A Risk-Based Analysis of Malaria Transmission and Healthcare Needs among Nomads in North Central Nigeria

Résumé

Nigeria continues to bear a disproportionate share of the global malaria burden, with nomadic populations remaining one of the most underserved and vulnerable groups. This study presents a risk-based and spatiotemporal assessment of malaria transmission and healthcare access among nomadic communities in North Central Nigeria. A cross-sectional mixed-methods design was employed, integrating quantitative surveys (rapid diagnostic tests and structured questionnaires), qualitative interviews, and geospatial analysis. Data were obtained from 100,000 nomadic individuals across six states. Results indicate that malaria prevalence among febrile individuals was 45%, with significantly higher rates among children under five years (63%). Overall transmission was influenced by seasonal patterns, with prevalence rising to 67% during the rainy season. Logistic regression analysis identified key determinants of malaria infection, including age under five (AOR = 2.53), distance greater than 5 km to health facilities (AOR = 1.88), and lack of formal education (AOR = 1.62), while insecticide-treated net (ITN) use (AOR = 0.69) and formal healthcare utilization (AOR = 0.75) were protective. Despite high awareness of malaria (85%), preventive practices and healthcare utilization remain suboptimal, with only 28% reporting ITN use and 18% accessing formal health facilities. Structural barriers such as distance (55%), cost (48%), and cultural factors continue to limit access to care. The study highlights significant spatial clustering of malaria risk in riverine and hard-to-reach areas. The findings underscore the urgent need for mobile, culturally sensitive, and geographically targeted malaria interventions to improve prevention, diagnosis, and treatment among nomadic populations.