Understanding the importance of malaria control tools by pregnant and nursing mothers is key to ending malaria burden in Nigeria: A case study of eight communities in South-South Nigeria

The current National Malaria Strategy Plan (NMSP) 2014 to 2020, aims to transit Nigeria from malaria control to malaria elimination status by 2020. However, the most recent WHO Malaria Report 2018 revealed that Nigeria accounted for 25% of 219 million of the global malaria cases and 19% of 435,000 malaria deaths in 2017. The strategies of NMSP among others are: To significantly scale up Indoor Residual Spray (IRS); universal coverage of Long Lasting Insecticide Net (LLIN) and emphasis on parasite confirmation before malaria treatment. This study was carried out to determine how these core strategies have impacted pregnant and nursing mothers in the proper use of these malaria control tools. We surveyed 183 nursing and pregnant mothers with a total of 560 children, most under five years, and employed quantitative questionnaire and interviewed the mothers on how their perceptions of the malaria strategies are limiting the effort of malaria elimination in Nigeria. Our findings revealed that LLIN is still low: 1 bed net to 4 persons instead of the recommended 1 to 2 persons by WHO. Over 90% believed that sleeping under LLINs produce heat and nightmares and therefore reluctant to use them. IRS is unpopular and rarely used with just 3% applying IRS for malaria bite prevention. All the women claimed to be familiar with malaria symptoms and by implication, 76% use the antimalarial drugs without parasite confirmation. The Nigerian government needs to support strategies with awareness campaign to educate on the proper use of vector control tools and the risk of drug resistance due to indiscriminate use of antimalarial drugs. It can be concluded that the war against malaria in Nigeria can only be won when the target beneficiaries are made to understand and take ownership of strategies to eliminate the malaria burden. Key words: Malaria, parasite, vector control tools, malaria elimination, insecticide resistance, environmental pollution, malaria vaccines.