Correlation of laboratory result and clinical diagnosis of uncomplicated malaria in a specialist health facility in Nigeria: rational or irrational treatment?

Malaria remains a major cause of morbidity and mortality especially among children. While early diagnosis and prompt treatment are crucial to its control, anecdotal evidence has shown that there is increasing overdiagnosis of the illness. This study therefore aims to compare the outcome of laboratory and clinical diagnosis in our patients in order to determine the prevalence of laboratory confirmed malaria. A25% smear positive rate for malaria was obtained amongst a total of 419 patients recruited for the study. The over-diagnosis was more among children where a smear positive rate of 10.3%was obtained compared to 36.9% in adults. It is recommended that a laboratory confirmation must be immediately obtained before any patient is commenced on anti-malaria. Where there are doubts about the laboratory result, such patients who are smear negative should be treated in view of deep cell schizogony and high endemicity of malaria in this environment, while other causes of the symptoms are explored. Keywords: Laboratory results, clinical diagnosis, malaria