Health
Malaria interventions must be guided by community needs, experts say
By Iyanuoluwa Abiola
Health experts have cautioned that declining malaria cases in Nigeria may not reflect the true risk the disease poses, urging authorities to look beyond prevalence figures.
They said focusing mainly on malaria prevalence, the number of people infected, could overlook how severe infections are and how actively the disease is spreading.
The warning was given on Tuesday during the 2026 Online Research Seminar organised by the Centre for Transdisciplinary Research in Malaria and Neglected Tropical Diseases, University of Lagos, with participation from researchers at the London School of Hygiene and Tropical Medicine.
Presenting findings from a sub-analysis of the 2021 Nigeria Malaria Indicator Survey, Alexandra Blair said prevalence alone does not provide a complete picture of malaria burden.
She explained that two communities may record similar malaria prevalence but differ significantly in parasite density, meaning one may face a much higher risk of severe disease and continued transmission than the other.
“Malaria prevalence does not fully capture the burden. Parasite density shows differences in infection intensity that prevalence may miss.
“When you only look at prevalence, you miss how intense infections are and how transmission differs from place to place,” Blair said.
Parasite density refers to the number of malaria parasites present in a person’s blood.
Blair further noted that combining parasite density with other indicators provides a clearer understanding of transmission patterns.
“It allows us to see patterns across regions and seasons that prevalence alone cannot explain,” she said.
She stressed the need for targeted interventions, noting that strategies must reflect local realities.
“If you are planning interventions, you have to focus on specific regions because the same measures will not be effective everywhere,” Blair added.
The findings come despite Nigeria continuing to bear the world’s highest malaria burden.
According to the World Malaria Report 2024, Nigeria accounts for 27 per cent of global malaria cases and 31 per cent of malaria deaths.
The disease remains a leading cause of illness and death among children under five and pregnant women.
PUNCH Healthwise reports that sleeping under insecticide-treated nets, eliminating mosquito breeding sites and testing for malaria before treatment are ways to reduce the malaria burden in the country.
Also speaking, the Director of the Centre, Prof Wellington Oyibo, said while Nigeria has recorded progress, the situation still demands sustained attention.
“We have made significant progress, but we still have a lot of work to do,” he said.
He noted that malaria prevalence has declined but warned against complacency.
“Prevalence has dropped from about 22 per cent to 15 per cent across the country, but that does not mean the problem is solved,” he added.
Oyibo stressed that response efforts must continue to be guided by evidence.
“States and the national malaria programme must continue to respond to findings from surveillance and research,” he said.
He added that expanding how malaria is measured could improve interventions.
“Including parasite density in our surveillance will provide more information on transmission and help us design better targeted control strategies,” he noted.
A Professor of Molecular Parasitology at the London School of Hygiene and Tropical Medicine, Prof David Conway, said advances in genetic research are helping scientists better understand how malaria parasites evolve and spread.
According to him, such insights could support the development of improved diagnostics, vaccines and treatments, while also helping detect drug resistance early.
He added that although some countries are close to eliminating malaria, global progress has slowed, making sustained research critical.
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