The malaria test positivity rate disaggregated by geopolitical region, year, and month of survey. Each point is sized by the number of children tested for malaria by microscopy.

The malaria test positivity rate disaggregated by geopolitical region, year, and month of survey. Each point is sized by the number of children tested for malaria by microscopy.

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Urban population growth in Nigeria may exceed the availability of affordable housing and basic services, resulting in living conditions conducive to vector breeding and heterogeneous malaria transmission. Understanding the link between community-level factors and urban malaria transmission informs targeted interventions. We analyzed Demographic and...

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... More recent guidance from the WHO suggests that communities can be excluded from receiving bed nets during net distribution campaigns based on current and historical data on malaria prevalence rate [35]. However, fine-scale malaria risk data at the smallest administrative levels are often unavailable for urban areas in malaria-endemic countries [36][37][38]. ...
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Background Malaria continues to be a major cause of illness and death worldwide, particularly affecting children under the age of five and those living in high-burden countries like Nigeria. Long-lasting insecticidal nets (LLINs) are one of the effective interventions for malaria control and prevention. In response to funding constraints in the Global Fund Grant Cycle 7, Nigeria's National Malaria Elimination Programme (NMEP) aimed to develop an approach that maximizes the impact of limited malaria interventions by focusing on areas with the greatest need. We developed an urban LLINs distribution framework and a novel strategy, which was piloted in Ilorin, the capital of Kwara State. Methods A participatory action research approach, combined with abductive inquiry, was employed to co-design a framework for guiding bed net distribution. The final framework consisted of three phases: planning, data review and co-decision-making, and implementation. During the framework's operationalization, malaria risk scores were computed at the ward level using four key variables, including malaria case data and environmental factors, and subsequently mapped. A multistakeholder dialogue facilitated the selection of the final malaria risk maps. Additionally, data from an ongoing study were analyzed to determine whether local definitions of formal, informal, and slum settlements could inform community-level stratification of malaria risk in cities. Results Akanbi 4, a ward located in Ilorin South and Are 2, a ward in Ilorin East consistently had lower risk scores, a finding corroborated during the multistakeholder dialogue. A map combining malaria test positivity rates among children under five and the proportion of poor settlements was identified as the most accurate depiction of ward-level malaria risk. Malaria prevalence varied significantly across the categories of formal, informal, and slum settlements, resulting in specific definitions developed for Ilorin. Thirteen communities classified as formal settlements in Are 2 were de-prioritized during the bed net distribution campaign. Conclusions The framework shows promise in facilitating evidence-based decision-making under resource constraints. The findings highlight the importance of stakeholder engagement in evaluating data outputs, particularly in settings with limited and uncertain data. Enhancing surveillance systems is crucial for a more comprehensive approach to intervention tailoring, in alignment with WHO's recommendations.
... This study explores malaria burden, IHCP competence, and patronage reasons across Nigerian urban settlements from the perspectives of the users and providers, identifying areas for improvement to integrate IHCPs into formal healthcare and enhance malaria services. Findings revealed the persistence of malaria in the studied Nigerian cities, despite the common assumption that it is primarily a rural issue and in contrast to recent findings from a quantitative study reporting low urban malaria prevalence [25]. This suggests that there is sustained malaria transmission in Nigerian cities, which is, however, in line with previous studies in the same setting where this study was conducted [26,27]. ...
... This is, however, not unexpected because in informal settlements and slums, the level of hygiene is usually low, and accessibility to basic amenities such as potable water remains a challenge in sub-Saharan countries like Nigeria [28]. Household proximity to water bodies such as rivers was also identified as a driver of malaria transmission especially in informal settlements, consistent with studies in Nigeria and Africa linking higher malaria positivity rates to informal settlements and nearby water reservoirs [25,26,29,30]. ...
