African Fever Patients Often Misdiagnosed With Malaria

Scientists have found that many African patients hospitalized with fever are wrongly diagnosed with Malaria when they have other infections.

Asian Scientist (Jul. 22, 2013) – People hospitalized with fever in Africa are most likely to be treated for malaria. However, an international team of scientists has found that, in some areas, nearly all of these patients are ill because of a different infection.

In a new study published today in PLoS Neglected Tropical Diseases, more than 800 severely ill inpatients in Tanzania were carefully studied to identify the causes of their fever.

On admission, more than half of the patients were diagnosed with malaria, but it turned out that less than two percent actually had malaria when tested.

By contrast, invasive bacterial infections like typhoid fever and animal-associated infections like leptospirosis were very common but never considered.

According to Professor John Crump, the leader of the study, malaria has been the diagnosis of choice for fever among healthcare providers and patients in Africa for decades.

“However, declines in malaria since 2004 associated with control efforts and improved treatment mean that a growing proportion of patients with fever actually have an infection other than malaria,” said Professor Crump.

“The increasing use of malaria rapid diagnostic tests in Africa along with research such as ours is showing that in many areas malaria is an increasingly uncommon cause of fever.”

Because laboratory infrastructure to diagnose infections other than malaria is limited, the researchers worked with international reference laboratories to rigorously identify other infections.

The finding that invasive bacterial infections and animal-associated diseases are major causes of fever took many by surprise.

Dr Venance Maro, Chief of Medicine at Kilimanjaro Christian Medical Centre, Moshi, Tanzania said that prior to the new study, he and his colleagues did not consider infections like leptospirosis, Q fever, and rickettsial infections and had little information on the main causes of sepsis in their area.

“The results of the study have changed the way that we think about patients with fever,” said Dr Maro.

“Our findings suggest that rigorous and comprehensive studies of causes of fever need to be conducted at multiple sites in the tropics to work out what is really causing fever,” said Professor Crump.

The article can be found at: Crump et al. (2013) Etiology Of Severe Non-Malaria Febrile Illness In Northern Tanzania: A Prospective Cohort Study.

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Source: University of Otago.
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