This document discusses the spatial patterns of malaria transmission globally and within Nigeria. It finds that malaria transmission is heaviest in sub-Saharan Africa, where nearly 300 million people lack access to preventative measures. Within Nigeria, malaria prevalence can be as high as 85% and is a major public health burden. The research analyzed malaria data from 1993 to 2007 and found seasonal variations influence transmission. States in Nigeria's north central and northeast regions had the highest infection rates, while states in the southwest and northwest had the lowest. Targeted interventions are needed in highly-affected states to reduce malaria's public health and economic impacts.

1. MALARIA
SPATIAL AND TEMPORAL
PATTERNS
CASE STUDY: NIGERIA

2. EXCELLENCE OBJECTIVE
To fully describe a spatial or temporal pattern of the
geographic topic using geographic terminology and concepts.

3. WORLD
DISTRIBUTION
OF MALARIA

4. MALARIA TRANSMISSION
Malaria transmission occurs in five WHO regions.
Globally, an estimated 3.4 billion people in 91
countries and territories are at risk of being
infected with malaria and developing disease
(map), and 1.1 billion are at high risk (>1 in 1000
chance of getting malaria in a year).

5. WORLD DISTRIBUTION OF MALARIA
According to the World Malaria Report 2016, there were
212 million cases of malaria globally in 2015 (uncertainty
range 148–304 million) and 429 000 malaria deaths
(range 235 000–639 000), representing a decrease in
malaria cases and deaths of 22% and 50% since 2000,
respectively.
The burden was heaviest in the WHO African Region,
where an estimated 92% of all malaria deaths occurred,
and in children aged under 5 years, who accounted for
more than two thirds of all deaths.

6. WORLD DISTRIBUTION OF MALARIA

8. ESTIMATED CASES 2000-2015
The number of malaria cases globally fell from an estimated
262 million in 2000 (range: 205–316 million), to 214 million
in 2015 (range: 149–303 million), a decline of 18%.
Most cases in 2015 are estimated to have occurred in the
WHO African Region (88%), followed by the WHO South-East
Asia Region (10%) and the WHO Eastern Mediterranean
Region (2%). The incidence of malaria, which takes into
account population growth, is estimated to have decreased by
37% between 2000 and 2015. In total, 57 of 106 countries
that had ongoing transmission in 2000 have reduced malaria
incidence by >75%. A further 18 countries are estimated to
have reduced malaria incidence by 50–75%.

9. MALARIA MDG 6
The target of Millennium Development Goal
(MDG) 6 “to have halted and begun to reverse
the incidence of malaria” (Target 6C) has been
achieved.

10. REPORTED CONFIRMED CASES 2014
77.946.026 confirmed malaria cases were reported in
2014, by 95 countries and territories with ongoing
malaria transmission.
Reported confirmed malaria cases represent cases
identified in the health care system and reported
through each country’s surveillance system.
Due to incomplete attendance, diagnostic testing and
reporting of cases, the number of reported cases is
unlikely to represent the true number of cases, and is
usually lower than the number of estimated cases,
which takes these factors into account.

11. SPATIAL PATTERNS IN MALARIA
Malaria transmission continues to affect 97 countries
and territories around the world, inflicting a
tremendous burden on countries in sub-Saharan Africa.
Nearly 300 million people in sub-Saharan Africa still
lack access to a protective insecticide-treated net, and
at least 15 million pregnant women do not receive the
protective treatment they need to keep themselves and
their unborn child healthy.
And malaria is still responsible for more than 450,000
child deaths in Africa each year.

13. PATTERNS IN SUB-SAHARAN AFRICA
In 2013, it is estimated that in sub-Saharan Africa 278
million of the 840 million people at risk of malaria live
in households with no access to a single ITN;
15 million of the 35 million pregnant women did not
receive a single dose of IPTp;
Between 100 and 140 million children with malaria did
not receive an ACT for treatment.

14. CONGO AND NIGERIA
Together, DR Congo and Nigeria accounted for over
40% of the estimated global total of malaria deaths.
Tanzania, Uganda, Mozambique and Côte d’Ivoire are
also highly affected by malaria.
These six countries account for an estimated 47% (103
million) of global malaria cases.
In South-East Asia, the second most affected part of the
world, India has the highest malaria burden, followed
by Indonesia and Myanmar.

