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2015 Nigeria Malaria Indicator Survey (NMIS)
Atlas of Key Indicators
Niger
BornoYobe
Taraba
Bauchi
Kogi
Kebbi
Oyo
Kaduna
Kwara
Edo
Benue
Sokoto
Zamfara
Adamawa
Jigawa
Kano
Plateau
Katsina
Ogun
Delta
Nasarawa
Ondo
Osun Ekiti
Imo
Gombe
CrossRiver
RiversBayelsa
Enugu
Abia Ebonyi
FCT-Abuja
AkwaIbom
Lagos
Anambra
NORTHEAST
NORTHEAST
NORTHWEST
NORTHWEST
NORTHCENTRALNORTH
CENTRAL
SOUTHWEST
SOUTHWEST
SOUTHSOUTHSOUTHSOUTH
SOUTH EAST
SOUTH EAST
The 2015 Nigeria Malaria Indicator Survey (2015 NMIS) was implemented by the National Malaria Elimination Programme (NMEP), the National Population Commission (NPopC), and the National Bureau of Statistics (NBS) from October 2015 through November 2015. Funding for the 2015 NMIS was provided by the United States President’s Malaria Initiative (PMI); the Global Fund to Fight AIDS, Tuberculosis, and Malaria; and the United Kingdom Department for International Development (DFID) through the Support to National Malaria Program (SuNMaP). Other partners who provided technical support include the World Health Organization (WHO), United Nationals Children’s Fund (UNICEF), and Society for Family Health (SFH). ICF International provided technical assistance as well as funding to the project through The DHS Program, a project funded by the United States Agency for International Development (USAID), providing support and technical assistance in the implementation of population and health surveys in countries worldwide.
Additional information about the survey can be obtained from the National Malaria Elimination Programme 1st Floor, Abia House, Central Business District, Abuja; Nigeria; Telephone: +234 803000296 or the National Population Commission (NPC), Plot 2031, Olusegun Obasanjo Way, Zone 7 Wuse, PMB 0281, Abuja, Nigeria; Telephone: (234) 09 523-9173; Fax: (234) 09 523-1024; Email: [email protected]; www.population.gov.ng
Additional information about The DHS Program may be obtained from The DHS Program, ICF International, 530 Gaither Road, Rockville, MD, U.S.A. (Telephone: 1.301.572.0200; Fax: 1.301.572.0999; e-mail: [email protected]).
Recommended citation: National Malaria Elimination Program (Nigeria), and ICF International, 2016. 2015 Nigeria Malaria Indicator Survey: Atlas of Key Indicators. Rockville, Maryland, USA: National Malaria Elimination Program (Nigeria), and ICF International.
Page 12015 Nigeria Malaria Indicator Survey
About the 2015 NMISThe 2015 Nigeria Malaria Indicator Survey (NMIS) is designed to provide data on malaria indicators and malaria and anaemia prevalence in Nigeria. The 2015 NMIS is the second Malaria Indicator Survey conducted in Nigeria; the first was conducted in 2010. In addition, malaria data have also been collected in the 2003, 2008, and 2013 Nigeria Demographic and Health Surveys. Repeated surveys allow for an analysis of trends over time.
Who participated in the survey? A nationally representative sample of 8,034 women age 15–49 were interviewed in 7,745 selected households. This represents a response rate of 99%. Over 6,000 children under 5 were tested for malaria as part of the 2015 NMIS. This sample provides most indicators for the country as a whole, for urban and rural areas separately, and for each of the country’s six geo-political zones. Some of the survey indicators are provided for each of the 36 states and the Federal Capital Territory (FCT).
2015 NMIS AtlasMaps allow for a visual interpretation of population and health indicators across regions. Malaria prevention, treatment, and prevalence are not consistent across all regions. Maps help to show where the patterns exist, which regions are making good progress towards better health and which regions require additional interventions. Most malaria indicators collected through the 2015 NMIS are available at the state level. Some, however, are only available at the zonal level. In addition, the 2010 NMIS only has data available at the zonal level. Therefore, this atlas includes some maps at the zonal level when there is no state-level data available, especially when comparing data from the 2010 and 2015 surveys.
