Acute Febrile Illnesses
Conditions
Keywords
Fever, Tanzania, Pneumonia, HIV, Diabetes, Indoor Air Pollution
Brief summary
Following the decline of malaria in Sub-Saharan Africa, clinicians face febrile patients in whom an alternative diagnosis has to be made. This situation has led to an overuse of antibiotics by clinicians. It is crucial to increase knowledge on etiologies and risk factors of outpatient febrile illness in order to improve their management. This present proposal aims to investigate the etiologies of fever among adult patients attending an outpatient department in urban Tanzania. It also aims to assess the clinical significance of nasopharyngeal (NP) respiratory viruses and bacteria documentation in this setting. Third, it aims to compare the spectrum of infections in this population with that of children included in the same setting in a previous study. The last objective is to assess diabetes mellitus (DM) as a risk factor for infection and exposure to indoor air pollution (IAP) as a risk factor for acute respiratory infections (ARI) in adults in Tanzania. The investigators hypothesize that acute respiratory infections are the main cause of adult febrile illness in a urban low-income setting and that use of quantitative molecular assays on naso-oropharyngeal samples can improve the diagnosis of pneumonia. The investigators also think that the spectrum of infections is different between children and adults, mainly due to a high HIV prevalence in adults. The investigators also hypothesize that experiencing IAP and/ or DM is a risk factor for infections in adults.
Interventions
None listed
Sponsors
Ifakara Health Institute
Swiss Tropical & Public Health Institute
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Temperature \>=38°C * History of fever for less than 8 days * First consultation for the present problem
Exclusion criteria
* Refusal of HIV screening * Main complaint is injury or trauma * Antibiotic treatment in the last 7 days * Within 6 weeks after delivery * Hospitalization during the last month
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of patients with each disease among all febrile patients, overall and stratified by HIV status | 1 year | Description of the distribution of causes of fever based on pre-defined case definitions for each disease. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of febrile patients with acute respiratory infection infected with a certain respiratory pathogen, compared to the proportion of healthy controls infected with the same pathogen. | 1 year | Nasopharyngeal respiratory viruses and bacteria documentation (presence/absence as well as pathogen loads) will be compared between patients with acute respiratory infection and a control group of healthy volunteers |
Other
| Measure | Time frame | Description |
|---|---|---|
| Strength of association between each febrile disease and diabetes mellitus and between acute respiratory infections and indoor air pollution | 1 year | Screening of diabetes mellitus and screening of exposure to indoor air pollution will be performed among patients with fever. The strength of association between diabetes and each type of febrile disease and exposure to indoor air pollution and acute respiratory infections will be measured. |
Countries
Tanzania
Outcome results
None listed