Am very excited to start the process of writing this research proposal because malaria is one of the most deadly diseases in Africa, especially in Ghana. so the reason behind this research proposal is that I want us to prevent this disease once and for all in our community. But am not done with this research I will continue it someday.

1. ACCRA SCHOOL OF HYGIENE
KORLE-BU
The burden of malaria at Ablekuma south municipal
Assembly
In the Greater Accra Region, Ghana.
BOAKYE GYAN
(SOHAEH200057)
MARCH, 2022

2. DECLARATION
I declare that my thesis is an original result resulting from my effort. Except other
literally works of scholars duly been acknowledged, this proposal is the result of my
study done at Accra School of Hygiene.
SIGNATURE…………………………………..
DATE……………………………
BOAKYE GYAN
(STUDENT)
CERTIFICATION
We the undersigned, hereby certify that the preparation and presentation of this
research work were supervised in accordance with its formats on supervising of
research aid down by the Accra School of Hygiene, Korle-Bu.
ABSTRACT
Malaria is a mosquito-borne infectious disease that affects humans and other
animals. Malaria causes symptoms that typically include fever, tiredness, vomiting,
and headaches. In severe cases, it can cause jaundice, seizures, coma,

3. or death. Symptoms usually begin ten to fifteen days after being bitten by an
infected mosquito. If not properly treated, people may have recurrences of the disease
months later. In those who have recently survived an infection, reinfection usually
causes milder symptoms. This partial resistance disappears over months to years if the
person has no continuing exposure to malaria.
Malaria is caused by single-celled micro-organisms of the Plasmodium group. It is
spread exclusively through bites of infected Anopheles mosquitoes. The mosquito bite
introduces the parasites from the mosquito's saliva into a person's blood. The parasites
travel to the liver where they mature and reproduce. Five species of Plasmodium can
infect and be spread by humans. Most deaths are caused by P. falciparum, whereas P.
vivax, P. ovale, and P. malariae generally cause a milder form of malaria. The
species P. knowlesi rarely causes disease in humans. The study will employ a
descriptive cross-sectional study design using a quantitative method to determine the
burden of malaria in mobile populations in the Greater Accra region Accra. There will
be proper documentation on the burden of malaria to serve as reference material to the
Greater Accra region especially Ablekuma, the District Health Management team as
well as the Non-Governmental Organizations (NGOs), who are concerned with the
improvement of sanitation, cleaning of choked gutter, apply mosquitos repellent with
DEET (diethyltoluamide) to expose skin, drape mosquitos netting over bed, put a
screen on windows and doors, and also educate the people in Ablekuma.
DEDICATION
This work is dedicated to my parent Afari Gyan and Asantewaa Mary for their love,
care, and support throughout the three years stay at Accra School of Hygiene

4. TABLE OF CONTENT
DECLARATION
CERTIFICATION
ABSTRACT
DEDICATION
CHAPTER ONE
INTRODUCTION
1.1 Background of the study
1.2 Statement of the problems
1.3 The objective of the study
1.3.1 Main objective
1.3.2 Specific objective
1.4 Research question
1.5 Significance of the study
1.6 Delimitation
REFERENCE
1.1 Background to the study

5. Malaria is a recurrent and intermittent fever caused by a protozoan parasite that
infects red blood cells and is spread by mosquitoes in many tropical and subtropical
areas.
Plasmodium falciparum is the most serious public health issue on a global scale,
accounting for more than 90% of malaria-related deaths. In 2015, an estimated 212
million new cases of malaria were reported worldwide (range: 148–304 million), with
the bulk of cases occurring in Africa (90 percent).
In recent years, there has been a renewed interest in the problem of urban malaria in
Sub-Saharan Africa. Urban malaria is projected to become more important shortly, as
rising urbanization will result in the majority of Africa's population residing in cities.
It is widely considered that urbanization reduces malaria incidence by reducing
Anopheles breeding sites, reducing bite rates due to a larger human-to-mosquito ratio
improving access to treatment, and improving (mosquito-proof) housing. However,
there is fear that places of rapid, unplanned urbanization, which are often linked with
low income, poor education, poor health care, and bad housing/sanitary conditions,
may not see such significant reductions in crime(Nonvignon et al., 2016)
Malaria is responsible for around 1800 hospital admissions and 10 fatalities per
100,000 people in Ghana, according to a World Health Organization (WHO) report.
Human population movement has been recognized as a fundamental problem in
handling malaria control and elimination programs, as it necessitates an understanding
of how malaria's spatial distribution evolves over time and across numerous areas that
become interrelated through population movement. (Diallo et al., 2017).

