Prevalence of Bacterial Febrile Illnesses in Children in Kilosa District, Tanzania

Abstract

IntroductionBacterial etiologies of non-malaria febrile illnesses have significantly become important due to high mortality and morbidity, particularly in children. Despite their importance, there are few reports on the epidemiology of these diseases in Tanzania, and the true burden of such illnesses remains unknown. This study aimed to identify the prevalence of leptospirosis, brucellosis, typhoid fever and urinary tract infections and their rate of co-infections with malaria.MethodsA cross-sectional study was conducted at Kilosa district hospital in Tanzania for 6 months. Febrile children aged from 2–13 years were recruited from the outpatient department. Patients were screened by serological tests such as IgM and IgG ELISA, and microscopic agglutination test.ResultsA total of 370 patients were enrolled; of these 85 (23.0%) had malaria parasites, 43 (11.6%) had presumptive acute leptospirosis and 26/200 (13%) had confirmed leptospirosis. Presumptive acute brucellosis due to B. abortus was identified among 26 (7.0%) of patients while B. melitensis was detected in 57 (15.4%) of the enrolled patients. Presumptive typhoid fever due to S. Typhi was identified in thirty eight (10.3%) of the participants and 69 (18.6%) had urinary tract infections. Patients presented with similar symptoms; therefore, the identification of these diseases could not be done based on clinical ground alone. Co-infections between malaria and bacterial febrile illnesses were observed in 146 patients (39.5%). Although antibacterials and/or anti-malarials were prescribed in most patients, some patients did not receive the appropriate treatment.ConclusionThe study has underscored the importance of febrile bacterial diseases including zoonoses such as leptospirosis and brucellosis in febrile children, and thus such illnesses should be considered by clinicians in the differential diagnoses of febrile diseases. However, access to diagnostic tests for discrimination of febrile illnesses is needed. This would allow febrile patients to receive the correct diagnoses and facilitation of accurate and prompt treatment.

Poor performance of the rapid test for human brucellosis in health facilities in Kenya

“…Despite this, we noted a not unsurprising belief amongst laboratory technicians and clinicians working in both study health facilities that the FBAT, marketed with separate ‘abortus’ and ‘melitensis’ antigens, can distinguish between infections with these different Brucella species. This misconception is likely to be strengthened by the inconsistent results obtained with the ‘abortus’ and ‘melitensis’ suspensions of FBAT, as illustrated by our work and recently published work from Tanzania [50]. Long and repeated experience [11,18,24,51] shows that the most plausible reasons for these inconsistencies are deficient standardisation of antigen suspensions and poor antigen quality.…”

Incidence, clinical profile, and risk factors for serious bacterial infections in children hospitalized with fever in Ujjain, India

“…In our study, out of the 38 patients presenting with UTI, only 9 (24%) had confirmed SBI. A low (18%) [19] and high (30%) [22] proportion of SBI in UTI in febrile children have been reported. UTI remains the most common cause of nonlocalized fever in children below 2 years of age and can be a co-infection in confirmed viral infections as well [21].…”

“…The proportion of SBI is known to vary between 24 to 40%, according to geographical area and the age of children [18,19]. We choose a proportion of 30% from above studies to calculate the sample size.…”

Metagenomic next-generation sequencing of samples from pediatric febrile illness in Tororo, Uganda

“…Other studies evaluating causes of febrile illness in African children have focused on a limited number of pathogens [30][31][32][33]. In a study of febrile children in Tanzania utilizing serologic, culture, and molecular assays, viruses accounted for 51% of lower respiratory infections, 78% of systemic infections, and 100% of upper respiratory infections [34].…”