Professor Abayomi made this announcement at the ‘Study Kick-Off of the Pathway to Pre-Elimination and Digitization Project,’ which focuses on malaria diagnostic accuracy and the capacity of healthcare providers to manage fevers.
“We need to get malaria out of this region once and for all,” Abayomi emphasized. “It’s crucial for our healthcare providers to shift their mindset: on average, 95 per cent of fevers they see are not malaria-related.”
For too long, the standard response to fever in Lagos has been to administer anti-malarial drugs, often without proper testing. The Commissioner warned that this practice is not only wasteful but dangerous, accelerating AMR – a global threat where common infections become untreatable due to the overuse of medications. He cited research showing significant AMR in animals, with 60 per cent of human infections originating from them, highlighting the interconnectedness of the problem.
To combat this, the Ministry of Health, supported by a World Bank grant and in collaboration with Professor Wellington Oyibo’s Research Team, is implementing an evidence-based “test, treat, and track” strategy for fever management.
Under this new pathway, Lagos residents experiencing fever will first undergo a Rapid Diagnostic Test (RDT) for malaria. If the result is negative, which is expected for the vast majority of cases, healthcare providers will then conduct thorough examinations and investigations to pinpoint the true cause of the fever, such as pneumonia, gastroenteritis, or other infections.
The Ministry is also tightening regulations on pharmacies, making it illegal to dispense anti-malarials or antibiotics without a valid prescription from an accredited healthcare practitioner. Professor Abayomi urged the Pharmacy Council of Nigeria to strictly enforce this, stating, “If we don’t stop that practice, we are going to be the capital of antimicrobial resistance.”
Professor Wellington Oyibo, Director of the Centre for Transdisciplinary Research for Malaria and Neglected Tropical Diseases and the study Coordinator, underscored the severe consequences of misdiagnosis. He explained that a child presenting with pneumonia might show similar symptoms to malaria. “If you now give anti-malaria medicine without a test, that child will die quickly of pneumonia,” Oyibo warned.
A key strategy to eliminating malaria in Lagos involves a policy shift towards using Rapid Diagnostic Tests (RDTs) over traditional microscopy. RDTs are favored due to their proven accuracy and operational feasibility, especially in low-resource settings.
Lagos State is notably the only state whose epidemiological parameters qualify it as being at the “pre-elimination” stage for malaria in Nigeria. However, fevers and other malaria-like symptoms that are non-specific to malaria are still frequently misdiagnosed as malaria, significantly contributing to high reported malaria burdens.
This bold initiative aims to usher in an era of evidence-based medicine in Lagos, where accurate diagnosis and intellectual rigor protect society from the cascading harms of incorrect treatment and drug resistance.
