Misconceptions, Community Perceptions, and the Fight Against Malaria in Nigeria
- NOIPolls
- 2 days ago
- 4 min read
When malaria is being discussed, common associations may include the characteristic buzzing of mosquitoes, the habitual clapping to swat them away, the onset of fever, the bitter taste in the mouth, or the similar bitter-tasting medication.
Malaria remains a major public health concern and is endemic in several countries, including Nigeria. According to the World Malaria Report of 2023 by the World Health Organization, Nigeria accounts for approximately 27% of the global malaria cases and 31% of global malaria deaths, bearing a disproportionate share of the global burden. Nigeria continues to record one of the highest malaria-related mortality rates worldwide, particularly among children under five years of age.
In response to this ongoing health crisis, the National Malaria Elimination Programme (NMEP) launched the High Burden to High Impact (HBHI) approach in collaboration with global health partners. Furthermore, Nigeria developed a National Malaria Strategic Plan (NMSP) 2021–2025, which aims to achieve a malaria-free Nigeria by significantly reducing malaria morbidity and mortality through coordinated interventions. In alignment with national objectives, state governments have also implemented tailored subnational malaria programs that address context-specific needs at local government and community levels.
To assess public awareness and perceptions regarding malaria, a telephone-based survey was conducted by NOIPolls in partnership with Solina Centre for International Development and Research (SCIDaR) in February/March 2025. A total of 4,000 respondents across Kano and Kaduna were queried on their knowledge of malaria causation, treatment-seeking behaviour, and prevention practices.
Misconceptions About the Cause of Malaria
Despite widespread efforts involving community outreach and education campaigns, many respondents demonstrated a limited or incorrect understanding of malaria transmission. While malaria is scientifically known to be caused by Plasmodium parasites transmitted through the bites of infected female Anopheles mosquitoes, several alternative beliefs were recorded during the survey (see image below). These beliefs suggest a profound gap between biomedical understanding and community perceptions, which can hinder effective prevention and treatment behaviours.
Misinterpretation of Malaria Symptoms
The symptoms of malaria which are typically fever, chills, headache, and malaise are well documented. However, respondents' interpretations of symptoms were often inaccurate and could lead to misuse of medications. For instance, some respondents remarked that;
● “A fever that starts at 5 PM is a sign of malaria.”
● “Malaria wipes the memory; it formats the brain.”
● “If a headache persists after three days of using Paracetamol, then it's definitely malaria.”
These misconceptions may contribute to delayed or inappropriate treatment, risking progression to severe malaria, including cerebral malaria, which is associated with seizures, impaired consciousness, and death, if untreated.
Treatment Practices and Harmful Beliefs
The World Health Organization recommends Artemisinin-based Combination Therapy (ACT) as the first-line treatment for uncomplicated malaria. Despite this, traditional and non-evidence-based treatments remain prevalent (see image below for random opinions). These practices not only lack scientific validity but may also lead to treatment failure, increased drug resistance, and adverse health outcomes.
Malaria Prevention: Misaligned Practices
Vector control which is primarily through the use of insecticide-treated nets (ITNs) and indoor residual spraying (IRS) is a cornerstone of malaria prevention. However, survey responses indicated a reliance on ineffective or unverified practices including:
● “Burning special leaves or dried orange peels repels mosquitoes.”
● “Wearing white clothing to bed deters mosquito bites.”
● “Burning rags soaked in red palm oil drives away malaria.”
● “The only way to prevent malaria is to leave the country.”
These beliefs highlight a critical disconnect between public knowledge and scientifically endorsed prevention strategies, thereby reducing the overall effectiveness of malaria control efforts.
Strategic Recommendations
The persistent prevalence of malaria in Nigeria, despite robust national and subnational programs, underscores the influence of misinformation and cultural beliefs on health behavior. To address this, the following actions are recommended:
Strengthen Health Education Campaigns: Expand culturally sensitive and evidence-based public education campaigns that demystify malaria transmission, treatment, and prevention.
Engage Community Leaders and Influencers: Partner with religious, traditional, and community leaders to counteract harmful myths and promote uptake of proven interventions.
Leverage Strategic Integration of Relevant Institutions and Partners. For example, Patent and Proprietary Medicine Vendors (PPMVs) and chemists can be integrated into national malaria elimination strategies through targeted education, training, and inclusive frameworks.
Improve Access to Diagnostics and ACTs: Ensure universal access to malaria testing and effective treatment at all levels of the healthcare system.
Monitor and Regulate Informal Drug Markets: Implement regulatory frameworks to limit the spread of substandard medications and unsafe practices.
Support Operational Research: Conduct localized research to understand barriers to effective malaria control and to refine intervention strategies.
Conclusion
Malaria control in Nigeria requires more than distribution of insecticide-treated nets and antimalarial drugs. To achieve a malaria-free Nigeria, it is imperative to address the deep-rooted cultural misconceptions and harmful practices that hinder progress. By combining medical interventions with behavioral change strategies, it is possible to significantly reduce the malaria burden and move closer to elimination.
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