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Ending the Epidemic of Malaria in Nigeria Towards Attaining SDG Target 3.3.3: A Systematic Review of the Progress in Intervention Coverage

Henry Omoregie Egharevba, Margaret Idongesit Ekpenyong

National Institute for Pharmaceutical Research and Development, Nigeria

Background: Meeting SDG 3, ‘healthy lives and well-being for all,’ is one of the bedeviling challenges of low-/medium income countries like Nigeria whose health index is adversely impacted by the burden of malaria, an epidemic that seems to have defied all interventions aimed at eliminating it and achieving the SDG target. A confounding problem in the efforts so far is the apparent inability to expand and sustain interventions coverage. This review systematically examines available evidence to determine if the current level of malaria intervention coverage in Nigeria could help achieve the SDG target 3.3.3. Methods: Data were systematically extracted through online search of ProQuest databases and BioMed Central website for publication between 1st January 2015 and 3rd February 2024. Of the 26 potential articles that met the inclusion criteria, 12 were selected for quality assessment using the CASP checklist. Seven of the studies reported coverage for seasonal malaria chemoprevention (SMC), while coverage for insecticide-treated nets (ITNs) or long-lasting insecticide-treated nets (LLINs) interventions was reported by 6 of the publications. One study each reported coverage for indoor-residual spraying (IRS) and rapid diagnostic tests (RDTs). The findings were thematically discussed. Findings: The included studies were 1 systematic review (SR), 7 randomized controlled trials (RCTs) and 4 household or community campaigns/surveys. Apart from one study, all the others raised questions of external validity due to the small sample size. The descriptive statistics of the evidence showed that the mean intervention coverages for SMC, ITNs/LLINs, IRS, and RDTs, were 40.31%, 50.02%, 51.1% and 39.67%, respectively. Conclusion: The current intervention coverage is not adequate to meet the National Malaria Elimination Programme (NMEP) vision/goal of 0:10:5:80:80 and the SDG targets 3.3.3 set for the elimination of malaria by 2025 and 2030, respectively. An incremental minimum annual coverage of about 6.3% is needed over the next 6 years to meet 80% coverage for SMC. The same trajectory is estimated for other intervention components.



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