Nigeria: No, Malaria Doesn't Kill 300,000 People in Nigeria a Year, As Insurance Seller Claimed

Malaria is transmitted among humans by mosquitoes.

Malaria kills "an average of 300,000 people yearly" in Nigeria, a health tech start-up tweeted in August 2019, prompting both interest and disbelief from users. The tweet attracted more than 2,300 reactions.

WellaHealth says it works with health insurers to make malaria care affordable. Subscribers to its services can get treatment for N450 a month (about US$1.20).

Nigeria is Africa's most populous country. But does it lose this many people to malaria?

'Our data is from the WHO'

A WellaHealth executive, Olanrewaju Akintobi, attributed the figure to the World Health Organization.

"We don't just cook up data. The figure you are referring to came from WHO," Akintobi told Africa Check.

WellaHealth founder Dr Ikpeme Neto told us the figure was from a 2011 factsheet "from the US Department of State that quotes figures from the WHO". The factsheet however did not specifically attribute this number to the UN agency.

Neto said that while malaria deaths in Nigeria had fallen recently, they may have been undercounted. He sent us an August 2019 paper published in Scientific Reports, an open-access journal.

The paper concluded that the burden of malaria in sub-Saharan Africa was "considerably underestimated" when anaemia was not considered. We have contacted the researchers for more details.

Neto also sent an article by US news organisation CNN that said malaria cases had risen in more than 13 countries, including Nigeria. He said WellaHealth believed "the higher number is closer to the reality on the ground".

The CNN report was based on the WHO's 2018 World Malaria Report, the most recent.

Nigeria's share of deaths much lower

The WHO report estimates that there were 435,000 malaria deaths globally in 2017, a decrease from 451,000 deaths in 2016.

If there were 300,000 malaria deaths in Nigeria, this would have been 69% of the global toll.

But the report puts Nigeria's share of global malaria deaths in 2017 at 19%, or 81,640 deaths. Deaths could have been as low as 64,400 or as high as 98,800. This estimate is the lowest since 2010.

Nigeria did see an increase in malaria cases - those confirmed by a diagnostic test - from 52.4 million in 2016 to 53.7 million in 2017.

But it was "definitely incorrect" to say malaria killed 300,000 people in Nigeria a year, Dr Audu Mohammed, who coordinates the country's National Malaria Elimination Programme, told Africa Check.

"Maybe the figure came from WHO reports of more than 10 years ago when Nigeria recorded a lot more deaths from malaria," he said.

"The primary data used for Nigeria in WHO's malaria reports come from us. And I can tell you that annual estimates for malaria deaths in the country have not been that high in recent years."

Two national malaria surveys, in 2010 and 2015, showed that cases and deaths were falling, Mohammed said. The next survey, due in 2020, would "give us a clearer picture".

What of the anaemia question?

Malaria-related deaths from anaemia complications were considered when estimating Nigeria's toll, Prof Olugbenga Mokuolu, the malaria technical director at the National Malaria Elimination Programme, told Africa Check.

"People that die of malaria don't just die, they usually die due to complications. We count malaria-related deaths resulting from all complications, including anaemia, which is the highest on our list of such complications," he said.

"Besides, our Health Management Information System and the statistical model used by WHO takes care of all forms of under-reporting or poor quality data." Mokuolu is also a professor of paediatrics at the University of Ilorin and a consultant for the WHO.

(Note: For more on the challenges of collecting data on malaria in Nigeria and how they are addressed, read our 2018 fact-check of a claim by a major insecticide brand.)

Conclusion: 81,640, not 300,000 lives, lost to malaria in Nigeria each year

To highlight the burden of malaria in Nigeria, a tech start-up said the disease killed an average of 300,000 people in the country a year.

The company said the number was from the World Health Organization. But the WHO's most recent report estimates a much lower toll - 81,640 deaths in 2017.

But there is still work to be done to combat the mosquito-borne disease, as the rising number of malaria cases in the country shows.

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