Updated: August 2026
Malaria is so common in Nigeria that fever is sometimes automatically assumed to be malaria.
That can be dangerous.
Not every fever is malaria, and treating every fever with antimalarial medicine without appropriate testing can delay the diagnosis of another illness.
At the same time, malaria itself should never be dismissed as an ordinary fever. It remains a potentially life-threatening disease, particularly for young children, pregnant women and people with weakened immunity.
The good news is that malaria is preventable, testable and curable.
And malaria prevention has changed considerably in recent years. In addition to insecticide-treated nets, preventive medicines and mosquito control, children in several African countries, including Nigeria, can now benefit from malaria vaccination. (World Health Organization)
Quick Answer: What Is Malaria?
Malaria is an infectious disease caused by Plasmodium parasites.
People usually become infected after being bitten by an infected female Anopheles mosquito.
Malaria commonly causes:
fever
chills
headache
weakness and tiredness
muscle or body aches
nausea or vomiting in some people
Severe malaria can cause confusion, seizures, difficulty breathing, severe anaemia, jaundice, kidney problems and death.
Early testing and appropriate treatment are therefore important.
What Causes Malaria?
Malaria is caused by parasites, not by mosquitoes themselves.
Mosquitoes act as vectors, carrying malaria parasites from one infected person to another.
Five Plasmodium species are recognised as causes of human malaria:
Plasmodium falciparum
Plasmodium vivax
Plasmodium malariae
Plasmodium ovale
Plasmodium knowlesi
P. falciparum is particularly important in Africa. It is the most prevalent malaria parasite on the continent and is responsible for most severe malaria and malaria deaths globally. (World Health Organization)
How Does Malaria Spread?
The main route is the bite of an infected female Anopheles mosquito.
When the mosquito bites an infected person, it can acquire malaria parasites.
After the parasites develop within the mosquito, a later bite can introduce them into another person.
The parasites first undergo development in the liver before infecting red blood cells.
This blood-stage infection produces many of the symptoms associated with malaria.
Can Malaria Spread From Person to Person?
Malaria does not normally spread through everyday person-to-person contact.
You cannot catch malaria simply by:
hugging someone
sharing food
sitting beside someone
coughing or sneezing
However, because malaria parasites can be present in blood, transmission can occasionally occur through contaminated needles, unsafe blood transfusion or from mother to baby. (World Health Organization)
What Are the Symptoms of Malaria?
Early malaria symptoms commonly include:
fever
headache
chills
weakness
fatigue
Some people also experience sweating, body aches, nausea, vomiting or abdominal discomfort.
Symptoms commonly begin around 10 to 15 days after an infective mosquito bite, although timing can vary. (World Health Organization)
The problem is that these symptoms are not unique to malaria.
Fever and headache can occur with many other infections.
That is why symptoms alone are not a reliable way to diagnose malaria.
What Are the Warning Signs of Severe Malaria?
P. falciparum malaria can progress rapidly.
Seek urgent medical care when malaria or suspected malaria is accompanied by symptoms such as:
extreme weakness or exhaustion
confusion or impaired consciousness
repeated seizures
difficulty breathing
dark or bloody urine
jaundice
abnormal bleeding
inability to drink
repeated vomiting
severe deterioration in general condition
WHO warns that untreated P. falciparum malaria can progress to severe illness and death within a short period. (World Health Organization)
Severe malaria is a medical emergency.
Who Is Most at Risk of Severe Malaria?
Anyone can develop malaria, but some groups are particularly vulnerable.
These include:
Children Under Five
Young children have not yet developed the partial immunity that can occur after repeated exposure in malaria-endemic areas.
They therefore carry a substantial burden of severe disease and death.
Pregnant Women
Pregnancy changes immunity and increases vulnerability to malaria.
Malaria during pregnancy can contribute to maternal illness, anaemia, premature birth and low birth weight.
People With Weakened Immunity
People with significant immune suppression can face increased risks from malaria.
Travellers From Non-Endemic Areas
Someone who has grown up outside a malaria-endemic area may have little acquired immunity.
This can increase the risk of severe disease when infection occurs.
Why Is Malaria Particularly Important in Nigeria?
Nigeria carries one of the world's largest malaria burdens.
According to WHO's latest estimates, the African Region accounted for about 95% of global malaria cases and deaths in 2024.
