95% of fever cases in Lagos not malaria – Health Commissioner

A study conducted across Lagos State has found that about 95 per cent of people who sought medical attention for fever did not test positive for malaria.

The Lagos State Commissioner for Health, Akin Abayomi, disclosed the findings in a post on X on Friday, September 4.

According to him, the study covered more than 78,000 people across 514 healthcare outlets in the state.

Abayomi said only about five per cent of those who presented with fever were confirmed to have malaria, while tests showed that other conditions were responsible 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 findings have led the Lagos State Government to adopt a “Test Before Treat” approach to discourage residents from assuming that every case of fever is malaria and taking antimalarial drugs without a proper diagnosis.

Abayomi said the study had also exposed the risks associated with the widespread practice of self-medication, particularly when residents experience fever.

He explained that the common pattern was for people to assume they had malaria, purchase antimalarial drugs and, when there was no improvement, proceed to other medications, 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.

He urged residents to adopt a different approach by seeking professional medical care, undergoing the necessary tests and taking medicines based on the diagnosis.

According to the commissioner, the “Test Before Treat” policy was introduced in response to the study’s findings and the changing pattern of malaria in Lagos.

He further highlighted the role of community pharmacies and patent medicine stores, noting that they are frequently the first points of contact for residents who develop fever.

Abayomi said quality-assured malaria rapid diagnostic tests should be available at such outlets, with clear referral systems for patients whose results are negative.

He cautioned residents against automatically treating fever as malaria, stressing that a negative malaria test should trigger further investigation rather than the immediate use of another medication.

“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.”

The commissioner said the policy would encourage accurate diagnosis and responsible medicine use, while also helping to reduce unnecessary consumption 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.