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.
調査の概要
状態
条件
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Dar es Salaam、タンザニア
- Mwananyamala Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
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
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
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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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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Proportion of patients with each disease among all febrile patients, overall and stratified by HIV status
時間枠：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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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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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.
時間枠：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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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Strength of association between each febrile disease and diabetes mellitus and between acute respiratory infections and indoor air pollution
時間枠：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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協力者と研究者
捜査官
- 主任研究者：Valerie D'Acremont, MD PhD、Swiss Tropical & Public Health Institute
出版物と役立つリンク
一般刊行物
- 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.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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