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Background Informal Healthcare Providers (IHCPs), including Proprietary Patent Medicine Vendors (PPMVs), drug peddlers, traditional healers, and herbal drug sellers are often the first choice for malaria treatment, especially in urban slums. Unplanned urbanization significantly impacts malaria transmission by creating cities with inadequate safety nets and healthcare access, increasing reliance on IHCPs. While the World Health Organization recognizes IHCP’s crucial role and emphasizes integrating them into formal healthcare for improved malaria care, they lack requisite training in malaria management and operate outside official regulations, raising concerns about the quality of care they provide. Understanding IHCPs' perceptions and practices is essential for their proper integration. This study explored the perceived malaria burden, IHCPs’ competence in malaria treatment, and reasons for visiting IHCPs in various urban settlements from both community member and provider perspectives. Methods This qualitative cross-sectional study was carried out in Ibadan and Kano metropolises. Eighteen Focus Group Discussions among 157 adult community members and twelve Key-Informant Interviews among PPMVs, drug peddlers, traditional healers and herbal drug sellers were conducted in these cities. Participants were drawn purposively from settlements—designated as formal, informal, and slum based on local definitions—in selected wards within the cities. Data were collected using pre-tested guides and analysed thematically. Results This study reveals that malaria remains a significant health problem in these Nigerian cities. Patronage of IHCPs generally is driven by affordable treatment, perceived mildness of illness, and access to credit facilities. However, cultural belief was key to patronage of traditional healers and herbal drug sellers, largely among informal and slum residents. Furthermore, while IHCPs had a strong perceived competence in managing malaria cases, inadequate diagnosis and treatment were standard practices. Conclusions IHCPs remain consistently patronized across urban settlements. IHCPs are continuously patronized in all urban settlement. Educating and equipping IHCPs with diagnostic tools, enhancing access to affordable healthcare, and raising public awareness is crucial for proper malaria management and promoting collaborations with formal healthcare providers.
... Findings revealed the persistence of malaria in the two Nigerian urban cities, despite the common assumption that it is primarily a rural issue and a recent study reporting its low prevalence in urban areas. [23] This suggests that there is sustained malaria transmission in Nigerian urban cities, which is however, in line with previous studies in the same setting where this study was conducted. [23][24][25] Environmental factors which support the breeding of malaria vectors were identi ed as the main drivers of malaria transmission, and these were serious concerns in informal settlements and slums. ...
... [23] This suggests that there is sustained malaria transmission in Nigerian urban cities, which is however, in line with previous studies in the same setting where this study was conducted. [23][24][25] Environmental factors which support the breeding of malaria vectors were identi ed as the main drivers of malaria transmission, and these were serious concerns in informal settlements and slums. This is, however, not unexpected because in informal settlements and slums the level of hygiene is usually low and accessibility to basic amenities such as portable water remains a challenge in sub-Saharan countries like Nigeria. ...
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Informal Healthcare Providers (IHCPs), including Proprietary Patent Medicine Vendors (PPMVs), Drug Peddlers (DPs), Traditional Healers (THs), and Herbal Drug Sellers (HDSs) are often the first choice for malaria treatment, especially in urban slums. Unplanned urbanization significantly impacts malaria transmission by creating cities with inadequate safety nets and healthcare access, increasing reliance on IHCPs. While WHO recognizes IHCP’s crucial role and emphasizes integrating them into formal healthcare for improved malaria care, they lack requisite training in malaria management and operate outside official regulations, raising concerns about the quality of care. Understanding IHCPs' perceptions and practices is essential for their proper integration. This study explored the perceived malaria burden, IHCPs' competence in malaria treatment, and reasons for visiting IHCPs in various urban settlements from both community member and provider perspectives. This was a qualitative cross-sectional study in Ibadan and Kano metropolis. Eighteen (18) Focus Group Discussions (FGD) among 157 adult community members, and twelve (12) Key-Informant Interviews (KIIs) among PPMVs, DPs, THs, and HDSs were conducted in these cities. Participants were drawn purposively from settlements - designated as formal, informal and slum based on local definitions - in selected wards within the cities. Data were collected using pre-tested guides and analyzed thematically. Our study reveals that malaria remains a significant health problem in these Nigerian cities. Patronage of IHCPs is driven by affordable treatment, perceived mildness of illness and access to credit facilities while cultural belief was key to patronage of HDSs and THs, largely among informal and slum residents. Furthermore, while IHCPs had a strong perceived competence in managing malaria cases, inadequate diagnosis and treatment were common practices. Educating and equipping IHCPs with diagnostic tools, enhancing access to affordable healthcare, and raising public awareness are crucial for proper malaria management and promoting collaborations with formal health care providers.
