Journal of Tropical Pediatrics最新文献

{"title":"A growing crisis of neonatal hyperosmolar-hypernatremic dehydration during heat waves: clinical insights from a semi-arid region.","authors":"Swasthi Kabi Satpathy, Choudri Muzafar Paswal, Arun Kumarendu Singh, Neeraj Gupta, Sushil Kumar Choudhary","doi":"10.1093/tropej/fmag028","DOIUrl":"10.1093/tropej/fmag028","url":null,"abstract":"<p><p>Hyperosmolar-hypernatremic dehydration (HHND) is a life-threatening yet preventable neonatal condition, often due to inadequate breastfeeding. The recent North Indian heat wave heightened dehydration risks, necessitating an evaluation of extreme temperatures' impact on neonatal hydration. This retrospective study analysed neonates admitted to a tertiary care level 3 neonatal intensive care unit (NICU) at AIIMS Jodhpur between April and June 2024. Case records were reviewed, and details on maternal age, feeding practices, presenting complaints, biochemical profile, and outcome were studied. The 2024 (April-May) heat wave led to a threefold increase in NICU admissions for HND compared to the previous 2 years, with cases rising from 2 to 3 per year to 10. Primigravida mothers accounted for 70% of the cases. The mean age of presentation was 6.7 days. Affected neonates experienced weight loss ranging from 11% to 33%, with serum sodium levels between 149 and 185 mEq/l and plasma osmolarity reaching 370-450 mOsm/l. Six neonates required peritoneal dialysis (PD) due to encephalopathy/anuria. One developed aortic thrombosis with lower limb gangrene, necessitating thrombolytic therapy. MRI abnormalities were observed in one case. Despite intensive management, one neonate succumbed to sepsis. Extreme environmental heat significantly heightens the risk of hyperosmolar-hypernatremic dehydration (HND) in neonates. Proactive neonatal monitoring, early breastfeeding support, and parental education are critical to preventing dehydration and its complications, especially in tropical and resource-limited settings, where extreme heat, early discharge, and limited lactation support increase neonatal vulnerability. Judicious fluid management targeting plasma osmolarity and timely intervention with PD in severe cases can optimize survival and neurological outcomes, underscoring the need for heightened vigilance during heat waves.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"72 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of virological failure in HIV-infected children and adolescents on first-line anti retrovirals in three treatment centres in the Bamenda municipality, Cameroon.","authors":"Andreas Chiabi, George Nana, Cecilia Fomenky, Samuel Angwafor, Lucas Tanlaka, Claudia Suiru, Martin Meh Geh, Gloria Enow Ashuntantang","doi":"10.1093/tropej/fmag038","DOIUrl":"10.1093/tropej/fmag038","url":null,"abstract":"<p><p>Virological failure is defined as a plasma viral load above 1000 copies/ml in a human immunodeficiency virus (HIV) patient after two consecutive viral load measurements 3 months apart, with adherence support after the first test and being on treatment for at least 6 months. It can lead to disease progression and increased risk of opportunistic infections. We conducted a retrospective cohort study using data from medical records of children and adolescents aged 6 weeks to 19 years receiving first-line antiretrovirals (ARVs) at three treatment centres in Bamenda: the Regional Hospital, Nkwen District Hospital, and St Mary Soledad Catholic Hospital. Data were collected over a 5-month period (January to May 2025) and included patients with at least 6 months on ART and two documented viral load measurements taken three months apart. Of 419 patients recruited, 169 had virological failure, giving a prevalence of 40.3%, with most being male (53.8%). The factors associated with virological failure included being male (aOR = 0.54; P < .008), having a caregiver who is single (aOR = 3.36; P < 0.001), having WHO clinical stage 3 and 4 at ARV initiation (aOR = 3.38; P = .038), fair or poor adherence to ARVs (aOR = 15.73; P < 0.001) and greater than 10 missed appointments (aOR = 33.76; P < .001). A total of 14 children and adolescents with virological failure died, resulting in a mortality rate of 8.3%. This study shows that the prevalence of virological failure was high in the three HIV treatment centres in this part of Cameroon.