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Geographical and temporal variation in reduction of malaria infection among children under 5 years of age throughout Nigeria
- Source :
- BMJ Global Health, Vol 6, Iss 2 (2021), BMJ Global Health
- Publication Year :
- 2021
- Publisher :
- BMJ, 2021.
-
Abstract
- IntroductionGlobal progress in reducing malaria has stalled since 2015. Analysis of the situation is particularly needed in Nigeria, the country with by far the largest share of the burden, where approximately a quarter of all cases in the world are estimated to occur.MethodsWe analysed data from three nationwide surveys (Malaria Indicator Surveys in 2010 and 2015 and a National Demographic and Health Survey in 2018), with malaria parasite prevalence in children under 5 years of age determined by sampling from all 36 states of Nigeria, and blood slide microscopy performed in the same accredited laboratory for all samples. Changes over time were evaluated by calculating prevalence ratio (PR) values with 95% CIs for each state, together with Mantel-Haenszel-adjusted PRs (PRadj) for each of the six major geopolitical zones of the country.ResultsBetween 2010 and 2018, there were significant reductions in parasite prevalence in 25 states, but not in the remaining 11 states. Prevalence decreased most in southern zones of the country (South West PRadj=0.53; South East PRadj=0.59; South South PRadj=0.51) and the North Central zone (PRadj=0.36). Changes in the north were less marked, but were significant and indicated overall reductions by more than 20% (North-West PRadj=0.74; North East PRadj=0.70). Changes in the south occurred mostly between 2010 and 2015, whereas those in the north were more gradual and most continued after 2015. Recent changes were not correlated with survey-reported variation in use of preventive measures.ConclusionReductions in malaria infection in children under 5 have occurred in most individual states in Nigeria since 2010, but substantial geographical variation in the timing and extent indicate challenges to be overcome to enable global malaria reduction.
- Subjects :
- medicine.medical_specialty
prevention strategies
030231 tropical medicine
malaria
Nigeria
Blood slide
diagnostics and tools
North east
lcsh:Infectious and parasitic diseases
03 medical and health sciences
0302 clinical medicine
Surveys and Questionnaires
Epidemiology
South east
medicine
Humans
lcsh:RC109-216
030212 general & internal medicine
Prevalence ratio
Child
Original Research
lcsh:R5-920
Health Policy
Public Health, Environmental and Occupational Health
medicine.disease
Quarter (United States coin)
Geography
Child, Preschool
Health survey
epidemiology
lcsh:Medicine (General)
Malaria
Demography
Subjects
Details
- ISSN :
- 20597908
- Volume :
- 6
- Database :
- OpenAIRE
- Journal :
- BMJ Global Health
- Accession number :
- edsair.doi.dedup.....333c4e437ee888971c11666a3cd20298