A groundbreaking revelation has emerged in Lagos, Nigeria, where a staggering 95 out of every 100 fevers are not caused by malaria, according to the Lagos State Commissioner for Health, Prof. Akin Abayomi. This astonishing finding has prompted a new approach to fever management, aimed at combating misdiagnosis and preventing a looming crisis of antimicrobial resistance. Abayomi announced this at a three-day study kick-off of the Pathway to Pre-Elimination and Digitization Project in Lagos state, emphasizing the need to overhaul the region’s approach to fever treatment.
For far too long, the default response to fever in Lagos, and indeed nationwide, has been to administer anti-malarial drugs without proper diagnostic testing. This practice, Abayomi warned, is not only wasteful but also perilous, as it accelerates antimicrobial resistance (AMR), a global threat where common infections become untreatable. The commissioner cited recent research indicating significant AMR in animals, with 60% of human infections originating from them, highlighting the interconnectedness of the problem.
To tackle this issue, the Lagos State Ministry of Health is introducing a “test, treat, and track” pathway, where residents presenting with fever will first undergo a Rapid Diagnostic Test (RDT) for malaria. If the result is negative, which is anticipated for the vast majority, healthcare providers will conduct thorough examinations to pinpoint the true cause of the fever, be it pneumonia, gastroenteritis, or other infections. The ministry is also tightening regulations on pharmacies, making it illegal to dispense anti-malarial or antibiotic medication without a doctor’s or healthcare practitioner’s certificate.
Prof. Wellington Oyibo, Director of the Centre for Transdisciplinary Research for Malaria and Neglected Tropical Diseases, stressed the gravity of misdiagnosis, particularly in cases where pneumonia presents with similar symptoms to malaria. “If a child has pneumonia and is given anti-malaria medicine without a test, the child will die quickly of pneumonia,” Oyibo warned. The study coordinator emphasized the importance of adopting Rapid Diagnostic Tests (RDTs) over traditional microscopy due to their proven accuracy and operational feasibility in low-resource settings.
Lagos state has made significant progress in its fight against malaria, with epidemiological parameters qualifying it as a state at pre-elimination. However, the persistence of fever and malaria-like symptoms being misdiagnosed as malaria remains a significant challenge. This bold initiative aims to usher in an era of evidence-based medicine, where accurate diagnosis and intellectual capacity protect society from the devastating consequences of incorrect treatment and drug resistance. As the Lagos State Ministry of Health embarks on this new approach, it is clear that a paradigm shift is underway, one that prioritizes precision, patience, and a commitment to saving lives.
