Prevalence of Malaria among Children under Five Years in the Niger Delta Region of Nigeria

Background: Malaria still remains an overwhelming cause of morbidity and mortality among children under five years of age, especially in sub-Saharan Africa. The aim of this study was to determine the prevalence of Plasmodium parasitemia among children below 5 years of age in Akwa-Ibom, Delta and Rivers States, located in the Niger Delta region of Nigeria.

Methodology: A cross sectional study of 2630 children, selected by multistage sampling from Akwa-Ibom, Delta and Rivers States of Nigeria between April and June 2019. Parasitological diagnosis was by Plasmodium falciparum histidine-rich protein 2-based malaria rapid diagnostic test (RDT) and microscopy of giemsa-stained blood smears. Demographic information was collected using soft copies of pretested interviewer-administered questionnaires via the Open Data Kit application installed on android phones. Data analysis was performed using the statistical software SPSS version 25. Frequency, percentages, and Chi-square test were used to interpret data at a confidence interval of 95% and a p-value less than 0.05 was regarded as statistically significant.

Results: A total of 2630 children less than 5 years old were included in the study, 1016 from Akwa-Ibom and 807 each from Delta and Rivers states respectively. Malaria parasitaemia was detected in 230 (8.6%) and 198 (7.4%) children by RDT and microscopy, respectively. RDT used in this survey has high diagnostic accuracy (98.8%) compared to microscopy.

Conclusion: The study shows a decline in the prevalence of malaria in children under 5 years. It also demonstrates the reliability of the RDTs in the diagnosis of malaria. The use of RDTs is thus further recommended especially in peripheral centers where the access to skilled microscopists and laboratory infrastructure may be lacking.