Running head: MALARIA IN NIGERIA 1

The Bridge Empire Consultancy company

Applied Epidemiology Health Concern Info Session: Malaria in Nigeria
Pham Bao Ngoc Vuong – N01238584
Aubrey Benjamin – N00767942
BHSW 3500 – Applied Epidemiology
Instructor: Nora Zwingerman
Humber College
Sunday, February 9th 2020
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Abstract
The report provides descriptive epidemiological data on malaria in Nigeria to help
assimilate health concern information to our company, The Bridge Empire Consultancy (TBEC).
As we are expanding our branch to Nigeria, it is important to understand one of the most
prevalent infectious diseases in the country to have possible prevention to protect our employees’
health and wellness. Nigeria accounted for up to 19% of the global cases and 25% of the global
deaths in 2017 (WHO, 2018).
Executive summary

History of The Bridge Empire Consultancy

The Bridge Empire Consultancy (TBEC) Nigeria is a limited liability company that provides
professional consultation and processing services on education, migration, IT, career, and event
planning (TBEC, n.d.)

The purpose of the report

The purpose of this report is to present the descriptive information of malaria disease in Nigeria
to explain how common malaria is, who is at risk and how concerned TBEC Nigeria’s
employees should be. In 2015, malaria was reported to be the leading cause of death in Nigeria
with approximately 192,284 deaths and mostly young children (WHO, 2016).

Background of Malaria

Malaria is an urgent public health problem in Nigeria and in the world (WHO, 2019). Malaria is
a disease spread through the bite of a female Anopheles mosquito that is infected with parasitic
protozoans of the genus Plasmodium (Mac et al., 2019). There are 5 types of malaria parasite,
and Plasmodium falciparum is the deadliest of the 5 species and is common to Nigeria (Mac et
al., 2019). P. Falciparum causes several deaths globally and in Nigeria, where it is comorbid with
other diseases such as HIV, it accounts for over 99% of malaria cases (Mac et al., 2019).
Common symptoms of malaria include chills, fever, headache, sweating, malaise dizziness
muscle pains abdominal pains, feeling upset and unwell, mild diarrhea and dry mouth (feeling of
thirst(Trampuz et al., 2003) . Malaria can also result in death if an infection with P. falciparum is
not treated in a timely manner and correctly managed. Complications such as kidney failure,
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pulmonary edema and respiratory failure and anemia due to constant destruction of the red blood
cells can occur within 3 to 7days of onset of P. falciparum malaria on set (Trampuz et al., 2003).

The findings of Malaria in Nigeria

Nigeria has the greatest number of cases of malaria in the world with 25% of Malaria cases
worldwide in 2017 (WHO, 2018). Also, within that same year, Nigeria accounted for 19% of
global malaria death (WHO, 2018).

The prevalence of malaria death rate in 2017 in Africa

The map of Africa below (Fig. 1) shows “The prevalence of malaria death rate in 2017 in
Africa.” Nigeria accounted for a great number of malaria death cases among sub-Saharan
African countries, 69 deaths per 100,000 people to be exact.
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Figure 1. Malaria death rates in Africa in 2017. Adapted from Global Burden of Disease Study
2017, by Global Burden of Disease Collaborative Network, 2017. Retrieved February 8, 2020,
from https://ourworldindata.org/grapher/malaria-death-rates?time=1990..2017&country=CAF.
Copyright 2018 by Seattle, United States: Institute for Health Metrics and Evaluation (IHME).
Table 1. Malaria death rates in Africa in 2017
Countries The annual number of deaths from malaria per 100,000 people

Niger 133.51
Sierra Leone 132.94
Burkina Faso 130.24
Togo 108.02
Republic of the Congo 96.76
Mali 95.62
Guinea 95.57
Benin 85.02
Cameroon 90.96
Central African Republic 83.59

Equatorial Guinea 79.8

Ghana 75.79
Cote d’Ivoire 74.67
Liberia 73.89
Mozambique 71.51
Nigeria 69

Uganda 55.23
Congo 53.92
Chad 50.71
Malawi 46.82
Gabon 46.2

South Sudan 36.07

Angola 32.19
Zambia 29.39
Tanzania 28.86
Madagascar 26.72

Senegal 18.97
Guinea-Bissau 17.74
Kenya 12.73

Gambia 9.03
Mauritania 8.96
Somalia 8.12
Sudan 6.42
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Reported malaria cases

The decrease in malaria cases for the general population based on the provided information
started in 2006-2007, but the malaria cases for children less than 5 years continue to increase
based on the provided data. This is an indication that children are the ones most affected by
malaria.

