Trends in Acute Undifferentiated Febrile Illness in Patients Seeking Treatment from a Tertiary Care Hospital of Central Kerala

Abstract

BACKGROUND Acute undifferentiated febrile illness (AUFI / AFI) is one of the most common reasons for people seeking medical care globally. Investigation into the aetiology and trends in AUFI cases are valuable public health data source. Absence of such evidence-based data may result in unintended public health consequences. Present study was undertaken to address the gap in period specific trends in AUFI cases reported from the region. METHODS A record based descriptive study was done in patients treated with AUFI from January 1st, 2015 to December 31st , 2019 in Government Medical College, Ernakulam. Universal sampling technique was adopted, and the data was entered in Microsoft Excel and analysed using Epi-Info software. Line diagram was constructed to obtain the trends in AUFI cases over the five-year period. Chisquare test was applied to find out the association between age group (paediatric and others) and causative agents of AUFI. RESULTS A total of 7998 AUFI cases were included in this study. Highest number of AUFI cases (1986) was reported in the year 2017. Under five age group was the most common, 1564 (19.6 %). Majority of the AUFI were reported among males, 4947 (61.9 %). Undetermined fever was found to be the most common AUFI, 2188 (27.4 %). Dengue fever, 1993 (24.9 %) was the most diagnosed AUFI. Viral aetiology was found to be the most common, 3895 (48.7 %) in both paediatric and other age groups. No statistically significant association was found between (P-value = 0.22) age group and organisms causing AUFI. There were 121 (1.5 %) deaths reported among the AUFI cases during the five-year period. It was seen that the case fatality due to AUFI was highest (2.41 %) in the year 2019. CONCLUSIONS A lack of consistent pattern in the aetiology of AUFI cases reported over the fiveyear study period, calls for persistent vigil by the public health surveillance system in the region, to identify any impending infectious disease outbreak at the earliest. As this study is based on hospital-based surveillance record it can underestimate the disease incidence. KEYWORDS Acute Undifferentiated Febrile Illness (AUFI), Trends, Dengue, Acute Febrile Illness