Is malaria over-diagnosed? A world malaria day 2017 experience by excellence and friends management care centre (EFMC) and partners, Abuja Nigeria

Abstract

Malaria remains a major cause of mortality across the world, but particularly in sub-Saharan Africa. WHO-sponsored World Malaria Day activity has helped to improve education and has contributed to a reduction in mortality globally in the past decade. However, much needs to be done still in Africa. We report on a World Malaria Day scheme in three primary Healthcare Facilities in and around the Abuja Federal Capital Territory in Nigeria in 2017. Activity included educational talks to pregnant women and nursing mothers of young children, with malarial testing, distribution of free mosquito nets and also medical treatment if needed. We found a large clinical over-diagnosis of malaria with simple fevers of any cause being reported as malaria. None of these cases were found to be due to malaria on formal malarial testing. We conclude that efforts should continue into education and prevention of malaria with insecticide-impregnated mosquito nets a key factor. However, over-diagnosis of malaria and the use of unnecessary antimalarial treatment may lead to parasite resistance to antimalarial treatment, morbidity from drug side-effects and potential mortality from not receiving the right treatment for other febrile illnesses. We recommend that malarial testing, particularly with simple blood film microscopy is implemented more widely across Africa, as it is simple to perform and allows effective management plans to be drawn up for individual patients.

Malaria Diagnosis at the Pediatric Emergency Unit of a Teaching Hospital in Makurdi, North Central Nigeria

“…Most of the children for whom an assessment of malaria was made presented with fever (33%), and this is in keeping with the report of Oladosu et al ( 12 ), in Lagos, but in contrast with the report of Jombo et al who reported fever in only 1.8% of the children ( 10 ). However, 28.5% of the children presenting with fever tested negative for malaria which is similar to the report of Oleribe et al in Abuja ( 16 ), and this underscores the need to test every patient presenting with fever before treatment as not every fever in children is due to malaria ( 17 ).…”