Challenges in the etiology and diagnosis of acute febrile illness in children in low- and middle- income countries

Pui Ying Iroh Tam, Stephen K. Obaro, Gregory Storch

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Acute febrile illness is a common cause of hospital admission, and its associated infectious causes contribute to substantial morbidity and death among children worldwide, especially in low- and middle-income countries. Declining transmission of malaria in many regions, combined with the increasing use of rapid diagnostic tests for malaria, has led to the increasing recognition of leptospirosis, rickettsioses, respiratory viruses, and arboviruses as etiologic agents of fevers. However, clinical discrimination between these etiologies can be difficult. Overtreatment with antimalarial drugs is common, even in the setting of a negative test result, as is overtreatment with empiric antibacterial drugs. Viral etiologies remain underrecognized and poorly investigated. Moresensitive diagnostics have led to additional dilemmas in discriminating whether a positive test result reflects a causative pathogen. Here, we reviewand summarize the current epidemiology and focus particularly on children and the challenges for future research.

Original languageEnglish (US)
Article numberpiw016
Pages (from-to)190-205
Number of pages16
JournalJournal of the Pediatric Infectious Diseases Society
Volume5
Issue number2
DOIs
StatePublished - Jun 10 2016

Keywords

  • Antimicrobial stewardship
  • Clinical algorithm
  • Diagnostics
  • Epidemiology
  • Etiology
  • Management
  • Molecular
  • Resource-limited settings
  • Serology
  • Undifferentiated fever

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases

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