Prof. Akin Abayomi, the Lagos State Commissioner for Health, has disclosed that only five per cent of people presenting with fever in the state actually have malaria, urging healthcare providers and residents to abandon the long-standing practice of treating every fever as malaria without proper diagnosis.
Speaking after a special fever management session hosted by the World Bank Nigeria Country Office, Abayomi said findings from the Lagos State World Bank-supported IMPACT Project showed that malaria accounts for only a small fraction of fever cases.
The project, described as the largest field evaluation of malaria diagnosis ever conducted in Nigeria, tested nearly 78,000 fever patients across 392 health facilities, community pharmacies and Patent and Proprietary Medicine Vendor (PPMV) outlets.
According to the commissioner, while fever was historically assumed to be malaria in about 70 per cent of cases, laboratory testing using WHO-accredited malaria rapid diagnostic tests, validated by expert microscopy and Polymerase Chain Reaction (PCR), found the actual malaria prevalence to be just five per cent.
He warned that treating every fever as malaria leads to misdiagnosis, unnecessary use of antimalarial drugs and antibiotics, delays in identifying the real illness, and contributes to the growing challenge of antimicrobial resistance.
Abayomi said Lagos has now adopted quality-assured malaria Rapid Diagnostic Tests (RDTs) as the first-line test for all suspected malaria cases and is working with the Pharmacy Council of Nigeria to make the tests readily available in community pharmacies and PPMV outlets.
He explained that the state’s new fever management strategy is built on the principle of “Test. Treat. Track.” Under the approach, every fever case should be properly diagnosed before treatment begins, while confirmed malaria cases should trigger treatment, surveillance and environmental interventions to reduce transmission.
The commissioner stressed that fever is a symptom rather than a disease, noting that patients who test negative for malaria should be evaluated for other illnesses, including respiratory viral infections, dengue fever, Lassa fever, bacterial infections and inflammatory conditions.
He added that Lagos is working with stakeholders to scale the evidence-based approach nationwide through improved regulation, wider access to quality diagnostics and stronger collaboration with private healthcare providers.