Community prevalence of fever and relationship with malaria among infants and children in low-resource areas
Diarrhea and pneumonia are widely recognized to be major contributors to illness among infants and children in low-resource areas
Abstract
Diarrhea and pneumonia are widely recognized to be major contributors to illness among infants and children in low-resource areas. Investments in etiology research are yielding important insights into the major causes of diarrhea and pneumonia, providing valuable information to improve disease management and prevention efforts. However, fever is also common among infants and children in low-resource areas in the tropics. For patients with fever presenting without localizing features, clinical diagnosis is difficult and malaria may be the default diagnosis. More widespread use of malaria diagnostic tests has unmasked the problem of malaria over diagnosis. In addition to clinical misdiagnosis in life, the use of verbal autopsies to estimate malaria-attributable deaths lacks specificity, contributing to overestimation of the prevalence of malaria and misclassification of febrile deaths in burden of disease estimates. Apparent declines in malaria over the past decade mean that clinicians now face a growing proportion of febrile children without malaria. Sparse clinical microbiology services and limited comprehensive fever etiology research mean that the local epidemiology of causes of fever is seldom well understood.
Efforts to address fever in low-resource areas will require wider awareness of its prevalence and a robust understanding of the contribution of malaria relative to other causes. To provide a picture of the community prevalence of fever alone and with cough or diarrhea among children, we analyzed national Demographic and Health Survey (DHS) data. To explore the contribution of malaria to fever prevalence, we studied the relationship between fever prevalence and national proportion of population for the age 0–4 years at risk for malaria.
This is a publication arising from the Zoonoses and Emerging Livestock Systems (ZELS) programme.
Citation
Prasad N, Sharples K, Murdoch D, Crump J (2015). Community prevalence of fever and relationship with malaria among infants and children in low-resource areas. Am J Trop Med Hyg. 93(1):178–180.