Environmental and Health System Factors Influencing Malaria Recurrence among Patients Using Selected Primary Healthcare Centres in Sagamu, Ogun State

Abstract

Malaria remains a pervasive public health challenge in Nigeria, particularly in hyperendemic regions such as Sagamu, Ogun State, where individuals experience multiple Plasmodium falciparum infections annually. This study investigates the environmental and health system factors influencing malaria recurrence among patients attending selected primary healthcare centres in Sagamu. Employing a descriptive cross-sectional design, data were gathered from 160 respondents using structured interviews and surveys, and analysed using SPSS v26.0. Results indicate that 53.1% of respondents experienced malaria recurrence 2–5 times in the past year, with 43.1% reporting reinfection within three months of initial treatment. Key contributing factors included proximity to stagnant water (45.6%), persistent power outages (100%), limited access to insecticide-treated nets (42.5% rarely), and frequent shortages of malaria medication (39.4% often, 26.3% always). Moreover, 65% of respondents reported difficulties accessing malaria treatment, and 29.4% did not seek medical help during recurrences. Notably, 50% experienced more severe symptoms upon recurrence, while 25.6% reported incomplete recovery between episodes. The findings underscore the interplay of infrastructural inadequacies, environmental exposure, and healthcare limitations in sustaining malaria recurrence. The study recommends bolstering healthcare infrastructure, ensuring consistent supply of antimalarial medications, scaling up preventive measures, and improving environmental sanitation and power reliability to mitigate malaria recurrence and its public health burden.