Health 95% of fevers in Lagos not malaria – Commissioner

Data now shows an astounding 95 out of every 100 fevers experienced in Lagos are not caused by malaria, the Lagos State Commissioner for Health, Prof. Akin Abayomi says.

The critical finding is at the heart of a new, multi-pronged approach to fever management, designed to combat misdiagnosis and, crucially, to avert a looming crisis of antimicrobial resistance.

Abayomi said this at a three-day Study Kick-Off of Pathway to Pre-Elimination and Digitisation Project in Lagos State.

The focus was Malaria Rapid Diagnostic Test and Microscopy Comparative Study & Assessment of PPMVS’ Capacity to Manage Malaria and Febrile Illnesses.

Abayomi said: “We need to get malaria out of the region.

“It is very, very important that we do that once and for all, perform the mind shift in our healthcare providers that on average, 95 out of every 100 fevers that you may see are not caused by malaria.”

“For too long, the default response to fever in Lagos, and indeed nationwide, had been to administer anti-malarial drugs, often without proper diagnostic testing.

This practice, the commissioner warned, was not only wasteful but dangerous.

According to him, the widespread, often unnecessary use of anti-malarials and antibiotics is accelerating Antimicrobial Resistance (AMR), a global threat where common infections become untreatable.

“We are really sitting on a very major problem of microbial resistance. And we have to be careful how we dispense antimicrobials and how we dispense antibiotics.”

He cited recent research indicating significant AMR in animals, with 60 per cent of human infections originating from them, stressing the interconnectedness of the problem.

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Under the new “test, treat, and track” pathway/strategy, he said that Lagos 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 then conduct thorough examinations and investigations to pinpoint the true cause of the fever, be it pneumonia, gastroenteritis, or other infections.’

“The ministry is also tightening regulations on pharmacies.

“It is illegal to walk into a pharmacy and say, give me an antimalarial, or give me an antibiotic without a doctor’s or healthcare practitioner’s, accredited healthcare practitioner’s certificate.”

Underscoring the urgency of the situation, he urged the Pharmacy Council of Nigeria to enforce this, stressing, “If we don’t stop that practice, we are going to be the capital of antimicrobial resistance”.

To combat this, the ministry, with support from a World Bank grant, and in collaboration with the Prof. Wellington Oyibo’s Research Team, is instituting an evidence-based “test, treat, and track” pathway for fever management.

“The cornerstone of this approach is rigorous testing for malaria first.

“If negative—which is expected for over 90 per cent of cases in Lagos—healthcare providers are then mandated to investigate other potential causes of the fever, ranging from common colds to more serious bacterial or viral infections like E. coli, salmonella, or dengue.”

Oyibo, Director of the Centre for Transdisciplinary Research for Malaria and Neglected Tropical Diseases, who explained to the News Agency of Nigeria (NAN) the grave consequences of not testing, also underscored the severity of misdiagnosis.