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"72 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occurrence, causative pathogens, and antibiotic susceptibility patterns of urinary tract infections in children with cerebral palsy in Enugu, Nigeria.","authors":"Makuachukwu Bernice Eze, Ngozi Chinyelu Ojinnaka, Henrietta Uchenna Okafor, Bartholomew Friday Chukwu, Chibuzo Obiora Ndiokwelu","doi":"10.1093/tropej/fmag033","DOIUrl":"10.1093/tropej/fmag033","url":null,"abstract":"<p><p>Urinary tract infection (UTI) is a major cause of morbidity and is generally under-reported in children. Children with cerebral palsy (CP) due to motor dysfunction and other risk factors are prone to UTIs. Due to the paucity of studies, establishing etiological agents and antimicrobial sensitivity patterns provides a basis for recommending routine screening of these children for UTI. This single-center matched cross-sectional study compared the prevalence of culture-confirmed UTI between children with CP and apparently healthy controls at the University of Nigeria Teaching Hospital, Enugu. Eighty children with CP were consecutively recruited and matched by age, sex, and socioeconomic status with 80 healthy school children. Urine samples were analyzed using dipstick urinalysis, microscopy, and culture. Associations were assessed using chi-square tests, and predictors were evaluated with logistic regression at a significance level of P < .05. UTI prevalence was 43.8% among subjects compared with 7.5% among controls. Escherichia coli and Klebsiella species accounted for the majority of isolates among subjects and controls (71.4% and 17.1% vs 50% and 33.3%, respectively). The major isolates demonstrated 66.7%-100% sensitivity to quinolones and ceftriaxone. Dipstick urinalysis showed leukocyte esterase in 74.3% of participants with UTIs compared with 8.9% of those without UTIs [P < .001; AOR (95% CI) = 29.6 (8.3-106.1)]. Urine microscopy revealed pyuria in 88.6% of culture-proven UTI cases compared with 17.8% of culture-negative cases [P < .001; AOR (95% CI) = 26.2 (7.1-96.6)]. Escherichia coli and Klebsiella are common causes of UTIs in our environment. Microscopy showed a stronger association with culture-proven UTI than dipstick; further diagnostic accuracy studies are warranted. Treatment of UTIs in children with CP should be guided by urine culture and local antibiogram data, while fluoroquinolones should be reserved for specific indications such as multidrug-resistant infections.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"72 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac alterations associated with multisystem inflammatory syndrome in children related to COVID-19: a cross-sectional study from the Colombian Caribbean.","authors":"Melissa Rivero Roca, Gennys Gutiérrez Ramírez, Aida Luz Figueroa Reyes, Mauricio Guerrero Román, Jaime Plazas Román, Carlos M Ardila","doi":"10.1093/tropej/fmag029","DOIUrl":"10.1093/tropej/fmag029","url":null,"abstract":"<p><p>Multisystem inflammatory syndrome in children (MIS-C) is a severe hyperinflammatory condition that follows SARS-CoV-2 infection, characterized by persistent fever and multi-organ dysfunction. Cardiac involvement occurs in 67%-80% of cases, representing a critical clinical concern. Data from tropical and Caribbean regions remain limited in the global MIS-C literature. We conducted a cross-sectional study with retrospective data collection at Hospital Infantil Napoleón Franco Pareja, Colombia. Included patients were <18 years with a MIS-C diagnosis per WHO/CDC/RCPCH criteria and positive SARS-CoV-2 serology. Cardiac involvement was defined by elevated troponin, abnormal echocardiography, or electrocardiogram changes. Among n = 105 patients (median age 5 years, 61% male), cardiac involvement occurred in 25.7% (n = 27). The median number of affected organ systems was 4 (IQR: 3-4). Coronary artery dilation was the predominant cardiac finding (37.0% of cardiac cases), followed by mitral regurgitation and elevated troponin (both 33.3%). No patients showed left ventricular ejection fraction <55%. Treatment included corticosteroids (92.4%), acetylsalicylic acid (91.4%), and immunoglobulin (70.5%). All patients survived to discharge (100% survival). One-month follow-up revealed persistent coronary dilation in 2.9%. MIS-C affects multiple organ systems with coronary artery dilation as the predominant cardiac manifestation in our population. Favorable acute outcomes were observed with the current management protocols, including 100% survival and brief hospitalizations. However, persistent cardiac abnormalities in a subset of patients emphasize the need for systematic cardiac surveillance. These findings from a tropical Caribbean population provide insights applicable to resource-limited settings in other low- and middle-income countries.