Nigeria alone accounted for an estimated 31.9% of malaria deaths within the WHO African Region. (World Health Organization)
This makes malaria much more than an individual medical problem.
It affects:
child survival
maternal health
household spending
school attendance
workplace productivity
health facilities
national health expenditure
Reducing malaria therefore requires both individual prevention and effective public-health programmes.
How Is Malaria Diagnosed?
This is one of the most important messages in this article:
Do not assume every fever is malaria.
WHO recommends confirming suspected malaria using a parasite-based diagnostic test before treatment whenever appropriate testing is available. (World Health Organization)
The two main approaches are:
Malaria Rapid Diagnostic Test
A malaria rapid diagnostic test, or RDT, detects specific malaria parasite antigens in blood.
It can produce results relatively quickly and is particularly useful where high-quality microscopy is not immediately available.
Microscopy
A trained laboratory professional examines a stained blood sample under a microscope for malaria parasites.
Microscopy can help identify parasites and estimate parasite density when performed correctly.
Why Testing Before Treatment Matters
In malaria-endemic countries, it is easy to fall into the habit of calling almost every fever “malaria.”
But fever may instead be caused by:
respiratory infections
urinary infections
typhoid fever
meningitis
viral illnesses
other bacterial infections
several other conditions
If someone repeatedly takes antimalarial medicines without appropriate assessment, the actual cause of the illness may remain untreated.
Testing also supports better use of antimalarial medicines and malaria surveillance.
Can a Malaria Test Ever Be Wrong?
Yes.
No diagnostic test is perfect.
Factors such as parasite density, specimen quality, test storage, technique and parasite characteristics can affect results.
WHO is also monitoring P. falciparum parasites with genetic changes affecting proteins targeted by some rapid diagnostic tests. (World Health Organization)
If someone is seriously ill despite a negative test, they still require medical assessment.
A negative malaria result does not mean nothing is wrong.
It means clinicians should consider malaria alongside other possible diagnoses based on the circumstances.
How Is Malaria Treated?
Malaria should be treated with an effective antimalarial medicine.
The correct treatment depends on factors including:
the malaria parasite
severity of illness
local drug resistance
age and weight
pregnancy status
medicines already taken
For uncomplicated P. falciparum malaria, artemisinin-based combination therapies, commonly called ACTs, are central to treatment. (World Health Organization)
Nigeria's national malaria programme has also moved away from ineffective medicines such as chloroquine for routine P. falciparum treatment and prohibits oral artemisinin monotherapy. (NIMASA)
Why Combination Therapy?
Using artemisinin together with another effective antimalarial medicine improves treatment effectiveness and helps protect against resistance.
This is why people should not simply purchase any medicine labelled “malaria drug.”
Use the treatment recommended by appropriate national guidelines and qualified healthcare professionals.
What Is Severe Malaria Treatment?
Severe malaria requires urgent treatment in an appropriate health facility.
Patients may need injectable antimalarial treatment and supportive management for complications such as:
severe anaemia
low blood glucose
seizures
respiratory problems
kidney injury
shock
Someone with severe malaria symptoms should not remain at home trying different oral medicines.
Why Antimalarial Drug Resistance Matters
Parasites can become less sensitive to medicines used against them.
This is known as antimalarial drug resistance.
Partial artemisinin resistance has now been confirmed in several African countries, making surveillance increasingly important. (World Health Organization)
This does not mean ACTs have suddenly stopped working everywhere.
It means malaria programmes need to monitor treatment effectiveness carefully and adapt policies when necessary.
Using medicines correctly is also important.
How Can Malaria Be Prevented?
There is no single malaria-prevention tool that works perfectly by itself.
The strongest strategy combines several interventions according to local risk. WHO's current approach includes vector control, early diagnosis and treatment, chemoprevention and malaria vaccination where appropriate. (World Health Organization)
1. Sleep Under an Insecticide-Treated Net
Insecticide-treated mosquito nets remain an important malaria-prevention tool.
They provide a physical barrier while the insecticide also helps kill or repel mosquitoes.
For protection to work, the net needs to be used consistently and correctly.
Having a mosquito net folded in a cupboard provides no protection.
