Etiologies of Fever Among Adults in Dar es Salaam
Etiologies of Acute Febrile Illness Among Adults Attending an Outpatient Department in Dar es Salaam
Following the decline of malaria in Sub-Saharan Africa, clinicians face febrile patients in whom an alternative diagnosis has to be made. This situation has led to an overuse of antibiotics by clinicians. It is crucial to increase knowledge on etiologies and risk factors of outpatient febrile illness in order to improve their management.
This present proposal aims to investigate the etiologies of fever among adult patients attending an outpatient department in urban Tanzania. It also aims to assess the clinical significance of nasopharyngeal (NP) respiratory viruses and bacteria documentation in this setting. Third, it aims to compare the spectrum of infections in this population with that of children included in the same setting in a previous study. The last objective is to assess diabetes mellitus (DM) as a risk factor for infection and exposure to indoor air pollution (IAP) as a risk factor for acute respiratory infections (ARI) in adults in Tanzania.
The investigators hypothesize that acute respiratory infections are the main cause of adult febrile illness in a urban low-income setting and that use of quantitative molecular assays on naso-oropharyngeal samples can improve the diagnosis of pneumonia. The investigators also think that the spectrum of infections is different between children and adults, mainly due to a high HIV prevalence in adults. The investigators also hypothesize that experiencing IAP and/ or DM is a risk factor for infections in adults.
Descripción general del estudio
Estado
Condiciones
Tipo de estudio
Inscripción (Actual)
Contactos y Ubicaciones
Ubicaciones de estudio
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Dar es Salaam, Tanzania
- Mwananyamala Hospital
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Método de muestreo
Población de estudio
Descripción
Inclusion Criteria:
- Temperature >=38°C
- History of fever for less than 8 days
- First consultation for the present problem
Exclusion Criteria:
- Refusal of HIV screening
- Main complaint is injury or trauma
- Antibiotic treatment in the last 7 days
- Within 6 weeks after delivery
- Hospitalization during the last month
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
Cohortes e Intervenciones
Grupo / Cohorte |
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Adults with fever
Every adult with fever will be screened for different infectious diseases and for nasopharyngeal respiratory viruses and bacteria
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Healthy volonteers
For every adult with fever included with a diagnosis of pneumonia, a healthy volunteer will be included.
These healthy volunteers will be screened for nasopharyngeal respiratory viruses and bacteria.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Proportion of patients with each disease among all febrile patients, overall and stratified by HIV status
Periodo de tiempo: 1 year
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Description of the distribution of causes of fever based on pre-defined case definitions for each disease.
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1 year
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Proportion of febrile patients with acute respiratory infection infected with a certain respiratory pathogen, compared to the proportion of healthy controls infected with the same pathogen.
Periodo de tiempo: 1 year
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Nasopharyngeal respiratory viruses and bacteria documentation (presence/absence as well as pathogen loads) will be compared between patients with acute respiratory infection and a control group of healthy volunteers
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1 year
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Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Strength of association between each febrile disease and diabetes mellitus and between acute respiratory infections and indoor air pollution
Periodo de tiempo: 1 year
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Screening of diabetes mellitus and screening of exposure to indoor air pollution will be performed among patients with fever.
The strength of association between diabetes and each type of febrile disease and exposure to indoor air pollution and acute respiratory infections will be measured.
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1 year
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Valerie D'Acremont, MD PhD, Swiss Tropical & Public Health Institute
Publicaciones y enlaces útiles
Publicaciones Generales
- Boillat-Blanco N, Klaassen B, Mbarack Z, Samaka J, Mlaganile T, Masimba J, Franco Narvaez L, Mamin A, Genton B, Kaiser L, D'Acremont V. Dengue fever in Dar es Salaam, Tanzania: clinical features and outcome in populations of black and non-black racial category. BMC Infect Dis. 2018 Dec 12;18(1):644. doi: 10.1186/s12879-018-3549-z.
- Boillat-Blanco N, Mbarack Z, Samaka J, Mlaganile T, Mamin A, Genton B, Kaiser L, Calandra T, D'Acremont V. Prognostic value of quickSOFA as a predictor of 28-day mortality among febrile adult patients presenting to emergency departments in Dar es Salaam, Tanzania. PLoS One. 2018 Jun 14;13(6):e0197982. doi: 10.1371/journal.pone.0197982. eCollection 2018.
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- Fever Study
- Adult Fever Study (Otro identificador: SwissTPH)
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