15. CENTRAL AFRICA ROLL BACK
MALARIA NETWORK (CARN)
The Central Africa Roll Back Malaria Network (CARN)
coordinates partner support on technical and operational
issues for going to scale with effective malaria control
interventions to 9 Central African countries:
Angola, Cameroon, Chad, Congo, Gabon, Equatorial Guinea,
Central African Republic, DR Congo, Sao Tomé-et-Principe.
The CARN was officially established at an inaugural
meeting in Libreville, Gabon, 5-6 April 2005.

16. EAST AFRICA ROLL BACK
MALARIA NETWORK (EARN)
The East Africa Roll Back Malaria Network (EARN) coordinates
partner support on technical and operational issues for going
to scale with effective malaria control interventions to 13 East
African countries: Burundi, Comoros, Djibouti, Eritrea,
Ethiopia, Kenya, Rwanda, Somalia, South Sudan, Sudan,
Tanzania, Uganda, Yemen.

17. SOUTHERN AFRICA ROLL BACK
MALARIA NETWORK (SARN)
Southern Africa Regional Network (SARN) coordinates partner
support on technical and operational issues for going to scale
with effective malaria control interventions to 10 Southern
African countries:
Botswana, Madagascar, Malawi, Mozambique, Namibia, South
Africa, Swaziland, URT-Zanzibar, Zambia, Zimbabwe.
Key to the success of malaria elimination in Southern Africa is
the implementation of cross-border initiatives which
harmonize malaria control strategies in groups of
collaborating countries.

18. WESTERN AFRICA ROLL BACK
MALARIA NETWORK (WARN)
West Africa Roll Back Malaria Network (WARN) coordinates
partner support on technical and operational issues for going
to scale with effective malaria control interventions to 16 West
African countries:
Benin, Burkina Faso, Cap Vert, Cote d’Ivoire, The Gambia,
Ghana, Guinea, Guinea Bissau, Liberia, Mali, Mauritania,
Niger, Nigeria, Senegal, Sierra Leone, Togo.

19. SPATIAL PATTERNS
WHERE MALARIA OCCURS
Where malaria is found depends mainly on climatic factors
such as temperature, humidity, and rainfall.
Malaria is transmitted in tropical and subtropical areas, where
Anopheles mosquitoes can survive and multiply.
Malaria parasites can complete their growth cycle in the
mosquitoes (“extrinsic incubation period”).
Temperature is particularly critical. At temperatures below
20°C (68°F), Plasmodium falciparum (which causes severe
malaria) cannot complete its growth cycle in the Anopheles
mosquito, and cannot be transmitted.

20. These maps visually depict CDC’s malaria assessments for each country with
malaria. Assessments of malaria endemicity are based largely on national
surveillance reports which usually do not contain city-level information. Therefore,
the maps display assessments of the presence of malaria in most countries at only
the national and provincial level.
GO TO
https://www.cdc.gov/malaria/travelers/about_maps.html

21. SPATIAL PATTERNS
MALARIA-FREE AREAS
In many malaria-endemic countries, malaria transmission
does not occur in all parts of the country.
Even within tropical and subtropical areas, transmission
will not occur:
At very high altitudes
During colder seasons in some areas
In deserts (excluding the oases)
In some countries where transmission has been
interrupted through successful control/elimination
programs

22. SPATIAL PATTERNS
INTENSE MALARIA AREAS
Generally, in warmer regions closer to the equator
Transmission will be more intense
Malaria is transmitted year-round
The highest transmission is found in Africa, South of the
Sahara and in parts of Oceania such as Papua New Guinea.

23. CASE STUDY
SPATIAL PATTERN
OF MALARIA IN NIGERIA
SOURCE
An assessment of the spatial pattern
of malaria infection in Nigeria
By Onwuemele Andrew
Nigerian Institute of Social and Economic Research,
Social and Governance Policy Research Department,
Ojoo, Ibadan, Oyo State, Nigeria.

24. Spatial distribution of malaria in Nigeria in 2005

25. NIGERIA’S SPATIAL PATTERNS
MALARIA PREVALENCE RATE
In Nigeria, malaria prevalence is as high as 80 to 85% and
is the most common cause of visits to health facilities.
The malaria situation in Nigeria is very burdensome and it
impedes human development. The degree of malaria
infestation varies from region to region in Nigeria.
This spatial attribute of malaria infestation across regions
necessitate the needs for malaria mapping.
Also, the rate of malaria infection across space depends on
dynamic processes involving complex climatic,
environmental, physical, and social variables operating
differently in space.

