The Lagos State Government has introduced a “Test Before Treat” approach after a state-wide study revealed that about 95 per cent of people who sought treatment for fever did not have malaria.
The Lagos State Commissioner for Health, Akin Abayomi, disclosed this in a post on X on Friday, September 4, explaining that the study involved more than 78,000 people who visited 514 healthcare outlets across the state.
According to Abayomi, only about five per cent of those who presented with fever were confirmed to have malaria, while tests indicated that other conditions accounted for the remaining cases.
“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.
The commissioner said the findings had prompted the state government to discourage the widespread assumption that fever automatically means malaria, particularly the practice of taking antimalarial drugs without first confirming the cause of the illness.
He also raised concerns about self-medication, noting that many people typically assume they have malaria, purchase antimalarial drugs and, after failing to improve, switch to other medicines, including antibiotics.
“For years, the pathway has often been: patient feels unwell, sees a healthcare provider, undergoes history and examination, takes an appropriate test, receives a diagnosis and gets appropriate treatment,” he said.
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Abayomi urged residents to maintain that approach by consulting healthcare professionals, undergoing appropriate tests and using medication based on confirmed diagnoses.
He explained that the “Test Before Treat” policy was developed in response to the study’s findings and changes in the pattern of malaria cases across Lagos.
The commissioner also identified community pharmacies and patent medicine stores as important points of first contact for residents experiencing fever. He called for quality-assured malaria rapid diagnostic tests to be made available at such outlets, alongside clear referral arrangements for people whose malaria tests return negative.
Abayomi warned against treating every fever episode as malaria, stressing that a negative malaria result should lead to further investigation instead of automatically switching to 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.”
According to the commissioner, the policy is intended to promote proper diagnosis and responsible use of medicines, while reducing the unnecessary use of antibiotics.
“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.