Page 2 2015 Nigeria Malaria Indicator Survey
ItN owNerShIp
Household Ownership of Insecticide-Treated Nets (ITNs)Almost 70% of households in Nigeria own at least one insecticide-treated net (ITN). Less than 40% of households in Kwara, Edo, and Ogun own at least one ITN compared with 95% or more of households in Bauchi, Jigawa, and Katsina.
CAMEROON
NIGER
BENIN
CHADSokoto
77%
Zamfara89%
Katsina97%
Jigawa95%
Yobe83% Borno -
Urban64%
Adamawa71%
Gombe87%
Bauchi97%
Kano88%
Kaduna92%
Kebbi87%
Niger
61%
FCT-Abuja45%
Nasarawa76%
Plateau78%
Taraba53%
Benue42%
Kogi55%
Kwara38%
Oyo51%
Osun66%
Ekiti73%
Ondo50%
Edo39%
Anambra75%
Enugu57% Ebonyi
89%
CrossRiver83%
AkwaIbom74%
Abia52%
Imo46%
Rivers75%Bayelsa
45%
Delta43%
Lagos44%
Ogun39%
0 100 20050Kilometres
¯
Legend38% - 45%
46% - 61%
62% - 75%
76% - 87%
88% - 97%
Nigeria 69%
Page 32015 Nigeria Malaria Indicator Survey
uNIverSAl CoverAge of ItNS
Universal Coverage of Insecticide-Treated Nets
Universal coverage is defined as the proportion of households with at least one ITN for every two people in the household. Just over one-third of Nigerian households have at least one ITN for every two people in the household. Universal coverage of ITNs is below 15% in Kwara, Borno-Urban, and Lagos while more than half of households in Bauchi, Jigawa, Kaduna, Katsina, Ebonyi, Akwa Ibom, Cross River, and Ekiti have at least one ITN for every two people in the household.
CAMEROON
NIGER
BENIN
CHADSokoto
24%
Zamfara47%
Katsina54%
Jigawa56%
Yobe42% Borno -
Urban11%
Adamawa31%
Gombe38%
Bauchi53%
Kano40%
Kaduna53%
Kebbi22%
Niger
36%
FCT-Abuja23%
Nasarawa33%
Plateau34%
Taraba17%
Benue16%
Kogi20%
Kwara14%
Oyo19%
Osun38%
Ekiti50%
Ondo26%
Edo18%
Anambra48%
Enugu20% Ebonyi
63%
CrossRiver55%
AkwaIbom55%
Abia30%
Imo20%
Rivers47%Bayelsa
23%
Delta24%
Lagos12%
Ogun19%
0 100 20050Kilometres
¯
Legend11% - 19%
20% - 24%
25% - 38%
39% - 53%
54% - 63%
Nigeria 35%
Page 4 2015 Nigeria Malaria Indicator Survey
uSe of ItNS by houSehold MeMberS
Use of Insecticide-Treated Nets by Household Members Overall, more than one-third (37%) of Nigerians slept under an ITN the night before the survey. Use of ITNs by household members is especially low in Abia (7%) and Imo (6%), while more than 60% of household members in Jigawa and Kaduna slept under an ITN the night before the survey
CAMEROON
NIGER
BENIN
CHADSokoto
49%
Zamfara57%
Katsina54%
Jigawa76%
Yobe56% Borno -
Urban58%
Adamawa32%
Gombe34%
Bauchi59%
Kano44%
Kaduna62%
Kebbi38%
Niger
38%
FCT-Abuja17%
Nasarawa44%
Plateau38%
Taraba27%
Benue25%
Kogi22%
Kwara17%
Oyo31%
Osun21%
Ekiti27%
Ondo20%
Edo11%
Anambra24%
Enugu14% Ebonyi
50%
CrossRiver50%
AkwaIbom37%
Abia7%
Imo6%
Rivers32%Bayelsa
18%
Delta18%
Lagos11%
Ogun12%
0 100 20050Kilometres
¯
Legend6% - 17%
18% - 27%
28% - 38%
39% - 54%
55% - 76%
Nigeria 37%
Page 52015 Nigeria Malaria Indicator Survey
Use of Insecticide-Treated Nets by Children Under 5
uSe of ItNS by ChIldreN ANd pregNANt woMeN
Pregnant women are also particularly vulnerable to malaria and are advised to sleep under ITNs. Nationally, almost half (49%) of pregnant women age 15-49 slept under an ITN the night before the survey. This varies by zone, from a low of 23% in South East Zone to a high of 68% in North West Zone.
