Fever in Africa: do patients know when they are hot?

Einterz, Ellen M.; Bates, Myra E.

doi:10.1016/s0140-6736(97)24037-7

Cited by 56 publications

(52 citation statements)

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“…25 In children Ͻ 5 years of age attending an outpatient service in Cameroon, mothers or carers correctly reported fever in 46% of the cases, and the absence of fever in 92% of the cases (fever defined as an axillary body temperature Ն 37.5ЊC). 26 When these predictive values are applied to our study, the 2-week cumulative incidence of fever decreases from 72% to 35%. This adjusted value is still higher than would be expected on the basis of previously conducted prospective studies.…”

Section: Discussionmentioning

confidence: 88%

“…Observations for these 16 children were weighted twice. Thus, 318 cases were included in the study, of whom 35 did not participate or fully participate for the following reasons: refused consent (26), not home or temporarily absent (7), or hospitalized for burns (2). Of these 35 children, 14 were replaced by random selection, which brought the total number included in the analysis to 297.…”

Section: Methodsmentioning

confidence: 99%

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Anti-malarial drug use among preschool children in an area of seasonal malaria transmission in Kenya.

Verhoef¹,

Hodgins²,

Eggelte³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. The aims of this study were to estimate the proportion of asymptomatic Kenyan preschool children using anti-malarial drugs, to identify factors associated with chloroquine use, and to assess the validity of frequency of febrile episodes and drug use reported by mothers or carers. Of 318 children studied, 38% (95% confidence interval [CI] ϭ 30-47%]) tested positive for chloroquine or sulfadoxine. Of chloroquine-positive children, 15% had concentrations exceeding the estimated minimum therapeutically effective values. Among those testing negative for sulfadoxine, chloroquine-positive children were more frequently parasitemic (odds ratio ϭ 2.6, 95% CI ϭ 1.3-5.2), and had lower mean hemoglobin concentrations (6.1 g/L, 95% CI ϭ 2.1-10.1) than chloroquine-negative children. Mothers over-reported the frequency of malaria or fever episodes as usually defined in medical studies, and underreported anti-malarial drug use. We conclude that anti-malarials are frequently given for treatment of malaria or malariaassociated illness, rather than prophylactically or for symptoms unrelated to malaria. Questionnaire surveys cannot replace biochemical markers to obtain information on anti-malarial drug use.In developing countries, drugs are often used without prescription. They may be purchased from local shops, markets, or street vendors, obtained by sharing with other users, or used when left over from previous treatments. Home treatment or prophylaxis of illnesses with anti-malarials is more often the rule than the exception in many countries endemic for malaria.

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Section: Discussionmentioning

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Anti-malarial drug use among preschool children in an area of seasonal malaria transmission in Kenya.

Verhoef¹,

Hodgins²,

Eggelte³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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“…It is important to mention that use of MICS2 data has limitations. Concerns have been raised about potential bias of relying on the ability of mothers to identify and separate symptoms of fever, pneumonia or diarrhoea (Einterz and Bates, 1997).…”

Section: Sampling Designmentioning

confidence: 99%

Diarrhoea, acute respiratory infection, and fever among children in the Democratic Republic of Congo

Kandala

Emina

Nzita

et al. 2009

Social Science & Medicine

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Several years of war have created a humanitarian crisis in the Democratic Republic of Congo (DRC) with extensive disruption of civil society, the economy and provision of basic services including health care. These challenges are faced against a background of heavy disease burden, especially of HIV/ AIDS, tuberculosis, diarrhoea, acute respiratory infection, and malaria. Health policy and planning in the DRC are constrained by a lack of reliable and accessible population data.Thus there is currently a need for primary research to guide programme and policy development for reconstruction and to measure attainment of the Millennium Development Goals (MDGs).This study uses the 2001 Multiple Indicators Cluster Survey to disentangle children's health inequalities by mapping the impact of geographical distribution of childhood morbidity stemming from diarrhoea, acute respiratory infection, and fever. We account for important risk factors and nonlinear effects using a Bayesian geo-additive regression model based on Markov Chain Monte Carlo techniques.We observe a low prevalence of childhood diarrhoea, acute respiratory infection and fever in the western provinces (Kinshasa, Bas-Congo and Bandundu), and a relatively higher prevalence in the south-eastern provinces (Sud-Kivu and Katanga). However, each disease has a distinct geographical pattern of variation. Among covariate factors, child age had a significant association with disease prevalence. The risk of the three ailments increased in the first 8-10 months after birth, with a gradual improvement thereafter. The effects of socioeconomic factors vary according to the disease.Accounting for the effects of the geographical location, our analysis was able to explain a significant share of the pronounced residual geographical effects. Using large scale household survey data, we have produced for the first time spatial residual maps in the DRC and in so doing we have undertaken a comprehensive analysis of geographical variation at province level of childhood diarrhoea, acute respiratory infection, and fever prevalence. Understanding these complex relationships through disease prevalence maps can facilitate design of targeted intervention programs for reconstruction and achievement of the MDGs.

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“…However, clinical diagnosis is very inaccurate, even in areas where malaria is a common cause of fever, because signs and symptoms of uncomplicated malaria are nonspecific and overlap with those of other febrile infectious diseases, 46,47 and because the subjective sensation of fever is unreliable. 48,49 The specificity of clinical diagnosis (ie, declared fever) is only 20-60% compared with microscopy. [50][51][52][53][54] Microscopy (Giemsa-stained thin and/or thick smears) is traditionally the gold standard for diagnosis.…”

Section: Diagnosismentioning

confidence: 99%

Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development

Guérin¹,

Olliaro

Nosten

et al. 2002

The Lancet Infectious Diseases

320

201

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Fever in Africa: do patients know when they are hot?

Cited by 56 publications

References 1 publication

Anti-malarial drug use among preschool children in an area of seasonal malaria transmission in Kenya.

Anti-malarial drug use among preschool children in an area of seasonal malaria transmission in Kenya.

Diarrhoea, acute respiratory infection, and fever among children in the Democratic Republic of Congo

Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development

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