📖 ABSTRACT/OVERVIEW
Climate change is predicted to substantially alter malaria transmission dynamics in sub-Saharan Africa, with potentially severe consequences for childhood health in Nigeria, the country with the world's highest absolute malaria burden. Despite this urgency, the empirical and modelled relationships between climate variables, malaria epidemiology, and child health outcomes across Nigeria's diverse agro-ecological zones remain uncharacterised at high spatial resolution. This study integrates multi-decadal climate data (1990 to 2023), satellite-derived malaria incidence estimates, and childhood mortality data to examine historical climate-malaria-child health relationships and project future scenarios to 2050 under IPCC SSP2-4.5 and SSP5-8.5 climate pathways across all six geopolitical zones. Temperature and rainfall anomaly data from the Nigerian Meteorological Agency were linked to malaria parasite rate estimates from the Malaria Atlas Project and under-five mortality rates from NDHS and HMIS data. Poisson regression and distributed lag non-linear models (DLNM) were used to characterise temperature-malaria and malaria-mortality exposure-response relationships, accounting for time lags. Rising minimum nighttime temperatures above 18 degrees Celsius were associated with a 14.7% increase in malaria parasite rates in the historically lower-transmission north-central and north-west zones, suggesting northward transmission expansion. Under SSP5-8.5, climate projections indicate a 22 to 34% increase in population at risk of malaria-associated under-five mortality in northern zones by 2050. The study provides the first multi-zonal climate-malaria-child mortality analysis in Nigeria and contributes a novel predictive framework for climate-responsive child health planning. Keywords: climate change, malaria, child mortality, Nigeria, projection model.
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