95% of Fever Cases in Lagos Not Malaria – Health Commissioner

As many as 95 per cent of people who presented with fever in Lagos did not test positive for malaria, according to findings from a study conducted across the state.

The Lagos State Commissioner for Health, Akin Abayomi, disclosed this via a post on X on Friday, September 4, saying the study involved more than 78,000 people across 514 healthcare outlets.

Abayomi said only about five per cent of those who presented with fever tested positive for malaria, while the remaining 95 per cent had other causes of fever.

“Our extensive fever study, involving more than 78,000 people across 514 healthcare outlets, found that only about 5% of people with fever tested positive for malaria. That means 95% had another cause of fever,” he said.

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The finding has prompted the Lagos State Government to adopt a “Test Before Treat” approach aimed at discouraging residents from assuming that every fever is caused by malaria and taking antimalarial drugs without proper diagnosis.

Abayomi said the figures highlighted the dangers of the common practice of self-medicating for malaria whenever fever occurs.

He explained that the usual pattern was for patients to assume they had malaria, buy antimalarial drugs and, if their condition did not improve, move on to other medicines, including antibiotics.

“For years, the pathway has often been:

Patient feels unwell → assumes malaria → buys an antimalarial → if still unwell, moves on to another medicine, including an antibiotic,” the commissioner said.

He said residents should instead seek medical attention, undergo appropriate tests and receive treatment based on the diagnosis.

“The correct pathway is: Patient feels unwell → sees a healthcare provider → history and examination → appropriate test → diagnosis → appropriate treatment,” he said.

Abayomi said the “Test Before Treat” policy was informed by the study’s findings and Lagos’ changing malaria epidemiology.

He also identified community pharmacies and patent medicine stores as important points of care, noting that they are often the first places residents visit when they develop fever.

According to him, quality-assured malaria rapid diagnostic tests should be made available at such outlets, alongside clear referral pathways for patients who test negative.

The commissioner urged residents to stop automatically treating fever as malaria, stressing that a negative malaria test should lead to further investigation rather than the use of another medicine.

“My message to the public is simple: Do not assume every fever is malaria. Test before you treat,” Abayomi said.

He added, “If the test is positive, treat appropriately. If it is negative, do not simply move on to another medicine. Find out what is actually causing the illness.”

Abayomi said the policy would promote better diagnosis and responsible use of medicines while reducing unnecessary antibiotic consumption.

“This is about better diagnosis, better use of medicines and better healthcare. It is also about protecting our antibiotics from unnecessary use and helping Lagos move closer to malaria elimination,” he said.