27. NIGERIA’S SPATIAL PATTERNS
COLLECTING MALARIA DATA
This complexity makes the analysis of the spatial pattern of
malaria infection in Nigeria important. Such analysis can
explain the variations, providing a basis for policy
intervention.
It is against this background that this research examines
the spatial patterns of malaria infestation in Nigeria.
Malaria data for fifteen years (1993 to 2007) were
collected from the World Health Organisation (WHO) Data
Bank, Roll Back Malaria/Epidemiological Unit of both the
Federal and State Ministries of Health for twenty-three
states in Nigeria.

29. NIGERIA’S SPATIAL PATTERNS
SEASONAL VARIATIONS
The pattern of spatial variation in the rate of malaria infection
was analysed using principal component analysis (PCA).
The results indicate that seasonal variations play significant
roles in malaria infection in Nigeria. It also shows high
concentration of malaria infections in some few states.
This research recommends that deliberate effort should be
made to increase the distribution of treated mosquito nets and
drugs in the affected states and an increment in the financial
allocation to the affected states by the Federal Ministry of
Health with a few to reducing the effect of the disease in the
affected states.

31. NIGERIA’S SPATIAL PATTERNS
SEASONAL VARIATIONS
Malaria is a major
public health problem in Nigeria where it accounts for
more cases and deaths than any other country in the
world. Malaria is a risk for 97% of Nigeria’s population.
The remaining 3% of the population live in the malaria
free highlands. There are an estimated 100 million
malaria cases with over 300,000 deaths per year in
Nigeria. This compares with 215,000 deaths per year in
Nigeria from HIV/AIDS.

33. NIGERIA’S SPATIAL PATTERNS
MATERNAL MORTALITY
Malaria contributes to an
estimated 11% of maternal mortality according to:
Akpan, 1996;
Thompson,2004;
USEmbassyNigeria,2011;
Agency for International Development [USAID], 2011;
National Population Commission (NPC) [Nigeria],
National Malaria Control Programme (NMCP) [Nigeria],
and ICF International, 2012.

35. NIGERIA’S SPATIAL PATTERNS
CONSEQUENCE OF UNDERDEVELOPMENT
The malaria situation in Nigeria is very burdensome and it
impedes human development. It is both a cause and
consequence of underdevelopment, according to the
Department for International Development [DFID], 2008.
The degree of malaria infestation varies from region to region
in Nigeria.
This spatial attribute of malaria infestation across regions
necessitate the needs for malaria mapping among researchers.

37. NIGERIA’S SPATIAL PATTERNS
MAPPING OF PATTERNS
The mapping of patterns in the spatial distribution of features
has been of great significance in virtually all fields.
The primary aim in the mapping process is to bring out hidden
relationships among variables, according to Oluwafemi, 2013.
Detailed mapping of malaria in Africa using actual malaria
data have been very difficult due to paucity of data, thus the
use of climatic models, which can predict fairly accurately, the
real situation, is normally used.

39. NIGERIA’S SPATIAL PATTERNS
MAPPING OF PATTERNS
Most of the researches on malaria mapping in sub-Saharan
Africa have been concentrated in East and Southern Africa, in
Kenya, in East African Highlands, in Tanzania, in Zimbabwe, in
Burundi and Malawi.
Little or nothing have been done in West Africa, in Nigeria.

41. NIGERIA’S SPATIAL PATTERNS
RESEARCH CONCLUSIONS
Seasonal variations play significant roles in malaria
infection in Nigeria.
There are high levels of malaria infestation during the dry
season than the rainy season.
The research also indicates that Kogi, Niger, Benue and
Yobe states in Nigeria occupies the zones of high malaria
infection.

44. NIGERIA’S SPATIAL PATTERNS
RESEARCH CONCLUSIONS cont.
States like Oyo, Lagos, Kwara, Delta, Kano and Bornu
occupy the medium level malaria infection zones, while
states like Sokoto, Zamfara, Katsina, Kaduna, Bauchi,
Plateau, Adamawa, Ondo, Edo, Enugu, Imo, Cross River and
River occupy the low level malaria infection zones.
The concentration of malaria in a few states has specific
implications for the health of the people.

46. NIGERIA’S SPATIAL PATTERNS
CONSEQUENCES AND MEASURES
One consequence of the concentration is loss of income and
man hour on the part of infected people, while huge
governmental resources are wasted in procuring the
required drugs.
Deliberate efforts should be made to increase the
distribution of mosquito treated nets and drugs in the
affected states.
Measures should be introduced to increase the financial
allocation to the affected states by the federal ministry of
health with a few to reducing the effect of malaria
infection in the states located in the high infection zones.