Social and environmental determinants of malaria in under five children in Nigeria: a review.

ABSTRACT

There is no denying that malaria portends a serious present and future global concern; it is present in over one hundred countries worldwide, responsible for over 100 million clinical cases and an estimated 1-2 million deaths annually. However, the burden of mortality and morbidity is worse in poor countries and amongst the most disadvantaged in these countries. The World Health Organisation (WHO) suggests that Africa bear almost 90% of the global burden of malaria, and Nigeria, due to its population of over 160 million people bears the largest share of the burden. The last couple of decades have witnessed unprecedented global interest and efforts towards eradication of malaria. National and multinational bodies have expended millions of dollars on wide-ranging malaria control initiatives; unfortunately, results have not been completely positive, and malaria-related mortality amongst children has remained a core area of concern. This review shows that the persistence of Malaria, especially amongst under 5 children, can be linked to a dynamic interplay of biological, social and environmental risk factors and a host of health determinants. Cultural beliefs and values, knowledge and healthcare awareness of caregivers, the built environment, access, availability and affordability of food, water and healthcare are identified and discussed as the various socio-cultural, behavioural and environmental factors encumbering the success of malaria control initiatives in the country.