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"72 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability and efficacy of low-dose zinc with or without probiotics in acute watery diarrhoea-a prospective comparative study.","authors":"Praveen Kumar P, Podhini Jegadeesan, Shanthi Ananthakrishnan","doi":"10.1093/tropej/fmag025","DOIUrl":"10.1093/tropej/fmag025","url":null,"abstract":"<p><p>Acute watery diarrhoea (AWD) has not been well-treated with 20 mg elemental zinc, primarily because of adverse symptoms like vomiting. In contrast to 20 mg of zinc, this study sought to determine whether a lower dose of zinc, with or without probiotics, is as beneficial as 20 mg of zinc, yet tolerated better. The aim of this study was to compare the acceptability and efficacy of low-dose zinc (10 mg) with or without probiotics to the acceptability and efficacy of standard-dose zinc (20 mg) in children diagnosed with AWD. A prospective comparative study was conducted among children aged 6 months to 5 years with AWD at a tertiary healthcare centre. Eligible children were randomized into three groups: Group Z20 and Z10 were administered zinc acetate 20 mg/day and 10 mg/day, respectively, and Group Z10P with 10 mg/day with probiotics. Caregivers were followed daily via telephonic interviews for 14 days to record symptoms, adverse reactions, and treatment completion. Data were analyzed using Kruskal-Wallis test, one-way ANOVA, and the chi-square test. A total of 147 children were enrolled (49 in each group). The mean duration of AWD at enrollment was 3 ± 1.5 days, and the mean frequency was 5 ± 2 episodes/day. There was no significant difference in the mean duration of diarrhoea among the groups. The most common adverse reactions reported was vomiting (85%). Diarrhoea resolved within 3 days in 22.4% of Group Z10P, 10.2% of Group Z20, and 2% of Group Z10 (P = .03). Low-dose zinc (10 mg/day) was less effective than 20 mg zinc in controlling AWD. However, the combination of 10 mg zinc with probiotics significantly improved efficacy.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"72 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming habits, transforming health: a behaviour-centred WASH intervention in the urban slums of Darjeeling, India.","authors":"Aarif Hussain, Sampriti Samanta, Sharmistha Bhattacherjee","doi":"10.1093/tropej/fmag026","DOIUrl":"10.1093/tropej/fmag026","url":null,"abstract":"<p><p>Water, sanitation, and hygiene (WASH) promotion helps to prevent common childhood illnesses through behaviour change. The study assessed the effectiveness of a WASH education in improving household WASH practices in an urban slum of Darjeeling, West Bengal. A quasi-experimental intervention involving interactive discussions, role-playing, and live demonstrations was conducted among 75 households with children under 10 years of age. Baseline and endline behaviours were compared for any significant changes. A composite WASH score was applied to assess the intervention's effect between baseline and endline. Post-WASH intervention, significant improvements in water handling, sanitation, and hygiene behaviours were observed (P-value <.05). Key changes included increased use of clean, covered water containers, improved sanitation practices, safe waste disposal, and better personal hygiene. Overall, the mean WASH score rose significantly from baseline to endline (11.40 ± 5.25 vs 17.20 ± 5.28 respectively; P = .000). The prevalence of common childhood illnesses was assessed at baseline and at endline, with a statistically significant reduction in diarrhoea and skin infections at endline (P = .001 for both). Socioeconomic status was a significant predictor of behaviour change (adjusted R2=0.17, P-value <.05). Community-based WASH interventions significantly improved WASH practices among children and caregivers and reduced childhood diarrhoea and skin infections in urban slums of Darjeeling.