The prevalence of adherence among the participants was high. However, more serious efforts are needed to reduce the number of in-adherent patients. Interventions to improve adherence to ART should address challenges such as forgetfulness among the patients and frequent occurrence of adverse effects and consider specific patient-related factors such as daily tasks.

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Parasite-based diagnosis prior to treatment was poorly practiced, and inappropriate antimalarial drug management of MiP was observed. Addressing these observed deficiencies is necessary in order to achieve success in the fight against malaria during pregnancy in Nigeria.

61, 70 and 78.7 % of women with high, average, and low knowledge of malaria, respectively, (p = 0.078). Incidence rates of parasitaemia of 4.0, 1.6 and 6.25 % were obtained using peripheral microscopy, placental microscopy and peripheral rapid diagnostic test (RDT), respectively. Maternal infection was significantly associated with low birth weight (p = 0.020, peripheral microscopy; p = 0.020, placental microscopy) and maternal anaemia (p = 0.009, peripheral microscopy; p = 0.000, peripheral RDT). Conclusion: Knowledge gap still exists with regard to malaria and its interventions among mothers. Knowledge of malaria significantly influences the use of insecticide-treated bed nets. The negative impact of malaria infection during pregnancy is maternal anaemia and low birth weight infants.