Malaria prevention in Nigeria faces setbacks as 24 million test positive despite 320m insecticide-treated nets and drugs since 2009.

Nigeria continues to battle high malaria incidence, with 24 million cases reported between January and September 2025 despite the Federal Government distributing over 320 million insecticide-treated nets and 450 million preventive drugs since 2009.

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The persistence of malaria is largely attributed to household reluctance to use the nets due to heat, poor power supply, and limited sleeping space, rendering the country’s primary control measure ineffective.

Mrs Nike Adedeji, a businesswoman, recounted receiving free nets for her family but abandoning them after a few nights due to unbearable heat.

“The heat that comes as a result of poor power supply makes me no longer use them. We would wake up drenched in sweat,” she said.

Similarly, Godwin Okpe from Benue State admitted he dismantles his net each morning to create room in his house, while trader Mrs Olumoyin Abiodun highlighted exposure to mosquitoes during late evening work as undermining the nets’ effectiveness.

Insecticide-treated nets (ITNs), recommended by the World Health Organisation, are designed to repel or kill mosquitoes and have long been promoted as the most effective preventive measure against malaria.

Since 2009, the Federal Government has distributed over 320 million ITNs and 450 million antimalarial drugs, including Sulfadoxine-Pyrimethamine and Amodiaquine, targeting children under five.

Despite these interventions, Nigeria remains among the top five countries globally with the highest malaria incidence.

The World Malaria Report 2024 indicates that of 263 million global malaria cases in 2023, Nigeria accounted for over 68 million, including 194,000 deaths and 39.3 per cent of global malaria fatalities in children under five.

Experts attribute the rise to a combination of factors: population growth, apathy, misuse of ITNs, misdiagnosis, and improper self-treatment with Artemisinin-based Combination Therapy drugs.

Prof Olusegun Ademowo of the University of Ibadan questioned whether the distributed 320 million ITNs actually reached end users and highlighted inappropriate alternative uses, such as fishing in riverine communities.

Prof Florence Nduka of the University of Port Harcourt pointed to misdiagnosis due to the paucity of WHO-certified microscopists, stagnant water, bushy surroundings, and poor housing as major contributors to sustained malaria transmission.

She urged behavioural change, community sensitisation, and proper drug use to curb the spread.

Prof Omosivie Maduka, an epidemiologist, stressed the link between human behaviour and malaria control, noting that inconsistent ITN usage, poor electricity supply, overcrowding, and self-medication have hampered eradication efforts.

She advocated for additional strategies such as indoor residual spraying, seasonal malaria chemoprevention for children under five, and environmental management to eliminate mosquito breeding grounds.

Malaria remains a significant threat to maternal and child health in Nigeria.

It contributes 11 per cent to the maternal mortality ratio, while pregnant women face risks of anaemia, stillbirths, low birth weight, and neonatal death.

Economic losses from malaria exceed $1.1 billion annually.

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While some Nigerians, like nurse Chiamaka Ibeanu in Anambra State, consistently use ITNs, experts warn that without widespread behavioural adoption, sustained education, and improved infrastructure, Nigeria’s 2030 malaria elimination goal remains unrealistic.