Bacterial infection is the most common complication in paediatric oncological patients during cancer treatment. A suitable tool for early prediction of unfavourable course of infection is still needed. We performed a prospective longitudinal observational study to evaluate of the role of serum biomarkers (C-reactive protein, procalcitonin, interleukin-6, presepsin) in the early diagnosis of bacteraemia (gram-negative versus gram-positive) in patients with haematological malignancies. We observed 69 febrile episodes in 33 patients (17 male, 16 female; 1.5-18.9 years, mean 7.31 years, median 5 years). Within this sample, there were 22 cases of positive blood cultures, 16 cases of sepsis, 38 cases of fever with no signs or symptoms of sepsis, and two deaths from infectious complications. All markers tested had good negative predictive value (73% -93%). CRP was characterized by good specificity for registration bacteraemia (96%, 95% CI: 85% -99%), but other results were inconclusive. We identified comparably balanced sensitivity (64% -81%) and specificity (61% -88%) for interleukin-6 and procalcitonin, and we proved their quality to predict positive blood culture and clinical signs of sepsis as well. Patients with gram-negative bacteraemia had significantly elevated levels of PCT and IL-6 in comparison with a group of patients with gram-positive bacteraemia (p = 0.04 for PCT and p = 0.005 for IL-6). Presepsin was characterized by poor specificity (27%, 95% CI: 15% -43%) and positive predictive value (24%, 95% CI: 12 -39%) for predicting bacteraemia, and by better sensitivity (84%, 95% CI: 55% -98%) and specificity (58%, 95% CI: 42% -73%) for predicting clinical signs of sepsis. Key words: C-reactive protein, procalcitonin, interleukin-6, presepsin, fever, sepsisBacterial infection is the most common treatment-related complication in patients with haematological malignancies [1]. Documented mortality associated with paediatric febrile neutropenia is 2% [2]. The potential for early diagnosis of bacteraemia through serum biomarkers has been the subject to extensive research [3]. In 2012 Phillips et al published large meta-analysis of 25 studies exploring 14 different biomarkers in 3,585 episodes of febrile neutropenia. CRP, PCT and IL-6 were subject to quantitative meta-analysis. The bivariate estimates of diagnostic precision of these biomarkers and outcomes were done. Data were available for meta-analysis for CRP for microbiologically or clinically documented infection (results: cut off > 50mg/dl, sensitivity 65%, specificity 73%), for PCT assessing microbiologically or clinically documented infection (results: cut off > 0.2 mg/ml, sensitivity 96%, specificity 85%), for IL-6 reporting microbiologically or clinically documented infection (results: cut off > 235 pg/ml, sensitivity 68%, specificity 94%), and gram-negative bacteraemia (results: cut off > 1000 pg/ml, sensitivity 78%, specificity 96%). Huge inconsistencies and heterogeneity in the studies included in this review were the most important limiting factors [...

Abstract:The correlation between CRP blood levels and clinical presentation of malaria or blood parasitemia diagnosed microscopically or by PCR is one of the most discussed topics in the field of tropical medicine and malaria diagnostics. In total, 650 patients from the Lake Victoria area,

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spread of ATL, but we were unable to extrapolate findings from animal models to human disease. http://dx.Background: Muleba is one of the malaria sentinel sites in a country. It is known to have several malaria outbreaks. The first outbreak occurred in 1997 with a case fatality ratio (CFR) of 3.7% and the second was in 2006, with CFR of 2.8%. On the 1 st of June 2013, the Ministry received report of 123 cases with CFR of 7.3%, an increase in the number of admitted < 5 malaria cases from Muleba district. Tanzania FELTP conducted an investigation to confirm the existence of the outbreak, determine attributing factors and institute control measures. Methods & Materials:We reviewed the weekly line list and medical records of admitted patients from the 1 st epidemiology week of calendar year 2013 and interviewed 302 admitted feverpatients, parent, or care taker on bed net ownership and usage. Data was abstracted using a structured data collection check list. A total of 38 samples were taken for further investigations to rule out borrelia, yellow fever and dengue viral infection. Data was analysed using Microsoft Excel and Epi Info version 3.5.4Results: From 9 th -23 rd Epidemiology week, there were a total of 2,366 cases and 131 deaths (CFR = 5.5%); 86 (65.6%) due to malaria with majority 71 (82.6%) being < 5.A total of 302 fever admitted cases were interviewed; out of 184 tested for malaria, 149 (81%) were positive. Majority 258 (85.4%) came from villages that were uncovered by Indoor Residual Spraying (IRS) intervention. About 179 (59.3%) reported to own mosquito bed nets. Majority 233 (77.2%) delayed seeking medical care and sought traditional herbs.Of the 38 blood samples taken for analysis at the National Laboratory (NHL-QATC), 21 (55.3%) tested positive for malaria and all were negative for borrelia, dengue and yellow fever.Conclusion: An outbreak ofmalaria was confirmed. Factors contributing to high CFR included late medical seeking behaviour, use of traditional herbs at home, poor bed net usage and lack of IRS intervention activities. There is a need to sensitize communities on early medical seeking behaviour and revitalizing other malaria control initiatives like IRS. Other causes of fever other than malaria should also be explored.http://dx.

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