2. Reduce Mosquito Exposure
Depending on the setting, additional measures can include:
window and door screens
appropriate mosquito repellents
clothing that reduces exposed skin
indoor residual spraying where programmes recommend it
Mosquito control works best when interventions match the local mosquito population and resistance patterns.
3. Reduce Mosquito Breeding Around Homes
Standing water can provide breeding sites for mosquitoes.
Environmental management can therefore contribute to mosquito control.
However, malaria prevention should not be reduced to the slogan “keep your environment clean.”
Even a clean household can still be exposed to infected mosquitoes.
Environmental management should complement, not replace, proven interventions such as insecticide-treated nets, appropriate vector control, testing and treatment.
4. Prevent Malaria During Pregnancy
Pregnant women living in malaria-endemic areas need particular protection.
WHO recommends insecticide-treated nets as part of malaria prevention during pregnancy. (World Health Organization)
In appropriate African transmission settings, intermittent preventive treatment in pregnancy, commonly called IPTp, is another important intervention.
This involves giving an effective antimalarial medicine at specified antenatal contacts to prevent malaria and its consequences, even when the woman does not have symptoms at that moment.
Pregnant women should attend antenatal care early and consistently rather than self-prescribing malaria medicines.
5. Seasonal Malaria Chemoprevention
In parts of Africa where malaria transmission rises strongly during particular months, children may receive preventive antimalarial medicines during the high-risk season.
This approach is called seasonal malaria chemoprevention, or SMC.
It is particularly important in eligible areas of the Sahel and other settings with highly seasonal transmission.
The intervention is targeted according to local epidemiology rather than being something every child everywhere should automatically receive.
6. Malaria Vaccines
This is one of the biggest changes since the original AnjKreb malaria article was published.
Malaria vaccines now exist.
WHO recommends two vaccines for preventing P. falciparum malaria in children:
RTS,S/AS01
and
R21/Matrix-M. (World Health Organization)
WHO recommends malaria vaccination for children living in malaria-endemic areas, prioritising areas with moderate and high transmission.
Vaccination generally begins from around five months of age according to national programme schedules. (World Health Organization)
Is Malaria Vaccination Available in Nigeria?
Yes.
Nigeria is among the African countries that have introduced malaria vaccination. (World Health Organization)
This is an important development for a country carrying such a large share of the global malaria burden.
But parents need to understand something important:
The malaria vaccine does not replace mosquito nets, appropriate testing, prompt treatment or other malaria-prevention measures.
WHO recommends vaccination as part of a comprehensive malaria-control strategy. (World Health Organization)
For broader information about childhood vaccination, see AnjKreb's Nigeria Childhood Immunization Schedule guide.
Can a Vaccinated Child Still Get Malaria?
Yes.
Malaria vaccines reduce risk but do not provide complete protection.
A vaccinated child can still develop malaria.
Parents should therefore continue using recommended preventive measures and seek appropriate testing when a child develops symptoms suggestive of malaria.
This is similar to many public-health interventions: combining several partially protective measures often produces greater protection than relying on one alone.
Does Eating Garlic Prevent Malaria?
There is no good evidence that eating garlic provides reliable protection against malaria infection.
Garlic can be part of a normal diet, but it should not replace proven prevention.
The same caution applies to many herbal mixtures promoted as mosquito repellents or malaria cures.
“Natural” does not automatically mean effective or safe.
Can Bitter Leaf or Herbal Mixtures Cure Malaria?
Traditional remedies are widely used in many communities, but suspected malaria should be appropriately tested and confirmed malaria treated with recommended effective medicines.
The concentration and composition of unregulated herbal mixtures can vary considerably.
Some may also interact with medicines or cause toxicity.
Do not delay effective malaria treatment while experimenting with unproven remedies.
Can You Get Malaria From Cold Weather?
No.
Cold weather does not cause malaria.
Malaria requires infection with a Plasmodium parasite.
However, environmental conditions including temperature, rainfall and humidity can influence mosquito populations and parasite development, which can affect malaria transmission patterns.
For a deeper explanation, read Climate Change and Malaria in Africa: Why Malaria Risk May Be Shifting and replace this homepage link with the article's exact permalink in Blogger.
Does Malaria Occur Only During the Rainy Season?
No.
In some locations, transmission is strongly seasonal because rainfall creates more mosquito breeding opportunities.
