Beyond malaria--causes of fever in outpatient Tanzanian children.

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Version: Final published version
Serval ID
serval:BIB_A60A4F3E4E24
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Beyond malaria--causes of fever in outpatient Tanzanian children.
Journal
New England Journal of Medicine
Author(s)
D'Acremont V., Kilowoko M., Kyungu E., Philipina S., Sangu W., Kahama-Maro J., Lengeler C., Cherpillod P., Kaiser L., Genton B.
ISSN
1533-4406 (Electronic)
ISSN-L
0028-4793
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
370
Number
9
Pages
809-817
Language
english
Notes
Publication types: Journal Article
Abstract
BACKGROUND: As the incidence of malaria diminishes, a better understanding of nonmalarial fever is important for effective management of illness in children. In this study, we explored the spectrum of causes of fever in African children.
METHODS: We recruited children younger than 10 years of age with a temperature of 38°C or higher at two outpatient clinics--one rural and one urban--in Tanzania. Medical histories were obtained and clinical examinations conducted by means of systematic procedures. Blood and nasopharyngeal specimens were collected to perform rapid diagnostic tests, serologic tests, culture, and molecular tests for potential pathogens causing acute fever. Final diagnoses were determined with the use of algorithms and a set of prespecified criteria.
RESULTS: Analyses of data derived from clinical presentation and from 25,743 laboratory investigations yielded 1232 diagnoses. Of 1005 children (22.6% of whom had multiple diagnoses), 62.2% had an acute respiratory infection; 5.0% of these infections were radiologically confirmed pneumonia. A systemic bacterial, viral, or parasitic infection other than malaria or typhoid fever was found in 13.3% of children, nasopharyngeal viral infection (without respiratory symptoms or signs) in 11.9%, malaria in 10.5%, gastroenteritis in 10.3%, urinary tract infection in 5.9%, typhoid fever in 3.7%, skin or mucosal infection in 1.5%, and meningitis in 0.2%. The cause of fever was undetermined in 3.2% of the children. A total of 70.5% of the children had viral disease, 22.0% had bacterial disease, and 10.9% had parasitic disease.
CONCLUSIONS: These results provide a description of the numerous causes of fever in African children in two representative settings. Evidence of a viral process was found more commonly than evidence of a bacterial or parasitic process. (Funded by the Swiss National Science Foundation and others.).
Keywords
Ambulatory Care Facilities, Bacterial Infections/complications, Bacterial Infections/epidemiology, Child, Child, Preschool, Female, Fever/etiology, Gastroenteritis/complications, Gastroenteritis/epidemiology, Humans, Infant, Malaria/complications, Malaria/epidemiology, Male, Pneumonia/complications, Pneumonia/epidemiology, Respiratory Tract Infections/complications, Respiratory Tract Infections/epidemiology, Tanzania/epidemiology, Typhoid Fever/complications, Typhoid Fever/epidemiology, Urinary Tract Infections/complications, Urinary Tract Infections/epidemiology, Virus Diseases/complications, Virus Diseases/epidemiology
Pubmed
Web of science
Open Access
Yes
Create date
11/05/2014 14:39
Last modification date
20/08/2019 15:11
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