6. MIP accounted for 17.6% of outpatient department visits, 13.7 percent of hospital
admissions among pregnant women, and 3.4 percent of maternal mortality in Ghana
in 2014, with the first two measures falling to 14 and 11 percent in 2015. Malaria
transmission has decreased significantly globally, but it is unknown how this has
affected the malaria burden in pregnancy. Specifically, despite their vulnerability to
malaria, little is known about trends in asymptomatic P. falciparum parasitemia in
pregnant women in Ghana and other endemic countries. Such information is critical
for evaluating the efficacy of many years of focused preventive therapies, such as
IPT-SP and ITNs, either directly or indirectly. It will also be important to determine
where more money is needed(Osarfo et al., 2022).
Background In the fight against malaria, Ghana has achieved significant success.
Between 2005 and 2015, malaria incidences and fatalities reduced by almost 50% and
65 percent, respectively (Shretta et al., 2020).
To order to examine the influence of urban agriculture on malaria transmission risk,
entomological and epidemiological studies were conducted in Accra, Ghana. Malaria
prevalence was much greater in children living near urban agriculture (UA) in urban
Accra than in children living in neighborhoods remote from it, according to
epidemiological surveys. Only in a few groups, however, did the distance to
agriculture and malaria prevention have a strong negative relationship. There were
other groups outside of agriculture with high malaria incidence, suggesting that there
are likely to be additional relevant risk factors for urban malaria.
The results of a series of entomological research conducted in urban Ghana are
reported and compared to prior epidemiological studies(Klinkenberg et al., 2008).

7. Intra-country mobility and malaria risk in Sub-Saharan Africa is still poorly
documented in the literature. The extent of malaria in mobile populations and its
contribution to Ghana's local malaria situation are unknown. This study looked at the
malaria burden in mobile populations and their malaria-related risk factors in Ghana's
Greater Accra Region. This study's findings are extremely useful in bridging the
knowledge gap for programmatic improvement.
1.2 Statement of the problems
Two congenital cases, three cryptic cases, and two cases acquired by blood
transfusion were among the 2,161 confirmed malaria cases with symptoms reported to
the Centers for Disease Control and Prevention (CDC) in 2017. The number of
malaria cases detected in the United States has been growing since the mid-1970s; in
2017, the number of cases reported surpassed the previous record of 2,078 confirmed
cases in 2016, setting a 45-year high. In 2017, a total of 1,819 (86.1%) cases were
imported from Africa, including 1,216 (66.9%) from West Africa. The overall
proportion of imported cases from West Africa (57.6%) increased in 2017 compared
to 2016. (51.6%) of the population. The bulk of infections (1,523 cases) was caused
by P. falciparum. Due to the paucity of appropriate vector breeding grounds in highly
populated places, malaria has long been assumed to be a rural ailment in Ghana and
many other African countries. Although there is evidence that living closer to the

8. heart of a city diminishes mosquito breeding grounds, there have been several
reported cases of malaria transmission in cities(Diallo et al., 2017).
In Ghana due to the rapid growth of the population, especially Ablekuma has seen a
surge in urbanization. More than half of the population lives in the city. More than
half of the world's population lives in cities. Rapid urbanization has increased urban
poverty. Malaria is more common in the poorest parts of cities than previously
thought. In urban poor areas, inadequate housing, low socioeconomic level, and poor
sanitation (leading to the creation of breeding grounds) significantly increase the risk
of malaria. Malaria control in such areas becomes more difficult as a result of this.
Over the last two decades, several measures have been implemented in Ghana to
lower the prevalence of malaria. The malaria action plan and the rollback malaria
program are two examples. Despite these efforts, the rate of malaria in Ghana remains
high. The incidence has been reported to be on the rise. This has been ascribed to poor
drug treatment techniques, which have contributed to the spread of falciparum malaria
resistance. The key result, based on the data provided, is the "number of children
(under 5 years) who slept beneath a net the previous night," as determined by an
interviewer. The information from the household representative's questionnaire was
retrieved. All long-lasting insecticide-treated and other insecticide-treated bed nets
were defined. As a result, all insecticide-treated nets must be used. Whether long-
lasting insecticide-treated or retreated, are referred to as nets or bed nets in this
context. In terms of malaria-related media messaging, the survey found that
Information was obtained through television, radio, newspapers, posters, health
personnel, and community volunteers by inquiring of the household representative

9. "Have you seen or heard anything unusual in the last 12 months any letters informing
you that your families should sleep beneath the stars ITN focuses on pregnant mothers
and children(Owusu Adjah & Panayiotou, 2018).
Home-based remedies involving over-the-counter and leftover drugs, as well as the
use of herbs, are often the first treatment strategies for malaria in Ghana, particularly
Ablekuma, and other African countries, with individuals proceeding to a medical
facility for treatment if the condition worsens. The choice of alternative malaria
treatment has been attributed to misconceptions regarding malaria treatment, as well
as ease of accessibility and availability of alternative treatment.
1.3 Objective of the study
1.3.1 Main objective
The purpose of the study is to determine the burden of malaria in the mobile
population in the Greater Accra Region, Accra.
1.3.2 Specific objective
 To determine the knowledge level of the burden of malaria among the people
at ablekuma.
 To assess the socio-economic effects of the burden of malaria among the
people at ablekuma
 To recommend appropriate measures to be taken to prevent the burden of
malaria among the people at ablekuma.
1.4 Researchquestions

