behavioral change and communication is required to improve the knowledge of the mode of malaria transmission and its preventive and control measuresADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Kimbi”, “given” : “Helen K”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Nkesa”, “given” : “Sarah B”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ndamukong-nyanga”, “given” : “Judith L”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Sumbele”, “given” : “Irene U N”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Atashili”, “given” : “Julius”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Atanga”, “given” : “Mary B S”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “id” : “ITEM-1”, “issue” : “14”, “issued” : { “date-parts” : “2014” }, “page” : “1-9”, “title” : “Knowledge and perceptions towards malaria prevention among vulnerable groups in the Buea Health District , Cameroon”, “type” : “article-journal”, “volume” : “2014” }, “uris” : “http://www.mendeley.com/documents/?uuid=5e3432af-5374-48e9-8ea5-094d54abd049” } , “mendeley” : { “formattedCitation” : “(Kimbi et al., 2014)”, “plainTextFormattedCitation” : “(Kimbi et al., 2014)”, “previouslyFormattedCitation” : “(Kimbi et al., 2014)” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }(Kimbi et al., 2014).

The first national, population-based 2007-08 Tanzania HIV/AIDS Malaria Indicator survey (THMIS, 2007-08 ) showed that 18% of children under five years of age had tested positive for malaria on the Mainland in contrast to only 0.8% in Zanzibar. On the Mainland, the rural areas had a higher prevalence of 20% compared to the urban areas of 8%. The survey also showed an increasing prevalence by age from about 9% in infants (6-11 months) to 22% in children aged 2-4 years. Malaria prevalence showed a direct relationship with the socio-economic status and education of the mother of children under-five years of age. Those children whose mothers had no formal education had a malaria prevalence that was four times higher than those who had secondary education and above. (THMIS 2009-15).
REFERENCES
ADDIN Mendeley Bibliography CSL_BIBLIOGRAPHY Access, O. (2013). Community knowledge , attitude and practice about malaria in a low endemic setting of Shewa Robit Town , northeastern Ethiopia, 2013(13), 1–8.

Acremont, D., Acremont, D., Malaria, B., Tanzanian, O., Acremont, V. D., Ph, D., … Kyungu, E. (2014). Article Beyond Malaria — Causes of Fever in Outpatient Tanzanian Children Beyond Malaria — Causes of Fever in Outpatient Tanzanian Children, 370(9), 809–817. http://doi.org/10.1056/NEJMoa1214482
Aderaw, Z., & Gedefaw, M. (2013). Knowledge, Attitude, and Practice of the Community towards, 13(5).

Akaba, G. O., Otubu, J. A. M., Agida, E. T., & Onafowokan, O. (2013). Knowledge and utilization of malaria preventive measures among pregnant women at a tertiary hospital in Nigeria ‘ s federal capital territory, 16(2), 201–206.

Fuge, T. G., Ayanto, S. Y., ; Gurmamo, F. L. (2015). Assessment of knowledge , attitude and practice about malaria and ITNs utilization among pregnant women in Shashogo. Malaria Journal, 2015(14), 1–9. http://doi.org/10.1186/s12936-015-0755-7
Kimbi, H. K., Nkesa, S. B., Ndamukong-nyanga, J. L., Sumbele, I. U. N., Atashili, J., ; Atanga, M. B. S. (2014). Knowledge and perceptions towards malaria prevention among vulnerable groups in the Buea Health District , Cameroon, 2014(14), 1–9.

Kinung, S. M., Mashauri, F., Mwanga, J. R., Nnko, S. E., Kaatano, G. M., Malima, R., … Mboera, L. E. G. (2010). Knowledge , attitudes and practices about malaria among communities?: Comparing epidemic and non-epidemic prone communities of Muleba, 2010(10), 1–11.

Mazigo, H. D., Obasy, E., Mauka, W., Manyiri, P., Zinga, M., Kweka, E. J., … Heukelbach, J. (2010). Knowledge , Attitudes , and Practices about Malaria and Its Control in Rural Northwest Tanzania, 2010(10), 9. http://doi.org/10.4061/2010/794261
Ruberto, I., Camara, S., Banek, K., ; Loua, M. K. (2014). Knowledge , attitudes and practices of malaria control among communities from the health district of Forécariah in the Republic of Guinea , West Africa, 2014(June), 119–127.

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