The fight against malaria in Edo-North, Edo State, Nigeria: identifying risk factors for effective control
Authors: Braimah Joseph Odunayo , Edike Nnamdi , Okhaiomoje Augustine Ijeameran , Correa Fabio Mathias 
Published: November 2024

Background
This study investigated malaria epidemiology in Edo-North, Nigeria; a region within the equatorial rainforest belt that has lacked prior research on malaria prevalence. This research sought to investigate the prevalence of malaria and identify potential risk factors in Edo-North, Nigeria. Additionally, the study aimed to analyze trends in malaria cases to inform the development of effective malaria control measures.

Methodology
A cross-sectional study was conducted in six local government areas of Edo-North, Nigeria, between June and August 2023. Using systematic sampling, study zones, local governments, towns, villages, and households were selected. Data on sociodemographics and environmental risk factors were collected from 605 participants through questionnaires and blood samples. Blood smears were microscopically examined, binary and multivariate logistic regression was used for data analysis. Malaria disease rate trends were also analyzed from health records. Statistical analyses were performed using R software, with p-values less than 0.05 considered statistically significant.

Results
The overall malaria prevalence in the study area was 15.54%, with males more likely to be infected than females. Prevalence varied across localities, with Akoko-Edo having the highest rate. Children had the highest prevalence. Rural residents were more likely to have malaria than urban residents. Binary logistic regression identified several risk factors, including age, location, local government area, education, occupation, marital status, housing type, household size, water source, sanitation, surrounding environment, window net use, ceiling type, water storage, and parasite density. The multivariate logistic regression analysis identified several significant risk factors for malaria in the study population. Children, residents of Owan-East, individuals using pit latrines, and those not sleeping under LLINs were at significantly increased risk. Environmental factors such as proximity to bushes, streams/rivers, and storing water in open containers were also associated with higher malaria prevalence. History of malaria treatment at pharmacies and use of Chloroquine/Quinine medication were linked to recurrent infections. The study found a high average parasite density (5,146 parasites/μL) and low consistent LLIN use despite widespread ownership. Trend analysis from malaria records revealed a decline in malaria prevalence from 2020 to 2023.

Conclusions
The study identified several demographic, environmental and behavioural factors associated with malaria risk in Edo North. Males, children, urban dwellers, those living in mud houses and those in large households, proximity to natural features such as bushes, rivers and streams and low LLIN were more likely to contract malaria. These findings highlight the importance of implementing targeted interventions to address these risk factors and reduce the burden of malaria.