... It significantly impacts a child's development, resulting in stunted growth, diminished cognitive function, and more detrimental educational attainment [6]. Numerous risk factors, such as the country's climate, the location and behavior of malaria vectors, socioeconomic determinants, and the effectiveness of current control strategies, contribute to Nigeria's high malaria burden [7]. The prevalence of malaria transmission among Nigerian children under five years of age is unclear because of the complex interaction of factors affecting risk and prevention across regions, population groups, healthcare systems, and periods [8,9]. ...
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Background Malaria is a global disease burden, especially in Africa, with Nigeria having the highest prevalence of malaria, with approximately 50% affecting children. Children under five years of age are vulnerable to the risk of malaria spread. This research aimed to identify the determinants of malaria spread among children under the age of 5 in Nigeria. Methods This study used national malaria indicator survey data from 2021 (2021NMIS). The NMIS was implemented by the National Malaria Elimination Programme (NMEP), and data were collected between 12 October and 4 December 2021. This study included 3678 children, and data cleaning and analysis were performed via STATA version 17 software. Results There was a positive association between Child’s age in months of 13–23 (AOR = 2.97; 95% CI = 1.62–5.45), 24–35 months (AOR = 2.64; 95% CI = 1.43–4.88),36–47 months (AOR = 2.18; 95% CI = 1.17–4.08) and months of 48–59(AOR = 2.82; 95% CI = 1.53–5.23), households headed by females (AOR = 0.71; 95% CI = 0.54–0.95),households with all children slept in mosquito nets last night (AOR = 2.43; 95% CI = 1.39–4.21), some children slept in the mosquito bed net (AOR = 2.83; 95% CI = 1.50–5.35) and households with no mosquito bed nets (AOR = 2.18; 95% CI = 1.22–3.88),mothers who agreed to have heard or seen malaria messages in the last 6 months (AOR = 1.32; 95% CI = 1.62–1.74),respondents with medium level of awareness of malaria prevention messages had (AOR = 2.35; 95% CI = 1.62–3.4), Children from North East (AOR = 0.7; 95% CI = 0.54–0.9), South-South (AOR = 0.65; 95% CI = 0.5–0.85) and South West (AOR = 0.52; 95% CI = 0.37–0.73) and malaria status of children under five years of age in Nigeria. Conclusion The government and other concerned malaria prevention organizations should emphasize maternal education programs that are vital for malaria prevention, early symptom recognition, and timely treatment, empowering families to take proactive measures. Collaboration among health, education, and community organizations is also crucial for integrated malaria control and prevention.
... Notably, a prior study conducted in Southern Nigeria, reported a high prevalence (37%) of co-infection with malaria in LF patients, but no statistically significant impact of malaria on LF outcome was observed [55]. Risk factors for malaria include poverty, less education, and poor housing conditions [56,57]. People with lower socioeconomic status likely have limited access to preventive measures and live in housing that is not properly sealed or screened allowing mosquitoes to enter more easily, thus increasing the risk of malaria infection. ...
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Background: Understanding the level of exposure to Lassa virus (LASV) in at-risk communities allows for the administration of effective preventive interventions to mitigate epidemics of Lassa fever. We assessed the seroprevalence of LASV antibodies in rural and semiurban communities of two cosmopolitan cities in Nigeria with poorly understood Lassa epidemiology. Methods: A cross-sectional study was conducted in ten communities located in the Abuja Municipal Area Council (AMAC), Abuja, and Ikorodu Local Government Area (LGA), Lagos, from February 2nd to July 5th, 2022. Serum samples collected from participants were analyzed for IgG and IgM antibodies using a ReLASV® Pan-Lassa NP IgG/IgM enzyme-linked immunosorbent assay (ELISA) kit. A questionnaire administered to participants collected self-reported sociodemographic and LASV exposure information. Seroprevalence of LASV IgG/IgM was estimated overall, and by study site. Univariate and multivariate log-binomial models estimated unadjusted and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CI) for site-specific risk factors for LASV seropositivity. Grouped Least Absolute Shrinkage and Selection Operator (LASSO) was used for variable selection for multivariate analysis. Results: A total of 628 participants with serum samples were included in the study. Most participants were female (434, 69%), married (459, 73%), and had a median age of 38 years (interquartile range 28-50). The overall seroprevalence was 27% (171/628), with a prevalence of 33% (126/376) in Abuja and 18% (45/252) in Lagos. Based on site-specific grouped LASSO selection, enrollment in the dry season (vs. wet; aPR, 95% CI: 1.73, 1.33-2.24), reported inconsistent washing of fruits and vegetables (aPR, 95% CI: 1.45, 1.10-1.92), and a positive malaria rapid test (aPR, 95% CI: 1.48, 1.09-2.00) were independently associated with LASV seropositivity in Abuja, whereas, only a self-reported history of rhinorrhea (PR, 95% CI: 2.21, 1.31-3.72) was independently associated with Lassa seropositivity in Lagos. Conclusions: The LASV seroprevalence was comparable to that in other areas in Nigeria. Our findings corroborate those from other studies on the importance of limiting human exposure to rodents and focusing on behavioral factors such as poor hygiene practices to reduce exposure to LASV.
