July 10, 2026

Africa Health Report

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Elizabeth Effiwatt

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Only 5% of Fevers Are Malaria LAGOS, Nigeria - Only five per cent of patients presenting with fever in Lagos are confirmed to have malaria, prompting the state government to overhaul its approach to diagnosing and treating febrile illnesses, Health Commissioner Akin Abayomi says. Speaking after a fever management session hosted by the World Bank Nigeria Country Office, Abayomi said findings from the World Bank-supported IMPACT Project show that routinely treating every fever as malaria is fuelling misdiagnosis, unnecessary drug use and antimicrobial resistance. The study assessed nearly 78,000 patients with fever across 392 health facilities, including community pharmacies and Patent and Proprietary Medicine Vendor outlets, making it Nigeria's largest field evaluation of malaria diagnosis. According to Abayomi, malaria was historically diagnosed in about 70 per cent of fever cases, but laboratory testing found the actual prevalence to be only five per cent. "For decades, fever has become synonymous with malaria in our communities. Today, the evidence tells a different story," he said. He said the findings were confirmed using World Health Organization-accredited malaria rapid diagnostic tests, validated through expert microscopy and polymerase chain reaction testing. The commissioner announced that Lagos has adopted quality-assured Rapid Diagnostic Tests (RDTs) as the first-line diagnostic tool for all suspected malaria cases. The state is also working with the Pharmacy Council of Nigeria to expand access to accredited malaria test kits in community pharmacies and medicine vendor outlets. Abayomi said Lagos has introduced a new fever management strategy built on the principle of "Test. Treat. Track." Under the approach, every patient with fever will receive laboratory testing before treatment begins, while confirmed malaria cases will trigger surveillance and environmental interventions to reduce transmission. He stressed that patients who test negative for malaria should be assessed for other illnesses, including dengue fever, Lassa fever, respiratory viral infections, bacterial diseases and inflammatory conditions. "Perhaps the most important message is this: A negative malaria test is not the end of the story. It is the beginning of finding the true cause of a patient's illness," Abayomi said.

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