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"72 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Lungs: Rising Pediatric Mycoplasma pneumoniae Infections with Extrapulmonary Manifestations in the Post-COVID-19 Pandemic Era.","authors":"Aylin Irmak Kuruc, Kubra Aykac, Ali Bulent Cengiz, Yasemin Ozsurekci","doi":"10.1093/tropej/fmag036","DOIUrl":"10.1093/tropej/fmag036","url":null,"abstract":"<p><strong>Background: </strong>Following the relaxation of COVID‑19 mitigation strategies, Mycoplasma pneumoniae (MP) infections have resurged worldwide. Although respiratory involvement predominates, extrapulmonary manifestations in children are increasingly recognized. We aim to report a recent rise in pediatric MP infections with notable extrapulmonary features, including rash, mucositis, acute myocarditis, and other parainfectious eruptions.</p><p><strong>Methods: </strong>We describe 6 pediatric cases with extrapulmonary MP manifestations admitted to our center from March 2025 to October 2025. The diagnosis was confirmed through serology or PCR testing. We reviewed the clinical features, laboratory results, and treatment outcomes.</p><p><strong>Results: </strong>Five patients exhibited generalized targetoid rashes, often accompanied by fever, conjunctival hyperemia, or mucosal changes. The median age 14 years (min: 13 months -max: 17.5 years), and 3 patients were female. Several were initially misdiagnosed as meningococcemia, Kawasaki disease, or MIS‑C. One adolescent developed MP‑associated acute myocarditis, with hypotension, elevated cardiac markers, and mild cardiomegaly. Another patient presented with reactive infectious mucocutaneous eruption (RIME) limited to oral lesions. All patients received macrolide therapy (clarithromycin or azithromycin), with rapid clinical improvement, resolution of lesions, normalization of cardiac markers, and no major adverse effects.</p><p><strong>Conclusions: </strong>MP infection in children may present with dermatologic, mucocutaneous, or cardiac involvement even in the absence of respiratory symptoms. Clinical awareness beyond respiratory findings is crucial to avoid misdiagnosis and inappropriate treatment. Broader diagnostic and surveillance approaches are needed to improve recognition, especially in the context of evolving post‑pandemic host and pathogen dynamics.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"72 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of academic performance of primary school children presenting with strabismus and/or amblyopia in Nigeria with age- and sex-matched classmates.","authors":"Glory C Ojinnaka, Onochie I Okoye, Ngozi C Ojinnaka, Ifeoma R Ezegwui","doi":"10.1093/tropej/fmag027","DOIUrl":"10.1093/tropej/fmag027","url":null,"abstract":"<p><p>To compare the academic performance of urban primary school children with strabismus and/or amblyopia seen at the Eye Clinic of University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria, with that of their controls. In this comparative cross-sectional study, conducted in 2022, 92 primary school children with strabismus and/or amblyopia were consecutively recruited from UNTH Ituku-Ozalla, Enugu. They were compared with 92 age- and sex-matched classmates from schools who had normal visual acuity (6/6) and no strabismus. The academic performance of participants was evaluated using the average of individual subject scores in Mathematics, English, Science, and Social Studies, and the average overall scores in the three terms of an academic session. Scores of ≥75%, were classified as high academic performance; 50%-74%, was classified as average; and scores of <50%, was classified as poor. Student's t-test was used for comparison of means. The chi-square test/Fisher's exact test, as appropriate, was used for categorical variables. The level of statistical significance was set at P < .05. Patients and controls had an average overall score of 84.52 ± 11.35 and 83 ± 12.56, respectively, with no statistically significant difference. The majority of the patients (81.5%) had high academic performance. The lowest mean score was in mathematics for both groups. Patients had high academic performance with no statistically significant difference between that of the patients and their controls. Of all the school topics, both patient and control groups had the lowest mean scores in mathematics, with patients scoring lower than the controls.