Management of Malaria Outbreaks in a Primary Healthcare Setting: Lessons from Plateau State

Malaria outbreak management in primary healthcare settings requires a structured response framework that integrates epidemiological surveillance, community mobilisation, and case management capacity. This study evaluated the management practices employed during documented malaria outbreaks in primary healthcare centres across three local government areas of Plateau State, North Central Nigeria. A mixed-methods design combined retrospective review of outbreak records from 2021 to 2024 with key informant interviews among primary healthcare coordinators and malaria focal persons. Quantitative data assessed response timelines, case fatality rates, and artemisinin-based combination therapy stockout frequencies. Qualitative data explored health worker decision-making, community engagement strategies, and inter-agency coordination challenges. Findings revealed that average time from outbreak detection to formal notification was 6.2 days, exceeding the national threshold of 48 hours. Case fatality rates were highest in facilities with artemisinin-based combination therapy stockouts. Community sensitisation was reactive rather than anticipatory in all reviewed outbreaks. Key informants cited inadequate logistics, poor data management systems, and insufficient training as the principal operational gaps. The study proposes an adapted outbreak response protocol for primary healthcare settings in Plateau State, incorporating rapid diagnostic test deployment, treatment stockpile management, and community health worker activation as first-tier interventions. Keywords: malaria outbreak, primary healthcare, outbreak management, Plateau State, case fatality.