Background: Malaria is still thriving despite efforts to eradicate the disease. This study aimed to determine the prevalence of malaria and treatment-seeking behaviour among university students in Ikot Akpaden campus of Akwa Ibom State University Methods: A cross-sectional study on 700 undergraduate students randomly selected was carried out between July to December 2017 in Akwa Ibom State University. Structured questionnaires were administered to collect data. Microscopy and Rapid Diagnostic Tests (RDT) were done to determine parasitaemia for students who voluntarily consented to be tested. Chi-square test at P< 0.05 was used to evaluate the prevalence of malaria and the differences in the student’s attitude on malaria treatment and prevention practices. Results: Of the 500 students who filled the questionnaire, 100 students consented to undergo the test, 56 (56%) were males, while 44 (44%) were females. Only15 students (17.86%) were positive for both microscopy and RDT. Malaria prevalence by microscopy (84%) was significantly higher than RDT (27%). Fever and head-ache were the most common symptoms recorded. RDT had a sensitivity of 17.86%, a specificity of 25%, a positive predictive value of 55.56%, and a negative predictive value of 5.48%. Conclusion: This study revealed a higher prevalence of malaria by microscopy than RDT among the students, indicating that the use of RDTs is limited. RDTS may have more usefulness in remote areas, but microscopy remains the reference technique. Overall, 96.2% knew about malaria while 85.3% knew mosquito bites cause malaria. The majority, 69.2%, of participants go for malaria test as the first action when malaria is suspected, 83% use antimalarial combination therapy medication, and 62.6% sought treatment of malaria immediately.
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