Young children are especially vulnerable to malaria. Nationally, 44% of children under 5 slept under an ITN the night before the survey. Children living in North West Zone are most likely to have slept under an ITN the night before the survey (62%) compared with only 22% of children in South West Zone.
Use of Insecticide-Treated Nets by Pregnant Women
CAMEROON
NIGER
BENIN
CHAD
NorthCentral
39%
NorthEast50%
NorthWest62%
SouthEast25%
SouthSouth33%
SouthWest22%
0 200 400100Kilometres
¯
Legend22% - 25%
26% - 39%
40% - 62%
CAMEROON
NIGER
BENIN
CHAD
NorthCentral
38%
NorthEast56%
NorthWest68%
SouthEast23%
SouthSouth33%
SouthWest33%
0 200 400100Kilometres
¯
Legend23% - 30%
31% - 40%
41% - 68%
Nigeria 44%
Nigeria 49%
Page 6 2015 Nigeria Malaria Indicator Survey
INterMItteNt preveNtIve treAtMeNt durINg pregNANCy (Iptp)- 2 or More doSeS of Sp
IPTp—2 or More Doses of Sulphadoxine-Pyrimethamine (SP)Pregnant women should receive at two or more doses of SP during antenatal care visits to prevent malaria during pregnancy. Just over one-third of women age 15-49 with a live birth in the two years before the survey received at least two doses. Coverage of two or more doses of IPTp is lowest in Niger (10%) and above 70% in Lagos, Edo, and Borno-Urban.
CAMEROON
NIGER
BENIN
CHADSokoto
28%
Zamfara28%
Katsina34%
Jigawa29%
Yobe60% Borno -
Urban(77%)
Adamawa31%
Gombe51%
Bauchi42%
Kano26%
Kaduna21%
Kebbi32%
Niger
10%
FCT-Abuja(61%)
Nasarawa33%
Plateau19%
Taraba27%
Benue37%
Kogi59%
Kwara20%Oyo
(59%)
Osun31%
Ekiti59%
Ondo36%
Edo(75%)
Anambra(43%)
Enugu42%
Ebonyi44%
CrossRiver(56%)
AkwaIbom(26%)
Abia(36%)
Imo(45%)
Rivers49%Bayelsa
28%
Delta14%
Lagos71%
Ogun53%
0 100 20050Kilometres
¯
Legend10% - 27%
28% - 33%
34% - 43%
44% - 59%
60% - 77%
* Figures in parentheses are based on 25-49 unweighted cases
Nigeria 37%
Page 72015 Nigeria Malaria Indicator Survey
IPTp—3 or More Doses of SPUpdated IPTp guidelines recommend that pregnant women receive at least three doses of SP during pregnancy received during antenatal care visits. Nationally, only 19% of women with a live birth in the two years before the survey received three or more doses of SP. Coverage of three or more doses of IPTp is lowest in Delta (4%) and Kano (6%) and highest in Ekiti and Borno-Urban (45% each).
