Wahala Be Like Malaria Wey You No Test For

Despite the awareness about malaria and how easy it is to treat; malaria is still a huge concern in Nigeria. The 2021 World Malaria Report (WMR) shows that 29 countries (out of 193 countries) accounted for 96% of the global malaria cases, and Nigeria is ranked the highest. Additionally, malaria is the second leading cause of death for all ages and when compared to deaths from the COVID-19 pandemic, malaria killed six thousand times more people in 2020. To put these numbers into perspective, the number of deaths attributed to malaria in a year is equivalent to 50 plane crashes every month in an entire year.

Although, several arguments have questioned these numbers because of the huge financial investments committed to eliminating malaria and the high rate of presumptive treatment (taking malaria drugs without testing). However, as we are in the rainy season when malaria cases are usually at its peak due to high mosquito breeding, it is important to discuss some myths about fevers and presumed malaria.

Although Nigeria has adopted the malaria test before treatment policy, the presumptive treatment also known as “Oga, I know my body, na malaria, I no need test” (I know my symptoms, I don’ need a test to determine if I have malaria) has somewhat become the norm.

Herein lies the problem: Several infections/conditions, for example, COVID-19, typhoid fever, and pregnancy, have similar symptoms to malaria and therefore, fever patients could be wrongly self-diagnosed without appropriate tests. Consequently, due to the non-specificity of the malaria symptoms, more patients could wrongly self-diagnose without an appropriate test for malaria. Though seeming harmless, presumptive treatment has huge implications: not understanding the true malaria burden in Nigeria (hence undermining the government’s effort to eliminate malaria), poor management of fever illnesses that are not malaria, growing resistance of malaria infection to the available antimalarial drug and deaths from treating what was assumed to be malaria.

While several factors have contributed to reinforcing the presumptive treatment, one common factor which, over time, passively shapes our perspective on presumptive treatment is the advertisement of antimalarials.

Indulge me as I take you back memory lane to any advert on antimalarials which usually have the same script regardless of the brand. The adverts begin with an adult (fictitious Amaka) shivering on the bed, sweating, and unable to talk. Another healthy adult (fictitious Emeka) walks into the room to find out what the problem is and Amaka’s response is usually “Cold, fever, headache”. Emeka is then seen pondering a bit about the symptoms and figures it is MALARIA!! and he magically brings out a pack of antimalaria from his pocket, where he supposedly stores a catalogue of drugs to give Amaka. She is later seen at the end of the advert, healthy by the next day. This looks great, right? Having to match symptoms like a simple algorithm ignoring other biomedical changes and figuring out it is malaria within seconds, a quicker turnaround time than you would probably get in the laboratory. However, such commercialisation of medication use has distorted the perception of testing.

In response to this “unassuming public health emergency,” several policies are in place to increase access to affordable malaria tests at several points where people seek care beyond the hospitals and health facilities, for example, your friendly neighbourhood drug stores (chemist or pharmacist stores). In addition to the malaria test done in the laboratory or hospitals using a microscope, rapid tests such as the malaria test kit (Rapid Diagnostics Test) are now available in these pharmacy stores. This malaria test kit offers numerous advantages but a noteworthy one is it is a fast test (the result is ready after 15 minutes), accessible, easy, affordable, and reliable.

These opportunities for testing have made it easy for people to get a malaria test, either test done with a microscope or a malaria test kit.
Therefore, debunking the myth or idea that every fever you have is malaria and get a test. In conclusion, before you buy your next antimalaria drug, remember NOT EVERY FEVER IS MALARIA -TEST BEFORE YOU TREAT. Take responsibility for your health and not what Emeka says on TV.!!!
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Eze Nwamaka Public Health Consultant https://www.linkedin.com/in/eze-nwamaka

Nwamaka Eze (MPH.BMLS)
Public Health Consultant
https://www.linkedin.com/in/eze-nwamaka