Francis Abu has never been to hospital to treat malaria. “I think it’s a waste of money and time going to the hospital because of malaria. Whenever I feel feverish, I go to the Chemist shop.”

Aldine Give also doesn’t trust hospitals. “I decided to be treating my children at home once I notice they are feverish because most times even when you go to the hospital, the doctors will not conduct any test, but they will give you anti-malaria drug.”

Joy Igwe believes that because malaria has been with Nigerians for decades it is no longer a threat.  “No matter how you try to protect yourself, no one can escape being attacked by malaria.  Sometimes I wonder if what they are saying about mosquitoes and malaria is true.  For me I see it as natural cause in this part of the world.”

How do you identify malaria attack?  “The signs are there,” says Godwin Effiong. “Once there is feverishness, you don’t need a soothsayer to tell you it is malaria.” Since he grew up, Godwin has never gone to the hospital for malaria treatment. “I usually treat at home. Sometimes I use local herbs or go to the pharmacy.

“I have tried many of the laboratory outfits we have sometimes they even misdiagnose the disease.  Sometimes, they will tell you it is typhoid when actually it is malaria and sometimes you may not have malaria and you will be told is malaria.  I think the problem boils down to our healthcare system, there should be more education and awareness about how some of these things should be done,” Effiong noted.

These are just some of the typical reactions encountered when Good Health Weekly  went on the streets to obtain random views about malaria. Findings revealed that the typical Nigerian perception about the general causes, diagnosis, control and management of malaria is surprisingly low. From the investigations, it was clear that quite a number of persons blindly treat malaria without testing.

Experts describe this as over-diagnosis and treatment, capable of causing other complications.

Consultant Medical Parasitologist/ Associate Professor, Dr. Wellington Oyibo confirmed that malaria is over diagnosed because most Nigerians believed that that any fever should be malaria.

Oyibo, of the Department of Medical Microbiology & Parasitology, College of Medicine, University of Lagos, CMUL, says not all fever is malaria.

“If everybody feels that they have fever and they said they have malaria and they go to take malaria medicines they over treat themselves and when they over treat themselves it could be fatal because there could be other reasons that would have deserved far more urgent treatment if some testing was done first.

Antimalarial treatment

And without testing, people will continue to buy anti malaria medicines and continue to over use them and that is not good.”

On the malaria treatment policy, he argued: “What the policy says now is that there must be prior testing before treatment and the communication to the public is that when they feel they have malaria or fever and they feel it is malaria, they should do a test first because that fever presentation could be due to so many conditions and that is the reason for testing.

What government has tried to do is to see that those quality test tools are available  and of course they can get the ministry of health here to ask for the quality assured  rapid diagnostic tests that they can use.   “The country has provided direction on how diagnosis and treatment will go.

There is a national policy on diagnosis and treatment of malaria and government has provided guidelines as to what every healthcare provider should do and that guideline is available at the National Malaria Control website so that they don’t work on their individual opinion,” he added.

Recently, the Minister of Health, noted that the National programme on Malaria is embarking on Integrated Malaria Elimination involving, testing with Rapid Diagnostic Tests, RDT.

He also stated that diagnosis is being scaled up. Millions of RDTs have been procured and distributed to States. In addition, about 137 health officers have been trained in a Training of the Trainers workshop on RDT in Anambra, Bauchi and Niger States. Mass diagnosis campaign was conducted in four LGAs (Southern Ijaw, Sagbama, Ogbia and Yenagoa) in Bayelsa State.

“In our effort to ensure malaria commodity security, over 29,876,905 doses of ACTs and over 15,380,163 units of RDTs have been procured for staggered delivery to states. Capacity has been built in 36 states including FCT on Malaria Commodity Logistic System so as to improve on the quality of consumption data that is available for decision making. States specific quantification and gaps analysis has been carried out which provides the tool for advocacy and effective planning.”

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