INterMItteNt preveNtIve treAtMeNt durINg pregNANCy (Iptp)- 3 or More doSeS of Sp
CAMEROON
NIGER
BENIN
CHADSokoto
16%
Zamfara11%
Katsina24%
Jigawa8%
Yobe35% Borno -
Urban(45%)
Adamawa22%
Gombe38%
Bauchi18%
Kano6%
Kaduna16%
Kebbi28%
Niger
8%
FCT-Abuja(36%)
Nasarawa18%
Plateau12%
Taraba21%
Benue21%
Kogi38%
Kwara15%Oyo
(38%)
Osun12%
Ekiti45%
Ondo9%
Edo(36%)
Anambra(20%)
Enugu36%
Ebonyi41%
CrossRiver(31%)
AkwaIbom(12%)
Abia(24%)
Imo(9%)
Rivers16%Bayelsa
9%
Delta4%
Lagos10%
Ogun19%
0 100 20050Kilometres
¯
Legend4% - 10%
11% - 16%
17% - 22%
23% - 36%
37% - 45%
* Figures in parentheses are based on 25-49 unweighted cases
Nigeria 19%
Page 8 2015 Nigeria Malaria Indicator Survey
CASe MANAgeMeNt of fever ANd MAlArIA IN ChIldreNTesting among Children with Fever
Treatment with Any ACT
CAMEROON
NIGER
BENIN
CHAD
NorthCentral
45%
NorthEast31%
NorthWest36%
SouthEast47%
SouthSouth42%
SouthWest35%
0 200 400100Kilometres
¯
Legend31% - 35%
36% - 42%
43% - 47%
Nationwide, 41% of children under 5 had a fever in the two weeks before the survey. Among these children, only 13% had blood taken from a finger or heel for malaria testing. This testing among children with fever is lowest in North West Zone (10%) and highest in South West Zone (29%).
Among children under 5 with fever who took an antimalarial, 38% received any ACT, as recommended. Receipt of any ACT is most common in South East (47%) and North Central zones (45%) and least common among children in North East Zone (31%).
CAMEROON
NIGER
BENIN
CHAD
NorthCentral
16%
NorthEast11%
NorthWest10%
SouthEast11%
SouthSouth11%
SouthWest29%
0 200 400100Kilometres
¯
Legend10% - 15%
16% - 20%
21% - 29%Nigeria 13%
Nigeria 38%
Page 92015 Nigeria Malaria Indicator Survey
MAlArIA preveNtIoN MeSSAgeS
Exposure to Malaria Prevention MessagesOverall, 36% of women age 15-49 have seen or heard a message about malaria in the six months before the survey. The most commonly heard messages nationwide include the following: malaria is dangerous, malaria can kill, sleeping inside a mosquito net is important, and mosquitoes spread malaria. Women in Osun and Oyo are most likely to report having heard a malaria prevention message (65% each), while women in Adamawa (12%) and Kaduna (17%) are least likely to have heard a message.
CAMEROON
NIGER
BENIN
CHADSokoto
39%
Zamfara26%
Katsina55%
Jigawa18%
Yobe34% Borno -
Urban20%
Adamawa12%
Gombe44%
Bauchi39%
Kano37%
Kaduna17%
Kebbi46%
Niger
20%
FCT-Abuja31%
Nasarawa19%
Plateau37%
Taraba32%
Benue26%
Kogi23%
Kwara26%
Oyo65%
Osun65%
Ekiti37%
Ondo16%
Edo21%
Anambra47%
Enugu58% Ebonyi
43%
CrossRiver47%
AkwaIbom60%
Abia45%
Imo21%
Rivers37%Bayelsa
24%
Delta29%
Lagos29%
Ogun31%
0 100 20050Kilometres
¯
Legend12% - 21%
22% - 29%
30% - 37%
38% - 47%
48% - 65%
Nigeria 36%
Page 10 2015 Nigeria Malaria Indicator Survey
ANAeMIA prevAleNCe
Anaemia PrevalenceNationally, more than two-thirds of children age 6-59 months are anaemic, and 43% are moderately or severely anaemic. Anaemia in children is relatively high across the states, dropping below 50% in only three states (Borno-Urban, Anambra, and Lagos). Anaemia is especially high (85% or higher) in Jigawa and Zamfara.
