Use of Antimalarials Without Confirmed Diagnosis Among Rural Communities in Taraba State, North East Nigeria

Presumptive treatment of malaria without confirmatory diagnostic testing contributes to drug resistance, unnecessary healthcare costs, and mismanagement of febrile illnesses with non-malarial etiologies. This study investigated the prevalence and associated factors of antimalarial use without diagnostic confirmation among rural community members in Taraba State, North East Nigeria. A community-based, cross-sectional survey was conducted in six randomly selected villages across two local government areas. A total of 410 adults were interviewed using structured questionnaires assessing fever management practices, access to diagnostic facilities, and perceptions of malaria testing. Findings indicated that 74 percent of respondents self-medicated with antimalarials without prior laboratory testing, with fever alone serving as the basis for treatment in most cases. Access to malaria rapid diagnostic test kits was limited, with only 30 percent of respondents reporting availability at their nearest health post. Confidence in the diagnosis of malaria by community members was high despite low diagnostic literacy. Older age and lower educational attainment were significant predictors of presumptive antimalarial use. These findings highlight critical gaps in diagnostic capacity and community awareness in this region. The study recommends expanding access to rapid diagnostic tests in rural health posts, training community health workers in test administration, and empowering community pharmacists to promote test-before-treat strategies. Keywords: antimalarial use, presumptive treatment, malaria diagnosis, Taraba State, rural communities