Reported malaria cases in Nigeria

4500000 1200000
4000000
1000000
3500000

malaria cases, <5 years

malaria cases, all ages

3000000 800000
2500000
600000
2000000
1500000 400000
1000000
200000
500000
0 0
2000 2001 2002 2003 2004 2005 2006 2007 2008

Reported malaria cases, all ages Reported malaria cases, < 5 years

Figure 2. Reported malaria cases in Nigeria between 2000 and 2008. Adapted from
Malaria in Nigeria, by World Health Organization, 2009. Retrieved February 9, 2020, from
https://www.who.int/malaria/publications/country-profiles/2009/mal2009_nigeria_0033.pdf,.
Copyright 2019 by World Health Organization

Table 2. Reported malaria cases in Nigeria 2000-2008

Cases Years 2000 2001 2002 2003 2004 2005 2006 2007 2008

Reported m alari a 2476 2253 2605 2608 3310 3532 3982 2969 2834
cases, all ages 608 519 381 479 229 108 372 950 174
Reported m alari a 1718 5071 8142 8653 1004
cases, < 5 years 12 73 74 74 394
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Incidence rates by seasons

The chart (Fig. 2) shows “Incidence rates by seasons of Malaria in Nigerian children. As it can
be seen from the graph during the rainy periods (May to September) annually, the incidence of
Malaria is at its highest. In December there was a high incidence of cases.

Figure 3. The relationship between the incidence of Malaria in children and the seasonal
changes in Nigeria. Adapted from Seasonal Variation of Malaria Parasite Density in Paediatric
Population of North Eastern Nigeria, by L. M. Samdi, J. A. Ajayi, S. Oguche, and A. Ayanlade,
2012, Global Journal of Health Science, 4(2), pp.103–109. Copyright 2012 by the Canadian
Center of Science and Education

Table 3. The incidence of Malaria in children and the seasonal changes in Nigeria
% positive for
Months Number examined
malaria parasites
Rainy Season June 16 30
July 9 19
August 14 68
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September 10 36
October 14 55
November 10 62
Cold Dry Season
December 32 89
January 7 52
February 18 90
March 4 65
Hot/ warm season
April 8 29
May 16 49
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Impacts on TBEC’s plan for investment in Nigeria

From the descriptive epidemiological graphs, maps, and charts provided it can be seen
that malaria affects almost everyone in Nigeria. The majority of individuals severely affected by
malaria in Nigeria are children, pregnant women, HIV/AIDS patients, non-immune visitors to
the country and travelers. (WHO, 2020). It should be noted that malaria has been on the decline
in Nigeria from 2000 to 2018 (WHO, 2019). P. Falciparum malaria is still very harmful and can
result in death if not quickly treated with antimalarials. That means that our employees have to
follow strict guidelines while they are in the country. 
To avoid infection when visiting Nigeria, it is recommended that:
1. Employees wear mosquito repellant 24 hours each day. (WHO, 2020)
2. Sleep under insecticide treated mosquito nets (WHO, 2020)
3. Wear clothing that covers the legs, arms and body while traversing throughout Nigeria
(WHO, 2020).
4. Take prophylactic (preventative) medication to prevent malaria disease (WHO, 2020).
5. Should they develop any increase in temperature or feel on well they will need to be
examined by TBEC’s appointed physician.
The use of Malaria Rapid Diagnostic Tests (RDTs) along with the gold standard of a malarial
blood smear examined under a microscope, is highly recommended to regularly evaluate
employees while in the country and after they have left.
If the recommendations stated above are closely followed, then TBEC can progress with the
planned investment in Nigeria.
The information provided in the charts, graphs and map, show that although malaria is a
serious illness, the persons that are more seriously affected are children, although any person can
be affected. The malaria cases are highest during the rainy, hot and wet periods of the year.
During this period TBEC should minimize their activities in Nigeria if this is possible. If the
recommendations stated above are closely followed, then TBEC can progress with the planned
investment in Nigeria.
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References
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