CAMEROON
NIGER
BENIN
CHADSokoto
79%
Zamfara87%
Katsina74%
Jigawa85%
Yobe64% Borno -
Urban(38%)
Adamawa68%
Gombe53%
Bauchi62%
Kano83%
Kaduna79%
Kebbi84%
Niger
69%
FCT-Abuja68%
Nasarawa63%
Plateau63%
Taraba71%
Benue67%
Kogi61%
Kwara58%
Oyo60%
Osun59%
Ekiti58%
Ondo72%
Edo64%
Anambra49%
Enugu54% Ebonyi
74%
CrossRiver79%
AkwaIbom73%
Abia51%
Imo52%
Rivers67%Bayelsa
76%
Delta59%
Lagos48%
Ogun58%
0 100 20050Kilometres
¯
Legend38% - 58%
59% - 63%
64% - 69%
70% - 79%
80% - 87%
Nigeria 68%
Page 112015 Nigeria Malaria Indicator Survey
MAlArIA prevAleNCe
Malaria PrevalenceOverall, 27% of children age 6-59 months tested positive for malaria by microscopy in the 2015 NMIS. Malaria in children is most common in Kebbi (64%) and Zamfara (63%), while less than 10% of children tested positive for malaria in Kogi, Borno-Urban, Abia, Imo, Rivers, and Lagos.
CAMEROON
NIGER
BENIN
CHADSokoto
47%
Zamfara63%
Katsina28%
Jigawa28%
Yobe19% Borno -
Urban(<1%)
Adamawa35%
Gombe29%
Bauchi20%
Kano28%
Kaduna37%
Kebbi64%
Niger
34%
FCT-Abuja20%
Nasarawa36%
Plateau36%
Taraba43%
Benue45%
Kogi5%
Kwara26%
Oyo19%
Osun33%
Ekiti29%
Ondo21%
Edo19%
Anambra10%
Enugu11% Ebonyi
30%
CrossRiver26%
AkwaIbom23%
Abia8%
Imo5%
Rivers7%
Bayelsa31%
Delta20%
Lagos<1%
Ogun15%
0 100 20050Kilometres
¯
Legend0% - 11%
12% - 21%
22% - 29%
30% - 36%
37% - 64%
* Figures in parentheses are based on 25-49 unweighted cases
Nigeria 27%
Page 12 2015 Nigeria Malaria Indicator Survey
MAlArIA prevAleNCe by ZoNe: treNdS
According to the 2010 NMIS, 42% of children age 6-59 months in Nigeria tested positive for malaria by microscopy. In 2010, malaria prevalence was lowest in South East Zone (28%) and highest in South West (50%) and North Central (49%).
Malaria prevalence is markedly lower in the 2015 NMIS, with 27% of children age 6-59 months testing positive by microscopy. In 2015, malaria prevalence was lowest in South East (14%) and South West (17%) and highest in North West (37%).
2010: Malaria Prevalence by Zone
2015: Malaria Prevalence by Zone
CAMEROON
NIGER
BENIN
CHAD
NorthCentral
49%
NorthEast31%
NorthWest48%
SouthEast28%
SouthSouth32%
SouthWest50%
0 200 400100Kilometres
¯
Legend28% - 30%
31% - 35%
36% - 50%
CAMEROON
NIGER
BENIN
CHAD
NorthCentral
32%
NorthEast26%
NorthWest37%
SouthEast14%
SouthSouth19%
SouthWest17%
0 200 400100Kilometres
¯
Legend14% - 30%
31% - 35%
36% - 50%Nigeria 27%
Nigeria 42%