In 2024, Chioma Odu, a woman in her mid-50s from Imo State, woke up to a sharp pain in her joints. Concerned, she visited a nearby clinic where she was diagnosed with arthritis. But that diagnosis was later proven to be wrong.
While recounting her ordeal, she told BusinessDay how the singular event took a toll on her, leaving her emotionally traumatised.
“I will never forget that day in my life. I had lost hope completely until I called my daughter, who advised me to visit another hospital in Owerri,” she said.
Following a series of tests at the new hospital, the doctors informed her that she had no arthritis. “The doctors told me I had no arthritis after carrying out a series of tests on me, and I later regained my health after treatment,” she said.
Odu’s case ended in relief. But for Paul Tyokaa (not his real name), a misdiagnosis brought far more than confusion—it altered the course of his family’s life.
“The genotype results we got initially showed that I was AA and my wife was AS. That was why we went ahead with the marriage, only to realise later that the results were wrong,” he said.
It wasn’t until years later, after their children faced severe health issues, that the truth surfaced. “The doctor decided to carry out a genotype test only to realise that our two children were SS, meaning that they were sicklers,” he explained.
“Prior to this, we had spent a lot of money on treatment, drugs and several medical interventions. This amounted to a financial burden, which made us incur huge debts,” he added.
Their stories, among many, underscore a more profound crisis in Nigeria’s healthcare system.
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Facts, figures
Diagnostic accuracy in Nigeria stands at just 36.4 percent and fewer than four in 10 patients are correctly diagnosed, according to data from the Primary Healthcare Performance Initiative (PHPI), funded by the Bill & Melinda Gates Foundation.
“Malaria is the most misdiagnosed and mistreated ailment in Nigeria,” the report noted, pointing to a trend that affects even the most common conditions.
The toll of misdiagnosis is especially harsh in cancer care. According to COPE, a Nigerian cancer support organisation, misdiagnosis is responsible for 70 percent of cancer-related deaths in the country.
“In terms of cancer diagnosis in Nigeria, we still have a long way to go as 70 percent of cancer patients are misdiagnosed,” the group reported.
The dangers stretch beyond chronic illnesses. A 15-year review conducted at Ile-Ife by Ernest Orji and his research team found that 10 percent of ectopic pregnancies were initially misdiagnosed—often as appendicitis or cholera.
“The study found that there were 380 confirmed cases of ectopic pregnancies. Of these cases, about 38 (10 percent) were misdiagnosed initially at presentation,” the report stated.
Experts say that misdiagnosis has far-reaching consequences ranging from delayed treatment to worsening conditions or irreversible damage. On the other hand, it erodes trust in healthcare providers and adds pressure to an already overburdened system.
Diagnosis, as defined by the American National Cancer Institute, is the process of identifying a disease, condition, or injury based on signs and symptoms. It involves a comprehensive approach—health history, physical exams, blood work, imaging, and sometimes biopsies—to arrive at the correct answer.
Misdiagnosis, then, is wrong diagnosis of ailments among patients.
In a country where healthcare access is already uneven, getting the diagnosis right is not just important—it’s critical.
Causes of misdiagnosis
Taiwo Obindo, president of the Association of Psychiatrists in Nigeria (APAN), linked Nigeria’s rising cases of misdiagnosis to the decay of frontline health infrastructure.
“When primary healthcare centres meant to service communities are poorly equipped, service delivery such as proper diagnosis becomes inefficient or poorly performed,” he told BusinessDay.
Beyond infrastructure, diagnostic failures are also driven by the tools themselves.
Caleb Yakubu, a consultant radiologist, pointed to the proliferation of substandard and counterfeit diagnostic kits as a major contributor.
“Some diagnostic kits are not only fake, but are of low standards, which predispose medical personnel to wrong diagnosis,” he said in an interview with the News Agency of Nigeria.
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Globally, the crisis extends beyond tools and facilities to the people behind the systems.
Pamela Cipriano, president of the International Council of Nurses (ICN), warned of a deepening strain on the healthcare workforce.
“Across the globe, nurses are reaching a breaking point—overwhelmed by burnout and subjected to immense physical, mental, and emotional strain,” she said.
“Workers cannot perform efficiently where there are burnouts,” she noted.
She further said that unacceptable working conditions, insufficient compensation, lack of protection from workplace violence, occupational hazards, and limited opportunities for professional growth are fueling the crisis.
“These systemic failures are not only endangering the wellbeing of nurses, but also jeopardising the overall health of our communities and the resilience of healthcare systems worldwide,” Cipriano added.
There is also the challenge of inadequate knowledge of diagnosis by some medical personnel, especially young people, who are yet to understand the dynamics of their profession.
How to remedy misdiagnosis
Experts have outlined a number of strategies to curb the growing threat of misdiagnosis in Nigeria’s healthcare system. These include equipping healthcare facilities, especially in underserved communities, continuous training of healthcare workers, stricter regulation of diagnostic test kit imports, increased community engagement and public enlightenment.
Njide Ndili, president of the Healthcare Federation of Nigeria, emphasised the critical role of capacity-building in closing skill gaps and improving healthcare delivery.
“Times are changing, and technology is advancing,” she said.
“It is important to continuously train and retrain healthcare workers in order to ensure that they employ global standard practices at all times while delivering their services efficiently,” she noted.
Ndili stressed that rapid technological innovation in healthcare demands an upskilled workforce.
“Several technological tools have advanced in the healthcare sector and if workers are not trained, there are high chances of poor healthcare service delivery like misdiagnosis,” she explained.
Yakubu, an earlier source, pointed to the dangers posed by substandard diagnostic kits and called for tighter controls on imports.
“Imposing strict regulatory policies would reduce the importation of fake or substandard diagnostic test kits,” he stated.
“This will in turn reduce the rate of misdiagnosis in the country.”
Obindo reinforced the need to strengthen primary healthcare centers with modern diagnostic tools.
“Primary healthcare centers are the bedrock of the Nigerian health systems, serving several local communities across the country,” he noted.
“Equipping these facilities with the right tools will increase the chances of adequate service delivery,” he added.
An independent analyst also highlighted the importance of reducing factors that lead to the burnout of medical professionals. Lowering the burden, they noted, can prevent burnout and improve diagnostic accuracy.
“Reducing healthcare workers’ burden will help to reduce burnouts and stress, enhancing their capacity to carry out the right medical diagnosis with clarity and precision,” the analyst stated.