In other areas, malaria transmission can occur throughout much of the year.
Risk also differs between regions.
That is why malaria programmes increasingly use local surveillance data rather than treating every community as though transmission were identical.
Climate Change and Malaria
Climate affects mosquito survival, breeding and the development of malaria parasites.
Changes in temperature and rainfall can therefore alter when and where malaria transmission is environmentally suitable.
But climate change does not mean every part of Africa will automatically experience more malaria.
Transmission also depends on housing, mosquito-control programmes, healthcare access, population movement, immunity and many other factors.
Our dedicated Climate Change and Malaria in Africa article explores this issue separately so this page can remain focused on the fundamentals of malaria.
Why Malaria Surveillance Matters
Malaria control requires good information.
Health programmes need to know:
where cases are occurring
which age groups are most affected
whether treatments remain effective
whether mosquitoes are becoming resistant to insecticides
whether diagnostic tests remain reliable
which prevention strategies work best in particular areas
This allows interventions to be targeted more effectively.
WHO's 2026 prioritisation guidance specifically emphasizes adapting combinations of malaria interventions to local epidemiology and available resources rather than applying exactly the same package everywhere. (World Health Organization)
Frequently Asked Questions
Is malaria caused by mosquitoes?
More precisely, malaria is caused by Plasmodium parasites. Infected female Anopheles mosquitoes transmit those parasites between people.
Is malaria contagious?
Not through normal everyday contact. It does not spread like influenza or measles.
Can malaria kill?
Yes. Severe malaria can be fatal, particularly when diagnosis and treatment are delayed.
Should every fever be treated as malaria in Nigeria?
No. Suspected malaria should ideally be confirmed using microscopy or an appropriate rapid diagnostic test before treatment. (World Health Organization)
What is the best medicine for malaria?
There is no responsible universal answer for every patient. Treatment depends on the parasite, severity, age, weight, pregnancy status and local treatment guidelines. ACTs are central to uncomplicated P. falciparum malaria treatment. (World Health Organization)
Can malaria come back after treatment?
Symptoms can recur for several reasons, including reinfection, inadequate treatment, resistance or, with some Plasmodium species, relapse from dormant liver stages.
Repeated symptoms require proper assessment rather than simply repeating medicines indefinitely.
Are malaria vaccines real?
Yes. WHO recommends both RTS,S and R21 malaria vaccines for children in malaria-endemic settings according to programme recommendations. (World Health Organization)
Does the malaria vaccine completely prevent malaria?
No. It reduces malaria risk and severe disease but should be combined with other malaria-control interventions.
Can adults receive malaria vaccines?
Current WHO programmatic recommendations focus on children living in malaria-endemic areas. (World Health Organization)
Key Takeaways
Malaria remains one of Nigeria's most important infectious diseases.
Remember these points:
Malaria is caused by Plasmodium parasites transmitted mainly by infected female Anopheles mosquitoes.
Fever does not automatically mean malaria.
Suspected malaria should be appropriately tested.
ACTs remain central to treating uncomplicated P. falciparum malaria.
Severe malaria requires urgent medical care.
Insecticide-treated nets remain important.
Preventive medicines protect selected high-risk populations.
Malaria vaccines are now part of malaria prevention for eligible children.
Vaccination does not replace other malaria-control measures.
Nigeria continues to carry an exceptionally large share of Africa's malaria burden.
The Bottom Line
Malaria is familiar to many Nigerian families, but familiarity should not make us underestimate it.
The modern approach is not:
“I have a fever, so I will buy malaria medicine.”
It is:
recognise symptoms, test appropriately, treat confirmed malaria effectively, identify severe illness quickly and prevent future infection using proven interventions.
And malaria prevention now has another powerful tool.
The arrival of RTS,S and R21 vaccines means children in malaria-endemic African countries can receive additional protection that did not exist when this AnjKreb article was originally published.
The challenge now is making sure vaccines, mosquito nets, preventive medicines, effective diagnosis and appropriate treatment work together, rather than expecting any one intervention to eliminate malaria on its own.
References and Further Reading
World Health Organization: Malaria Fact Sheet
WHO Guidelines for Malaria, 2025 edition
WHO: Malaria Vaccines RTS,S and R21
Nigeria National Malaria Elimination Programme: National Guidelines for Diagnosis and Treatment
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