Abstract Background Malaria remains a major public health challenge in Nigeria, yet the potential for malaria transmission within healthcare facilities is poorly understood. This study investigated malaria prevalence among patients and caregivers, the presence of malaria vectors within hospital wards, and the potential for nosocomial malaria transmission in two secondary hospitals in Abeokuta, Ogun State. Methods A cross-sectional study was conducted among inpatients admitted for conditions other than malaria across the Surgical/Orthopaedic, Pediatrics, and Obstetrics/Gynaecology wards. Finger-prick blood samples were collected from inpatients and caregivers who had stayed in the wards for at least three nights. Thick and thin blood smears were examined for Plasmodium falciparum. Information on participant demographics, duration of admission, and use of bed nets was also obtained. Indoor-resting mosquitoes were collected using mouth aspirators, identified morphologically, and examined for abdominal status, parity, blood-meal source, and P. falciparum sporozoites using ELISA. Results A total of 134 participants were enrolled (80.6% patients; 19.4% caregivers). Malaria prevalence was high (74.6%), including 75.0% of patients and 73.1% of caregivers. Prevalence did not differ significantly by sex, ward type, or duration of admission (p > 0.05), and most infections involved low-density parasitaemia. Only 3.7% of participants reported using mosquito nets while on admission. A total of 714 mosquitoes were collected, including 80 Anopheles females. All Anopheles mosquitoes collected were members of the Anopheles gambiae s.l. Most Anopheles mosquitoes were fed (81.3%), all with human blood meals, and 38.8% were parous. Two Anopheles mosquitoes (2.5%) from the Obstetrics/Gynaecology ward tested positive for P. falciparum sporozoites. Conclusion The coexistence of asymptomatic parasitaemic patients, infective mosquitoes, and inadequate protective measures indicates a plausible risk of nosocomial malaria transmission within hospital wards. Strengthening malaria-specific infection-prevention and vector-control strategies, including routine malaria screening, improved ward screening and treatment, environmental management, and universal access to insecticide-treated nets, is essential to protect vulnerable patients and support malaria control efforts in Nigeria.
Fawole et al. (Wed,) studied this question.