Oyibo: Access to Diagnosis Key to Malaria Treatment

Rebecca Ejifoma

A Professor of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, Prof. Wellington Aghoghovwia Oyibo, has called for democratisation of malaria diagnosis across the country, as Nigeria and the Republic of Congo rank highest among malaria endemic countries in Africa.

“Democratising malaria diagnosis will ensure availability and performance of a user-friendly malaria test made for the people, used by the people and useful to the people.”

He gave this clarion call during his inaugural lecture, titled; ‘ParasitusFacultas Et HumanumIntelligentia: The Footprints of a Medical Parasitologist in the Neglected Tropical Parasitic Diseases, NTDs, and Malaria Landscape’ at the 7th inaugural lecture of the University of Lagos.

Oyibo added that there was need to urgently escalate access to malaria testing to communities, including the informal private sector through the Private Propriety Medicine Vendor, PPMVs or Medicine Retailers who attend to over 60 per cent of patients with fever, as this is critical in attaining the malaria case management target that has the objective of ensuring that malaria test is conducted for 80 to 100 per cent of patients suspected to have malaria by 2018 and 2020.

“Access to malaria diagnosis targeted around ease-of-use for the people will promote malaria testing and appropriate management of the conditions. Again, in democratising malaria diagnosis, tests that would not require invasive procedures in blood collection are likely to promote testing. Also with expanded access to malaria testing before treatment in line with paradigm shift, the use of clinical criteria would no longer be practiced.”

Speaking on laboratory-based malaria diagnosis, Oyibo noted that given the poor capacity of malaria microscopists, there were possibilities of them providing false positive malaria test results. “Clinical diagnosis of malaria based on symptoms is not specific; thereby resulting to over-diagnosis and over-treatment of malaria. One of our studies in 2013 showed 80 per cent over-diagnosis/treatment in children less than 12 years old that presented with fever in Lagos. Again, we recorded a 90- per cent-malaria over-treatment among clients 20 years and above who purchased ACTs from medicine retailers in six states of the country.”

With this, he called for mandatory malaria rapid test according to World Health Organisation (WHO) and national policy before treating malaria; adding that malaria was a disease of public health concern in the country; hence, effective case management requires early diagnosis and prompt treatment.