10.  What is the level of knowledge of the burden of malaria among the people at
Ablekuma?
 What are the socio-economic effects of the burden of malaria among the
people at Ablekuma?
 What are some of the appropriate measures to be taken to prevent the burden
of malaria among the people at Ablekuma?
1.5 Significance of the study
It is a leading cause of death and disease in many developing countries, where young
children and pregnant women are the groups most affected. According to the 2021
World Malaria Report: Nearly half the world's population lives in areas at risk of
malaria transmission in 87 countries and territories. In Ghana, it is estimated that 3.5
million cases of malaria are recorded each year. Evidence shows that malaria
contributes to about 38% of all outpatient cases and almost 50% of under-five hospital
admissions in the country. And after finding out all these results then we bring out the
possible ways of preventing malaria in Ghana which will based on the cleaning of
choked gutter, applying mosquito repellent with DEET (diethyltoluamide) to expose
skin, draping mosquitos netting over bed, putting a screen on windows and doors, and
also educate the people on things that will bring out the cause of malaria and the
health impact of it, to prevent the burden of malaria in Ablekuma, south municipal.
1.6 Delimitation
The research will be limited to the burden of malaria at Ablekuma south municipal in
the Greater Accra Region, Ghana.
REFERENCE:
Diallo, N., Akweongo, P., Maya, E., Aikins, M., & Sarfo, B. (2017). Burden of

11. malaria in mobile populations in the Greater Accra region, Ghana: a cross-
sectional study. Malaria Journal, 16(1), 1–9. https://doi.org/10.1186/s12936-
017-1751-x
Klinkenberg, E., Mccall, P. J., Wilson, M. D., Amerasinghe, F. P., & Donnelly, M. J.
(2008). Impact of urban agriculture on malaria vectors in Accra , Ghana. 9, 1–9.
https://doi.org/10.1186/1475-2875-7-151
Nonvignon, J., Aryeetey, G. C., Malm, K. L., Agyemang, S. A., Aubyn, V. N. A.,
Peprah, N. Y., Plange, C. N. B., & Aikins, M. (2016). Economic burden of
malaria on businesses in Ghana : a case for private sector investment in malaria
control. Malaria Journal, 1–10. https://doi.org/10.1186/s12936-016-1506-0
Osarfo, J., Ampofo, G. D., & Tagbor, H. (2022). Trends of malaria infection in
pregnancy in Ghana over the past two decades : a review. Malaria Journal, 1–12.
https://doi.org/10.1186/s12936-021-04031-3
Owusu Adjah, E. S., & Panayiotou, A. G. (2014). Impact of malaria-related messages
on the insecticide-treated net (ITN) use for malaria prevention in Ghana. Malaria
Journal, 13(1), 1–7. https://doi.org/10.1186/1475-2875-13-123
Shretta, R., Silal, S. P., Malm, K., Mohammed, W., Narh, J., Piccinini, D., Bertram,
K., Rockwood, J., & Lynch, M. (2020). Estimating the risk of declining funding
for malaria in Ghana : the case for continued investment in the malaria response.
Malaria Journal, 1–15. https://doi.org/10.1186/s12936-020-03267-9
Diallo, N., Akweongo, P., Maya, E., Aikins, M., & Sarfo, B. (2017). Burden of
malaria in mobile populations in the Greater Accra region, Ghana: a cross-
sectional study. Malaria Journal, 16(1), 1–9. https://doi.org/10.1186/s12936-
017-1751-x
Klinkenberg, E., Mccall, P. J., Wilson, M. D., Amerasinghe, F. P., & Donnelly, M. J.

12. (2008). Impact of urban agriculture on malaria vectors in Accra , Ghana. 9, 1–9.
https://doi.org/10.1186/1475-2875-7-151
Nonvignon, J., Aryeetey, G. C., Malm, K. L., Agyemang, S. A., Aubyn, V. N. A.,
Peprah, N. Y., Plange, C. N. B., & Aikins, M. (2016). Economic burden of
malaria on businesses in Ghana : a case for private sector investment in malaria
control. Malaria Journal, 1–10. https://doi.org/10.1186/s12936-016-1506-0
Osarfo, J., Ampofo, G. D., & Tagbor, H. (2022). Trends of malaria infection in
pregnancy in Ghana over the past two decades : a review. Malaria Journal, 1–12.
https://doi.org/10.1186/s12936-021-04031-3
Owusu Adjah, E. S., & Panayiotou, A. G. (2014). Impact of malaria-related messages
on the insecticide-treated net (ITN) use for malaria prevention in Ghana. Malaria
Journal, 13(1), 1–7. https://doi.org/10.1186/1475-2875-13-123
Shretta, R., Silal, S. P., Malm, K., Mohammed, W., Narh, J., Piccinini, D., Bertram,
K., Rockwood, J., & Lynch, M. (2020). Estimating the risk of declining funding
for malaria in Ghana : the case for continued investment in the malaria response.
Malaria Journal, 1–15. https://doi.org/10.1186/s12936-020-03267-9