Nigeria’s progress in reducing malaria prevalence is being undermined by gaps in diagnosis, with only 18 per cent of children under five who recently had fever tested for the disease, despite a decline in malaria parasite prevalence to 15 per cent in 2025.
The figures highlight a persistent weakness in the country’s malaria response, where falling infection rates have yet to translate into adequate access to essential diagnostic and preventive services for vulnerable populations.
The findings are contained in the 2025 Nigeria Malaria Indicator Survey (NMIS), released in Abuja on Thursday by the Federal Ministry of Health and Social Welfare through the National Malaria Elimination Programme (NMEP).
According to the survey, malaria prevalence among children aged six to 59 months fell from 42 per cent in 2010 to 23 per cent in 2018 and 22 per cent in 2021 before dropping to 15 per cent in 2025.
Despite the improvement, the survey identified shortcomings in testing, access to insecticide-treated nets and malaria prevention during pregnancy, raising concerns about the sustainability of the gains.
Among children under five who experienced fever in the two weeks preceding the survey, 59 per cent had advice or treatment sought, but only 18 per cent underwent malaria testing.
The figures underscore the importance of expanding diagnostic services, particularly because fever does not always indicate malaria and treatment decisions should be guided by appropriate testing.
Prevention through insecticide-treated nets also remains inadequate. The survey found that 54 per cent of households owned at least one insecticide-treated net, while only 21 per cent had enough nets to provide one for every two household members who slept there the previous night.
The findings also revealed gaps in malaria prevention among pregnant women. Of women aged 15 to 49 who had a live birth in the two years preceding the survey, 62 per cent received at least one dose of sulphadoxine-pyrimethamine, commonly known as Fansidar, during their most recent pregnancy. Only 33 per cent received at least three doses.
The burden of malaria also varies considerably across the country, with prevalence among children aged six to 59 months ranging from two per cent in Lagos State to 31 per cent in Ebonyi State.
The wide disparity suggests that national progress masks significant differences in local disease burdens, making state-specific interventions essential to closing the remaining gaps.
The survey will inform the National Malaria Strategic Plan (NMSP) 2026–2030, which targets a 50 per cent reduction in malaria parasite prevalence and malaria deaths from their 2025 levels by 2030.
The plan prioritises prevention, prompt diagnosis, appropriate treatment, improved surveillance, sustainable financing and stronger accountability, while seeking to direct resources towards communities with the greatest needs.
It targets at least 80 per cent access to and utilisation of malaria prevention interventions by 2030, alongside effective diagnosis and appropriate treatment coverage of at least 90 per cent among populations at risk.
The strategy also seeks to increase malaria surveillance performance from 47 per cent to 70 per cent and ensure that domestic sources provide at least 60 per cent of resources for malaria programmes.
Achieving the targets will require sustained commitment from federal and state governments, development partners, health workers, civil society organisations, private-sector actors and communities.
Although the decline in prevalence represents substantial progress, the survey’s findings show that expanding testing, improving preventive coverage and ensuring effective treatment will remain critical to reducing deaths and advancing Nigeria’s ambition of moving closer to malaria elimination by 2030.
