Nigeria

Malaria in Nigeria

Nigeria is one of four countries that carry 40% of the total malaria cases and death globally. Malaria is responsible for approximately 60% of outpatient visits and 30% of admissions. It is also believed that malaria contributes to approximately one in ten maternal death and one in four infant and under-five deaths (Malaria Indicator Survey [MIS] 2015).

According to the World Malaria Report 2016 Nigeria accounts for: 

• 29% of the global estimate of total malaria cases (highest in the world); and 
• 26% of the global estimate of total malaria deaths (highest in the world).

Malaria risk

In Nigeria, 85% of  the population live in areas of risk < 20% parasitaemia/ regular seasonal transmission and 15% live in areas of >60-70% parasitaemia/ year round transmission or >50 <70 % parasitaemia - intermittent transmission.

The Phase 1 LINK profile, completed in 2013, showed decreases in parasite risk patterns during the past decades, with risks falling in 19 of 36 States and the Federal Capital Territory; it also showed a 50% reduction of morbidity in these areas. There is evidence of regional differences in malaria prevalence across Nigeria, with prevalence for children under five in malaria ranges from 14% in south east to 37% in north west. The 2015 MIS also showed that 27% of children under five tested positive for malaria microscopy compared to 42% found in the 2010 MIS. These observed variations are likely to be due to climate and ecological differences but could also be attributed to socio-demographic factors and varying quality of health systems and programmatic implementation  (Nigeria National Malaria Strategic Plan [NNMSP] 2014). 

Bednet coverage total in household population has changed from 2010 to 2015. The 2015 MIS shows that 71% of households have at least one mosquito net, 69% have at least one insecticide treated net (ITN), and 69% have at least one  long-lasting insecticidal (LLIN). This compares to the 2013 DHS: 55% of households have at least one mosquito net, 50% have at least one ITN and 48% have at least one LLIN. The 2010 MIS showed 44% of households had at least one mosquito net, 42% had at least one ITN and 41% had at least one LLIN.

In 2015, 44% of children under five and 49% of pregnant women age 15-49, slept under an ITN.

Nigeria National Strategic Plan 2014 - 2020

The NNMSP 2014's mission is to provide equitable, comprehensive cost-effective and quality malaria control services ensuring transparency, accountability, client satisfaction, community ownership and partnership. It aims to achieve pre-elimination status (less than 5,000 cases per 100,000 persons) and reduce malaria-related deaths to zero by 2020.

LINK activities

In Phase 2 of the project, LINK is currently working with the National Malaria Elimination Programme (NMEP) to finalise the malaria epidemiological profile. The first re-engagement meeting, coordinated by the NMEP, took place on 2 March 2017. Mid-term dialogue meetings including the first decision-maker engagement workshop took place in June 2017.  The final dissemination meeting took place in November 2017 where an updated profile, malaria indicator poster and timeline of the major historical events in malaria control in Nigeria were presented. 

As part of Phase 2 work LINK has collated evidence from: 822 published articles or MSc/PhD theses and 24 implementation reports/ policies.

In 2013 during Phase 1, a report was produced on the epidemiology of malaria to guide the planning of its control in Nigeria. This profile was a collaboration between the INFORM Project, KEMRI-Wellcome Trust Programme and the NMEP.

Development of malaria control timeline

A timeline of the history of malaria control in Nigeria was produced with the help of the NMEP in 2017. The history of malaria dates back to 1889 when the first sanitation campaign in schools were started to 2017 when the national Insecticide Resistance Monitoring Plan was launched. In all, the timeline covers over 100 major events in malaria control specifically looking at the areas of policy, vector control, insecticide resistance, case management, surveillance, operational research and monitoring.