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"72 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of failure of high flow nasal cannula oxygen therapy in children: a prospective observational study.","authors":"Puneet Mishra, Urmila Jhamb, Pallavi Pallavi, Romit Saxena","doi":"10.1093/tropej/fmag034","DOIUrl":"10.1093/tropej/fmag034","url":null,"abstract":"<p><strong>Background: </strong>Use of heated humidified high flow nasal cannula (HFNC) has become the standard treatment modality for children with acute respiratory distress. This study aimed to identify the factors predicting HFNC failure. Methodology: Children 1 month-12 years of age requiring HFNC support were included in this prospective observational study. Vital signs, e.g. heart rate, respiratory rate (RR), Respiratory Clinical Score (RCS), indices, e.g. SF ratio (SpO2/FiO2) and ROX index (SF/RR) and patient outcomes regarding HFNC success or failure were recorded. Receiver operating characteristics (ROC) analysis with area under the curve (AUC) was done at different time points to find the best cut-off value for SF ratio and ROX index as predictors of HFNC failure. Results: Sixty children requiring HFNC were enrolled. Initial response in the RCS score occurred in 46 patients at 4 hours (interquartile range [IQR]: 2-6) and in RR 6 hours (IQR: 4-12). All patients except one (45/46) who had shown the initial response finally responded to HFNC therapy (75%), and the remaining 15/60 (25%) required escalation to invasive ventilation. Best cut-off value of the SF ratio was ≤192 at 12 hours, with 84.4% sensitivity and 84.6% specificity (AUC, 0.819). Similarly, the best ROX index value to predict HFNC failure was ≤5.27 at 24 hours with 72.1% sensitivity and 88.9% specificity (AUROC 0.864). Conclusion: SF ratio at 12 hours and ROX index at 24 hours are best for predicting HFNC failure in children. Initial response in the RCS score (20% reduction from baseline) by 4 hours is also a good indicator of HFNC success, as none (except one) of these patients failed HFNC therapy.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"72 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden, challenges, and control of malaria among under-5s in Nigeria.","authors":"Lenz Nwachinemere Okoro, Innocent Ayesiga, Michael Oppong Yeboah, Naya Gadzama Bulus, Jonathan Mawutor Gmanyami, Esther Ladidi Ismaila, Ovye Ahgu, Elijah Ogbu Otokpa, Eneh Nchiek Edet, Joy Malle Dogo, Tom Didimus Ediamu, Lorna Atimango, Isaac Isiko","doi":"10.1093/tropej/fmag014","DOIUrl":"https://doi.org/10.1093/tropej/fmag014","url":null,"abstract":"<p><p>Malaria remains a leading cause of morbidity and mortality among children under five years in Nigeria, a country accounting for over a quarter of global malaria cases. Despite the availability of interventions, Nigeria continues to face persistent challenges in controlling malaria, especially in the under-five population, thus, the need for this review. This narrative review synthesizes peer-reviewed literature, national reports, and policy documents published since 2010. A structured search was conducted across PubMed, Google Scholar, Scopus, and relevant grey literature from the WHO, UNICEF, and the Nigerian Ministry of Health. The review adhered to SANRA guidelines to ensure methodological rigour and focused on studies reporting malaria epidemiology, interventions, and control efforts targeting children under five in Nigeria. Findings revealed a high malaria burden among children in Nigeria, with notable regional disparities. Northern states report the highest prevalence, with rural areas disproportionately affected. Contributing factors include socioeconomic deprivation, climate variability, and suboptimal coverage of interventions. Key challenges include diagnostic limitations, drug resistance, and inconsistent use of preventive measures. While interventions such as long-lasting insecticidal nets (LLINs), intermittent preventive therapy, and indoor residual spraying have shown effectiveness, gaps remain in coverage and implementation. Innovations in diagnostics, vaccines, and surveillance systems are promising but underutilized. Despite progress, Nigeria faces multifaceted challenges in malaria control among under-fives. A coordinated, multisectoral response involving innovative strategies, stronger health systems, and policy reforms is essential. Attention must also be directed to enhancing the acceptability, fidelity, and longevity of these interventions.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"72 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147290115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}