... Nigeria is responsible for 27% of all worldwide malaria occurrences and 31% of global malaria-related deaths, thereby emerging as the primary contributor to the overall malaria burden globally (WHO, 2021). Recognizing the pivotal role of robust healthcare in the advancement of a nation, and notwithstanding the advancements achieved in the direction of malaria eradication, the disease persists as a notable public health challenge within Nigeria (Chilochibi et al, 2024) and specifically within Ondo State. Consequently, the fundamental objective of this investigation is to examine the spatial pattern and distribution of malaria cases within the Owo Local Government Area of Ondo State. ...
Article
This study investigates the spatial pattern and distribution of malaria cases in Owo Local Government Area, Nigeria. A multi-stage sampling technique was used, such that 50% of the 7 urban political wards were selected. The selected 4 urban political wards comprise of 12,466 household heads. Also, 10% of the 127 rural settlements were randomly selected making 14 rural settlements with 9,095 household heads. In all, 1.5% of the total household heads, comprising 187 in the urban areas and 136 in the rural settlements were interviewed using systematic random sampling techniques. A secondary data source obtained from relevant healthcare facilities was used for spatial analysis. Specifically, 59 selected residential settlements were used as the input feature class, while the records on malaria cases in each residential settlement during the reviewed year serve as the input field for the analyses. Spatial statistical functions provided by ArcGIS 10.8 and Geospatial tool are utilized for data analysis. Findings revealed preponderance of malaria within the urban core area of Owo. This can be attributed to inadequate wastewater management, poor waste disposal methods, and inadequate environmental education and awareness. On the other hand, malaria cases in rural areas were relatively low due to the use of alternative disease treatment methods. To ameliorate these challenges, there is a need for improved access to a safe and high-quality environment, implement suitable sanitation facilities and solid waste disposal methods, promote community-based educational initiatives and awareness campaigns, and encouraging hygienic behaviors. Through these, the health challenges of malaria can be mitigated.
... It signi cantly negatively impacts a child's development, resulting in stunted growth, diminished cognitive function, and more detrimental educational attainment [6]. Numerous risk factors, such as the country's climate, the location and behaviour of malaria vectors, socioeconomic determinants, and the effectiveness of current control strategies, contribute to Nigeria's high malaria burden [7]. Unfortunately, there is no clear prevalence rate for all risk factors for malaria transmission among Nigerian children under the age of ve. ...
