Geographical and temporal variation in reduction of malaria infection among children under 5 years of age throughout Nigeria

Introduction Global progress in reducing malaria has stalled since 2015. Analysis of the situation is particularly needed Nigeria, country with by far largest share burden, where approximately a quarter all cases world are estimated to occur. Methods We analysed data from three nationwide surveys (Malaria Indicator Surveys 2010 and 2015 National Demographic Health Survey 2018), parasite prevalence children under 5 years age determined sampling 36 states blood slide microscopy performed same accredited laboratory for samples. Changes over time were evaluated calculating ratio (PR) values 95% CIs each state, together Mantel-Haenszel-adjusted PRs (PR adj ) six major geopolitical zones country. Results Between 2018, there significant reductions 25 states, but not remaining 11 states. Prevalence decreased most southern (South West PR =0.53; South East =0.59; =0.51) North Central zone =0.36). north less marked, indicated overall more than 20% (North-West =0.74; =0.70). south occurred mostly between 2015, whereas those gradual continued after Recent changes correlated survey-reported variation use preventive measures. Conclusion Reductions infection have individual Nigeria 2010, substantial geographical timing extent indicate challenges be overcome enable global reduction.