Syndromic Diagnosis of Malaria in Rural Sierra Leone and Proposed Additions to the National Integrated Management of Childhood Illness Guidelines for Fever

Nnedu, Obinna N.; Rimel, Bryan; Terry, C. C.; Jalloh-Vos, Heidi; Baryon, Brima; Bausch, Daniel G.

doi:10.4269/ajtmh.2010.09-0188

Cited by 14 publications

(15 citation statements)

References 15 publications

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“…However, in order to facilitate implementation and interpretation of analysis results, the responses were collapsed to form a binary outcome. [22][23][24][25] Accordingly, the three response categories were recoded into a dichotomous dependent variable distinguishing between some chances (1) and no chance at all (0) of occurrence of harmful effects of fever.…”

Section: Dependent Variablementioning

confidence: 99%

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Perceptions of caretakers with different socioeconomic status about the harmful outcomes of fever in under-five children in Dodoma region, central Tanzania: A cross-sectional study

Kassile

Mmbando

Lokina

et al. 2018

Alexandria Journal of Medicine

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a b s t r a c tBackground: Socioeconomic status can affect health in childhood through many different pathways. Evidence on how households differ with regard to socioeconomic status and the degree to which this difference is associated with investment in child health is essential to the design of appropriate intervention strategies. Aim: This study examines the impact of caretakers' socio-economic characteristics on perceptions about the harmful outcomes of fever among under-five children.Material and methods: The study used a three-stage cluster sample of households with under-five children in Dodoma region, central Tanzania. Multilevel modelling approach was used to model the relationship between the outcome measure and caretakers' socioeconomic characteristics while controlling for other variables. Results: A total of 329 under-five children with fever were studied of which 74.8% were perceived by their caretakers to have some chances for harmful effects of fever to occur when they experienced fever. Secondary school education or above of caretakers was significantly associated with decreased beliefs about the occurrence of harmful effects of fever. Conclusion: Many caretakers are concerned about the occurrence of harmful effects of fever for their under-five children. Study findings suggest that promoting enrolment in secondary education or above and participation in the labour market particularly in non-farm activities of women would be valuable to the health of under-five children in central Tanzania. Ó 2017 Alexandria University Faculty of Medicine. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Section: Dependent Variablementioning

confidence: 99%

“…Fever continues to be one of the major public health problems in sub-Saharan Africa. 1 It is one of the most frequent reasons for caretakers of under-five children to visit health care facilities. 2 It is a frequently reported symptom in many childhood illnesses 3 including malaria, diarrhoea, pneumonia, measles, polio, and tuberculosis.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of caretakers with different socioeconomic status about the harmful outcomes of fever in under-five children in Dodoma region, central Tanzania: A cross-sectional study

Kassile

Mmbando

Lokina

et al. 2018

Alexandria Journal of Medicine

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“…In subSaharan Africa, fever remains a major public health problem since it is a particularly predominant symptom in children less than 5 years old (Nnedu et al, 2010) and a frequent reason for parents to seek primary care. In Cameroon, its prevalence in children of this age range was 42.2% in 2010, and it did not vary with age or gender (INS, 2010).…”

Section: Introductionmentioning

confidence: 99%

The assessment of fever in under-five children in the Ekounou Health Area of Yaounde, Cameroon: Usefulness of rapid diagnostic tests

Tiedeu¹,

Tadjouo²,

Sontsa³

et al. 2017

Int. J. Med. Med. Sci.

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Improper diagnosis and management of febrile patients results in the persistence of malaria and other conditions with similar symptoms. The algorithm established here with Rapid Diagnostic Tests (RDTs) will help in the follow-up and treatment of fever patients according to the guidelines on Integrated Management of Childhood Illness (IMCI). This study aimed at determining the causes of fever in children and at valorizing the use of RDTs for the diagnosis of febrile diseases. Fifty children with fever, aged between 0 and 5 years, were recruited in a cross-sectional study at the Ekounou Baptist Clinic in Yaounde. RDTs were used to assess for the four common causes of febrile illness in the area. Microscopy was done and the Plasmodium species were confirmed by nested Polymerase Chain Reaction (PCR). Of the 50 febrile children, none was rubella seropositive, while 8% had malaria, 22% had toxoplasmosis infection, 8% had Salmonella typhi, 14% had a malaria-typhoid fever co-infection, 4% had a malaria-toxoplasmosis co-infection, 6% had a malaria-toxoplasmosis-typhoid fever coinfection, and 38% were negative for all the suspected common causes of fever in the health district. The overall frequencies of occurrence attributed 32% to malaria, 32% to toxoplasmosis and 28% to typhoid fever. Among all the positive malaria cases (n=16 (32%)) Plasmodium falciparum, Plasmodium malariae and Plasmodium ovale were identified by nested PCR. Malaria RDT results agreed significantly with the microscopy (kappa=0.81; p<0.0001) and PCR (kappa=0.84; p<0.0001) results; and the microscopy results also concurred significantly with the PCR results (kappa=0.77; p<0.0001). Malaria was not the exclusive cause of fever. Toxoplasmosis was found to occur in the same proportion as malaria (32%) in the study population. S. typhi was the third most important infection. Therefore RDTs are appropriate tools for the management of childhood febrile diseases.

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“…[2][3][4][5][6] The Kenema District of Sierra Leone is a Lassa-endemic region, although it is currently unknown what the burden of Lassa fever is in relation to other febrile illnesses in the region. In addition, there are no studies to date that broadly examine the etiologies and outcomes of febrile illness in patients seeking healthcare in Sierra Leone.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Mortality in Febrile Patients in a Government Referral Hospital in the Kenema District of Sierra Leone

Roth¹,

Grant²,

Ngegbai³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. There is a paucity of data on the etiologies and outcomes of febrile illness in rural Sierra Leone, especially in the Lassa-endemic district of Kenema. We conducted a retrospective study of patients with subjective or documented fever (T 38.0 C) who were admitted to a rural tertiary care hospital in Kenema between November 1, 2011 and October 31, 2012. Of 854 patients admitted during the study period, 429 (50.2%) patients had fever on admission. The most common diagnoses were malaria (27.3%), pneumonia (5.1%), and Lassa fever (4.9%). However, 53.4% of febrile patients had no diagnosis at discharge. The in-hospital mortality rate was 18.9% and associated with documented temperature 38.0 C (adjusted odds ratio [AOR] = 2.89, P = 0.001) and lack of diagnosis at discharge (AOR = 2.04, P = 0.03). Failure to diagnose the majority of febrile adults and its association with increased mortality highlight the need for improved diagnostic capacity to improve patient outcomes.

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Syndromic Diagnosis of Malaria in Rural Sierra Leone and Proposed Additions to the National Integrated Management of Childhood Illness Guidelines for Fever

Cited by 14 publications

References 15 publications

Perceptions of caretakers with different socioeconomic status about the harmful outcomes of fever in under-five children in Dodoma region, central Tanzania: A cross-sectional study

Perceptions of caretakers with different socioeconomic status about the harmful outcomes of fever in under-five children in Dodoma region, central Tanzania: A cross-sectional study

The assessment of fever in under-five children in the Ekounou Health Area of Yaounde, Cameroon: Usefulness of rapid diagnostic tests

Factors Associated with Mortality in Febrile Patients in a Government Referral Hospital in the Kenema District of Sierra Leone

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