Opportunities and challenges to accurate diagnosis and management of acute febrile illness in adults and adolescents: A review

Grundy, Brian S; Houpt, Eric R.

doi:10.1016/j.actatropica.2021.106286

Cited by 6 publications

(3 citation statements)

References 62 publications

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“…After day 2, the difference in the prevalence of symptoms was negligible. The median length of stay (IQR) was 3 [2][3][4][5] among children with a constant diagnosis and 3 [2][3][4][5][6] among children with a changed diagnosis.…”

Section: Longitudinal Symptoms and Diagnosesmentioning

confidence: 99%

“…In formal healthcare settings in malaria endemic regions, a febrile child is usually tested with a malaria rapid diagnostic test (RDT) and by microscopy and, if positive, treated according to WHO guidelines [5]. If the test is negative, capacity to accurately diagnose non-malarial infections varies greatly between facilities and can be a challenge in resource-constrained settings, particularly for illnesses that present with symptoms similar to malaria [6].…”

Section: Introductionmentioning

confidence: 99%

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Fever in focus: Symptoms, diagnoses and treatment of febrile children in Ghana—A longitudinal hospital study

Rautman,

Maiga‐Ascofaré,

Eibach

et al. 2023

Tropical Med Int Health

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BackgroundHealthcare resources are often limited in areas of sub‐Saharan Africa. This makes accurate and timely diagnoses challenging and delays treatment of childhood febrile illness. We explored longitudinal characteristics related to symptoms, diagnosis and treatment of hospitalised febrile children in a rural area of Ghana highly endemic for malaria.MethodsFebrile children under 15 years, admitted to the study hospital paediatric ward, were recruited to the study and clinical data were collected throughout hospitalisation. Descriptive statistics were reported for all cases; for longitudinal analyses, a subset of visits with limited missing data was used.ResultsThere were 801 hospitalised children included in longitudinal analyses. Malaria (n = 581, 73%) and sepsis (n = 373, 47%) were the most prevalent suspected diagnoses on admission. One‐third of malaria suspected diagnoses (n = 192, 33%) were changed on the discharge diagnosis, compared to 84% (n = 315) of sepsis suspected diagnoses. Among malaria‐only discharge diagnoses, 98% (n/N = 202/207) received an antimalarial and 33% (n/N = 69/207) an antibiotic; among discharge diagnoses without malaria, 28% (n/N = 108/389) received an antimalarial and 83% (n/N = 324/389) an antibiotic.ConclusionsSuspected diagnoses were largely based on clinical presentation and were frequently changed; changed diagnoses were associated with lingering symptoms, underscoring the need for faster and more accurate diagnostics. Medications were over‐prescribed regardless of diagnosis stability, possibly because of a lack of confidence in suspected diagnoses. Thus, better diagnostic tools are needed for childhood febrile illnesses to enhance the accuracy of and confidence in diagnoses, and to cut down unjustified medication use, reducing the risk of antimicrobial and malaria resistance.

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Section: Longitudinal Symptoms and Diagnosesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fever in focus: Symptoms, diagnoses and treatment of febrile children in Ghana—A longitudinal hospital study

Rautman,

Maiga‐Ascofaré,

Eibach

et al. 2023

Tropical Med Int Health

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“…They include rapid diagnostic tests (RDTs), which can be operated at the point of care. Such diagnostic testing is important in the delivery of targeted care to patients with AFI, including antimicrobial treatments [5 , 6] . Diagnostic testing in AFI is also required in systems of passive disease surveillance [7 , 8] .…”

Section: Introductionmentioning

confidence: 99%

A pilot study investigating severe community-acquired febrile illness through implementation of an innovative microbiological and nucleic acid amplification testing strategy in Timor-Leste (ISIN-MANAS-TL)

Ximenes,

de Jesus,

de Sousa

et al. 2024

IJID Regions

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From fever to action: diagnosis, treatment, and prevention of acute undifferentiated febrile illnesses

Barathan

2024

Pathogens and Disease

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Acute Undifferentiated Febrile Illness (AUFI) presents a clinical challenge, often characterized by sudden fever, non-specific symptoms, and potential life-threatening implications. This review highlights the global prevalence, types, challenges, and implications of AUFI, especially in tropical and subtropical regions where infectious diseases thrive. It delves into the difficulties in diagnosis, prevalence rates, regional variations, and potential causes, ranging from bacterial and viral infections to zoonotic diseases. Furthermore, it explores treatment strategies, preventive measures, and the critical role of the One Health approach in addressing AUFI. The paper also addresses the emerging zoonotic risks and ongoing outbreaks, including COVID-19, Rickettsia spp., and other novel pathogens, emphasizing their impact on AUFI diagnosis and management. Challenges in resource-limited settings are analyzed, highlighting the need for bolstered healthcare infrastructure, enhanced diagnostics, and collaborative One Health strategies. Amidst the complexity of emerging zoonotic threats, this review underscores the urgency for a multifaceted approach to mitigate the growing burden of AUFI, ensuring early diagnosis, appropriate treatment, and effective prevention strategies.

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Opportunities and challenges to accurate diagnosis and management of acute febrile illness in adults and adolescents: A review

Cited by 6 publications

References 62 publications

Fever in focus: Symptoms, diagnoses and treatment of febrile children in Ghana—A longitudinal hospital study

Fever in focus: Symptoms, diagnoses and treatment of febrile children in Ghana—A longitudinal hospital study

A pilot study investigating severe community-acquired febrile illness through implementation of an innovative microbiological and nucleic acid amplification testing strategy in Timor-Leste (ISIN-MANAS-TL)

From fever to action: diagnosis, treatment, and prevention of acute undifferentiated febrile illnesses

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