Molecular Diagnosis and Epidemiological Study of Malaria Infection in Selected Local Government Areas of Sokoto State, Nigeria

Clinical diagnosis Based on symptoms Low Quick, no equipment Nonspecific, overlaps with other fevers Cheesebrough (2006) P-ISSN 2695-222X Diagnostic Method Principle Sensitivity Advantages Limitations Reference Microscopy Microscopic identification of parasites in stained blood films Moderate Species identification possible Requires skilled personnel Gilles (1993) RDTs Detects parasite antigen (e.g., HRP-2) Moderate to high Rapid, field- friendly False negatives in low parasitemia Seed et al. (2005) PCR Detects parasite DNA Very high Detects low parasite densities Expensive, lab- based Jaureguiberry et al. (1990) 2.8. Treatment and Control Antimalarial treatment aims to eliminate the parasite and prevent complications. Artemisinin- based combination therapies are the first-line treatments for P. falciparum infection. However, resistance to chloroquine and emerging artemisinin resistance pose serious challenges (WHO, 2016). Prevention strategies include vector control through ITNs, indoor residual spraying, larval source management, and health education. The Roll Back Malaria initiative and recent malaria vaccine rollout programs have contributed to global reductions in cases, although Nigeria still records the highest burden (WHO, 2023). 2.9. Summary of Literature Review Previous studies on malaria in Nigeria have primarily relied on microscopy and RDTs, which may underestimate true prevalence due to undetected submicroscopic infections (Akinboye & Ogunrinade, 1987; Okocha et al., 2005). Few studies have used molecular methods such as PCR to confirm Plasmodium species in Sokoto State. This gap underscores the need for molecular epidemiological studies to improve diagnostic accuracy and strengthen control efforts. 3.0. Materials and Methods 3.1. Study Area The study was conducted in Yabo, Gwadabawa, and Sokoto South LGAs of Sokoto State, Northwestern Nigeria. The region lies between latitudes 12°–14°N with a semi-arid climate, annual rainfall of 500–1,300 mm, and temperatures between 27°C and 40°C. 3.2. Study Design and Population A descriptive cross-sectional study design was adopted. Participants aged ?5 years from randomly selected households were included. 3.3. Sampling Technique and Sample Size A total of 660 participants were recruited using stratified and systematic random sampling. 3.4. Data Collection P-ISSN 2695-222X Structured questionnaires were administered to collect socio-demographic data and potential malaria risk factors. Blood samples were collected via venipuncture for microscopy, RDT, and PCR analyses. 3.5. Laboratory Analysis i. Microscopy: Thick and thin blood films stained with Giemsa were examined for parasite detection. ii. RDT: Conducted using HRP-2 antigen-based kits following manufacturer protocols. iii. Molecular Diagnosis: DNA was extracted using Qiagen kits; nested PCR targeted P. falciparum species-specific genes. 3.6. Data Analysis Data were analyzed using SPSS v23. Descriptive statistics were used for demographic variables, and chi-square and logistic regression determined associations (p < 0.05 considered significant). 4.0. Results and Discussion 4.1. Socio-Demographic Characteristics of Respondents Variable Category Frequency (n=660) Percentage (%) Sex Male 372 56.4 Female 288 43.6 Age 5–14 102 15.5 15–29 166 25.2 30–44 214 32.4 ?45 178 26.9 Occupation Farmers 240 36.4 Traders 178 27.0 Civil servants 132 20.0 Others 110 16.6 Source: Field Survey (2025) P-ISSN 2695-222X 4.2. Prevalence of Malaria by Diagnostic Methods Diagnostic Method Positive Cases Negative Cases Prevalence (%) Microscopy 258 402 39.1 RDT 257 403 38.9 PCR 276 384 41.8 Microscopy and RDT yielded similar prevalence rates, while PCR detected additional submicroscopic infections, confirming its superior sensitivity. 4.3. Risk Factors Associated with Malaria Prevalence Variable Category Prevalence (%) p-value Sex Male 40.3 0.21 Female 37.6 Occupation Farmers 49.6 0.03* Civil Servants 28.4 Blood Group O 48.2 0.04* Others 36.1 (p < 0.05 indicates statistical significance) Occupation and blood group were significantly associated with malaria prevalence. 4.4. Diagnostic Performance of RDT Compared with Microscopy Parameter Value (%) Sensitivity 70.0 Specificity 97.0 Positive Predictive Value 95.2 Negative Predictive Value 75.3 These findings align with prior studies (Singh et al., 2004; Kitchen & Chiodini, 2006), confirming that RDTs are useful for rapid screening but less sensitive for low parasitemia. P-ISSN 2695-222X 6.5 Hematological Parameters of Participants Parameter Malaria Positive (Mean ± SD) Malaria Negative (Mean ± SD) Haemoglobin (g/dL) 11.3 ± 1.6 12.1 ± 1.2 Packed Cell Volume (%) 33.9 ± 4.2 36.4 ± 3.8 WBC (×109/L) 6.2 ± 2.1 5.9 ± 1.9 Although slight reductions were observed in infected individuals, differences were not statistically significant (p > 0.05). 5.0. Conclusion and Recommendations 5.1. Conclusion Malaria remains highly endemic in Sokoto State, with Plasmodium falciparum as the sole identified species. PCR confirmed submicroscopic infections, demonstrating its higher diagnostic sensitivity compared to RDTs and microscopy. Despite control efforts, infection rates remain substantial, emphasizing the need for integrated molecular surveillance. 5.2. Recommendations 1. Introduce PCR-based molecular techniques in malaria surveillance. 2. Regularly evaluate and regulate RDT kits for diagnostic reliability. 3. Intensify health education on vector control and personal protection. 4. Strengthen laboratory capacity through training and equipment support. 5. Promote environmental sanitation to disrupt mosquito breeding sites. P-ISSN 2695-222X References Abdullahi, K. et al. (2009). Malaria prevalence in Nigeria: Epidemiological perspectives. African Journal of Public Health, 9(2): 45–52. Abdullahi, K. et al. (2009). Malaria prevalence in Nigeria: Epidemiological perspectives. African Journal of Public Health, 9(2): 45–52. Abdullahi, K., et al. (2009). 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