Assessing the Effectiveness of Current Malaria Control Strategies in Nigeria: A Systematic Review and Meta-Analysis

Abstract

A bstract Background: Malaria control strategies play a vital role in reducing morbidity and mortality associated with malaria. Nigeria continues to bear the highest burden of malaria globally, despite over two decades of control efforts. Objective: This systematic review evaluates the effectiveness of key malaria interventions, including insecticide-treated nets, indoor residual spraying, chemoprevention, and community-based education. Materials and Methods: A systematic literature search was conducted using PubMed, Medline, Google Scholar, and African Journals Online for articles published between 2019 and 2024. Studies were screened and selected based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Out of 52 full-text articles reviewed, eight studies were included. Data synthesis included both narrative analysis and pooled prevalence estimation. Quality appraisal was conducted using the Joanna Briggs Institute checklist. For studies reporting prevalence, a fixed-effects model was used to estimate pooled prevalence, and heterogeneity was assessed using the I 2 statistic. Results: The pooled malaria prevalence across four eligible studies was 53.0% (95% confidence intervals: 50.8%–55.3%), with substantial heterogeneity ( I 2 = 98.2%). The high prevalence was primarily linked to poor utilization of long-lasting insecticidal nets, limited awareness, environmental factors, and challenges in implementing national guidelines. Only a few studies reported high compliance or consistent intervention coverage. Health system gaps and behavioral barriers were recurrent limiting factors. Conclusion: Current malaria control strategies in Nigeria are partially effective but face major limitations in implementation and uptake. To reduce malaria burden, future programs must prioritize local engagement, continuous health education, strengthened vector control implementation, and integration of emerging tools such as the RTS, S/AS01 vaccine. Protocol deposited in the Open Science Framework repository: https://osf.io/4u9nt.