Lagos State Reveals Only 5% of Fever Cases are Malaria

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Lagos State Commissioner for Health, Prof. Akin Abayomi, has revealed that only 5% of people presenting with fever in Lagos actually have malaria. This shocking revelation was made following a special session on fever management hosted by the World Bank Nigeria Country Office. Abayomi, a renowned public health expert, has been the Lagos State Commissioner for Health since 2019. He was appointed by Governor Babajide Sanwo-Olu.

As the commissioner, Abayomi has been instrumental in shaping the state's health policies, including the fight against malaria.

The study, conducted by the Lagos State World Bank-supported IMPACT Project, tested nearly 78,000 patients with fever across 392 health facilities. The project aimed to improve the accuracy of malaria diagnosis and fever management in the state. The findings indicate that while malaria had historically been diagnosed in about 70% of fever cases, laboratory testing showed that the true malaria prevalence was only 5%. This means that the previous approach of treating every fever as malaria was not only ineffective but also contributed to the development of antimicrobial resistance.

The commissioner warned that indiscriminate use of antimalarial drugs and antibiotics delays accurate diagnosis, wastes scarce health resources, and contributes to the growing threat of antimicrobial resistance. He emphasized that patients who test negative for malaria should be investigated for other illnesses such as respiratory viral infections, dengue fever, Lassa fever, bacterial infections, and inflammatory conditions. Abayomi stressed that a negative malaria test is not the end of the story but rather the beginning of finding the true cause of a patient's illness.

The state has now adopted a new fever management strategy anchored on the principle of "Test. Treat. Track". Every fever should undergo proper diagnostic evaluation before treatment begins, while every confirmed malaria case should receive prompt treatment and trigger surveillance and environmental measures to curb transmission. The commissioner expressed appreciation to the World Bank Country Director for Nigeria, Matthew Verghis, and Senior Health Specialist, Dr.

Onoriode Ezire, for convening stakeholders to advance evidence-based fever management.

"This changes everything. It changes how we diagnose patients. It changes how we prescribe medicines. It changes how we train healthcare professionals. It changes how we allocate public resources. And ultimately, it changes how we protect our communities," Abayomi stated.

Writing about the study, Abayomi said that it has fundamentally changed the state's approach to malaria diagnosis and fever management. He noted that discussions at the World Bank Nigeria Country Office focused on scaling the Lagos model across the country through stronger regulation, wider access to quality diagnostics, and greater involvement of private healthcare providers.

The commissioner's remarks have sparked a crucial conversation about the need for accurate diagnosis and effective treatment of fever cases in Lagos. By shifting the focus from treating every fever as malaria, healthcare providers can now address the true causes of illness and prevent unnecessary drug use and antimicrobial resistance.

The Lagos State government's adoption of the new fever management strategy is a significant step towards improving healthcare outcomes in the state. By prioritizing accurate diagnosis and effective treatment, the state can reduce the burden of fever-related illnesses and promote public health. This approach can also serve as a model for other states in Nigeria to follow.