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The World Health Organization reported 241 million cases and 627,000 death from malaria in 2020 and Nigeria accounted for 27% of malaria death worldwide. Effective tools are continually developed through global efforts to have a malaria-free world. The study was aimed at assessing the prevalence and management of falciparum malaria among febrile patients in South-western Nigeria. This is a cross-sectional descriptive study conducted on febrile patients undergoing treatment at the outpatient units of selected hospitals in Ekiti and Ondo States, Nigeria between August 2019 and January, 2021. A total of 399 participants were enlisted in the study following informed consent. A structured questionnaire was administered to obtain socio-demographic information and the management of malaria among the participant and blood collected from them for malaria examination by microscopy and rapid test diagnosis. Two hundred and ninety-five (73.9%) of the subjects were females and 104(26.1%) males, with modal age of 21–28 years. There were 171(42.9%) and 228(57.1%) participants from Ekiti and Ondo States respectively. Subjects from Ondo State reported significantly higher occurrence of malaria than their counterparts from Ekiti State (p=0.005). Malaria occurrence was found to be significantly associated with age (p=0.047), occupation (p=0.001), individual’s perception of approach to malaria treatment (p=0.002) and use of local herbs (p=0.002). Artemisinin-based combination therapies (ACTs) were drugs of choice (76.3%) by the respondents; other drugs commonly used were Sulphadoxine-pyrimethamine (13.3%) and chloroquine/quinine (10.4%). The use of insecticide treated nets (26.6%), insecticide spray (25.3%), as well as, nets on windows and doors (15.8%) were reported as the major ways of controlling mosquito bites at home. The management of malaria among respondents is commendable; notwithstanding, healthcare professionals will need a combination of new approaches and tools in effective management of malaria.
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