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Background Malaria is one of the global disease burdens especially in Africa with Nigeria having the highest prevalence of the disease. Children under five are vulnerable to the risk of malaria spread. This research aimed at identifying the determinants of malaria spread among the under-5 children in Nigeria. Methods This study used 2021NMIS data. The NMIS was implemented by the National Malaria Elimination Programme (NMEP) and data was collected between 12 October to 4 December 2021. This study included 3678 children and data cleaning and analysis were done using STATA version 17 software. Results Child’s age in months of 13–23 (AOR = 2.97; 95% CI = 1.62–5.45, p-value: 0.00), 24–35 months (AOR = 2.64; 95% CI = 1.43–4.88, p-value: 0.002),36–47 months (AOR = 2.18; 95% CI = 1.17–4.08, p-value: 0.015) and months of 48–59(AOR = 2.82; 95% CI = 1.53–5.23, p-value: 0.001), households headed by females (AOR = 0.71; 95% CI = 0.54–0.95, p-value: 0.019),households with all children slept in mosquito nets last night (AOR = 2.43; 95% CI = 1.39–4.21, p-value: 0.002), some children slept in the mosquito bed net (AOR = 2.83; 95% CI = 1.50–5.35, p-value: 0.001) and households with no mosquito bed nets (AOR = 2.18; 95% CI = 1.22–3.88, p-value: 0.008),mothers who agreed to have heard or seen malaria messages in the last 6 months (AOR = 1.32; 95% CI = 1.62–1.74, p-value: 0.000),respondents with medium level of awareness of malaria prevention messages had 2.35 odds (AOR = 2.35; 95% CI = 1.62–3.4, p-value: 0.000), Children from North East (AOR = 0.7; 95% CI = 0.54–0.9, p-value: 0.005), South-South (AOR = 0.65; 95% CI = 0.5–0.85, p-value: 0.002) and South West (AOR = 0.52; 95% CI = 0.37–0.73, p-value: 0.000) were the determinants of malaria spread in Nigeria Conclusion Maternal education and Regional disparities in malaria risk need to be addressed through in-depth assessments, identifying specific factors contributing to varying risk levels across different regions. Based on these insights, region-specific strategies and resource allocation can tackle unique challenges faced by each area.
... Malaria risk in urban Nigeria is greatest among individuals in the lowest socioeconomic status, those living in low-quality housing and in neighbourhoods with environmental conditions that support exposure to vectors [7][8][9][10][11] . Previous research has shown that housing improvements are associated with a reduced likelihood of malaria infections 8 . ...
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Introduction Limited funding in the Global Fund Grant Cycle 7 prompted Nigeria’s National Malaria Elimination Programme (NMEP) to adopt a strategy to deprioritize the least vulnerable communities for malaria during bed net mass campaigns. A deprioritization approach piloted in Ilorin, the capital of Kwara state, in collaboration with the NMEP, the state malaria control program, and implementing partners is presented. Methods We employed a mixed-method approach to identify communities where bed net distribution would not take place during the 2023 Ilorin mass campaign. Ten combinations of variables, including test positivity rates among under-five children, settlement classification, enhanced vegetation index, and distance to water bodies, were utilized to generate a malaria risk score and rank wards accordingly. Deprioritized wards were then selected, and after settlement classification, deprioritized communities were identified. Results The multi-stakeholder dialogue provided valuable insights into the most suitable variables for settlement classification and highlighted the limitations of each variable. As a result, two wards, Are 2 and Akanbi, were chosen for deprioritization, and criteria for selecting deprioritized communities were established. Characteristics distinguishing formal, informal, and slum settlements were identified and used to adapt a checklist for the classification of 188 communities within Are 2 and Akanbi 4. Ultimately, 13 communities characterized as formal settlements were deprioritized. Conclusions The process of deprioritizing communities necessitates stakeholder involvement to evaluate analysis outputs, especially in settings with limited data availability and uncertain data quality. We demonstrate how this can be accomplished and emphasize that ongoing evaluations will inform future enhancements to this framework and related processes. Moreover, there is a need for enhanced surveillance systems to support a more comprehensive approach to intervention tailoring that is in line with WHO recommendations.
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Malaria remained a significant public health challenge in sub-Saharan Africa, disproportionately affecting children under five years of age. Understanding the socioeconomic and environmental risk factors associated with malaria in this vulnerable population was crucial for developing targeted interventions to reduce transmission and improve health outcomes. This review examined the complex interplay between socioeconomic status, housing conditions, environmental factors, and malaria risk among young children. A comprehensive literature search was conducted to synthesize current research findings on the topic. Key socioeconomic determinants included household income, maternal education, and access to preventive measures. Children from low-income families were at higher risk due to limited resources for malaria prevention and treatment, as well as poorer living conditions that facilitate mosquito breeding. Environmental factors such as proximity to stagnant water bodies, inadequate sanitation, and climate variability further exacerbated malaria transmission. The review highlighted the need for multifaceted approaches that address both biological and social determinants of health to effectively reduce the burden of malaria among children under five in sub-Saharan Africa.