How Using Mosquito Nets Properly Could Transform Malaria Control in Kebbi State

In one of Nigeria's most malaria-burdened regions, a new study is showing that an old, familiar intervention could still deliver extraordinary results, if it is actually used. Researchers from the Federal University Oye-Ekiti and its International Centre for Applied Mathematical Modelling and Data Analytics, working with experts from the University of Oxford, the Swiss Tropical and Public Health Institute, Malaria Consortium Nigeria and the National Malaria Elimination Programme, have analysed nearly ten years of malaria data from Kebbi State to understand the real impact of long-lasting insecticidal nets (LLINs). Their conclusion is clear: consistent use of LLINs could dramatically reduce malaria cases and push the state close to elimination.

Kebbi State at the heart of Nigeria's malaria crisis

Nigeria carries more than a quarter of the global malaria burden, and Kebbi State sits at the centre of this crisis. Surveys have shown that nearly half of the population can test positive for malaria at any given time. Transmission rises sharply during the rainy season, when mosquitoes breed rapidly and biting rates increase. Over the years, millions of insecticide-treated nets have been distributed through large-scale campaigns in Kebbi, yet malaria remains stubbornly high. The problem, the researchers argue, is not a lack of nets but low and inconsistent usage. Only about 38 percent of people report sleeping under an LLIN, a figure that has barely changed in recent years.

Turning data into a clearer picture

To understand what this means for malaria control, the research team built a mathematical model that simulates how malaria spreads between humans and mosquitoes in Kebbi State. The model uses routine monthly malaria case data from 2015 to 2024 and captures key realities of malaria in the region, including strong seasonality and the fact that people can be reinfected multiple times. When tested against real data, the model closely matched observed malaria trends, giving the researchers confidence to explore "what-if" scenarios about different levels of LLIN use.

What higher net use could achieve

The results are striking. The study shows that if Kebbi State had maintained 80 percent LLIN usage since 2015, the target set in national malaria plans, almost all malaria transmission could have been prevented. An estimated 5.1 million cases, about 98 percent of those recorded over the period, could have been avoided. Even a smaller increase to 50 percent usage would have reduced malaria cases by nearly 40 percent, preventing close to two million infections. Looking ahead, the projections are equally powerful: if current usage levels continue, Kebbi could see about 3.7 million cases by 2029. Raising usage to 50 percent could avert over one million of these cases, while reaching 80 percent could prevent nearly three million, bringing malaria close to elimination.

From distribution to real protection

The study's message goes beyond numbers. LLINs work best not just by protecting individuals from bites, but by reducing mosquito survival across entire communities. When enough people use them, malaria transmission drops sharply. But this only happens when nets are actually used every night. The authors stress that future efforts must focus on behaviour change, regular replacement of damaged nets, and community-level education to address discomfort and misconceptions. Reaching 50 percent usage is seen as a realistic short-term goal, while 80 percent should remain the long-term ambition. If these targets are met, the researchers argue, Kebbi State could shift from being Nigeria's malaria hotspot to a model for how sustained prevention can save millions of lives within a decade.