Aetiology of acute febrile illness in children in a high malaria transmission area in West Africa

B Kaboré; A Post; P Lompo; J D Bognini; S Diallo; B T D Kam; J Rahamat-Langendoen; H F L Wertheim; F van Opzeeland; J D Langereis; M I de Jonge; H Tinto; J Jacobs; A J van der Ven; Q de Mast

doi:10.1016/j.cmi.2020.05.029

Aetiology of acute febrile illness in children in a high malaria transmission area in West Africa

B Kaboré, A Post, P Lompo, J D Bognini, S Diallo, B T D Kam, J Rahamat-Langendoen, H F L Wertheim, F van Opzeeland, J D Langereis, M I de Jonge, H Tinto, J Jacobs, A J van der Ven, Q de Mast

Tropical Bacteriology

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Abstract

OBJECTIVES: Areas with declining malaria transmission in sub-Saharan Africa have recently witnessed important changes in the aetiology of childhood acute febrile illness (AFI). We describe the aetiology of AFI in a high malaria transmission area in rural Burkina Faso.

METHODS: In a prospective hospital-based diagnostic study, children aged 3 months to 15 years with AFI were recruited and assessed using a systematic diagnostic protocol, including blood cultures, whole blood PCR on a selection of bacterial pathogens, malaria diagnostics and a multiplex PCR on nasopharyngeal swabs targeting 21 viral and 4 bacterial respiratory pathogens.

RESULTS: A total of 589 children with AFI were enrolled from whom an infectious disease was considered in 575 cases. Acute respiratory tract infections, malaria and invasive bacterial infections (IBI) accounted for 179 (31.1%), 175 (30.4%) and 75 (13%) of AFI cases respectively; 16 (21.3%) of IBI cases also had malarial parasitaemia. A viral pathogen was demonstrated from the nasopharynx in 157 children (90.7%) with respiratory tract symptoms. Of all children with viral respiratory tract infections, 154 (92.4% received antibiotics, whereas no antibiotic was provided in 13 (17%) of IBI cases.

CONCLUSIONS: Viral respiratory infections are a common cause of childhood AFI in high malaria transmission areas, next to malaria and IBI. These findings highlight the importance of interventions to improve targeted treatment with antimicrobials. Most patients with viral infections received antibiotics unnecessarily, while a considerable number with IBI did not receive antibiotics.

Original language	English
Journal	Clinical Microbiology and Infection
Volume	27
Issue number	4
Pages (from-to)	590-596
Number of pages	7
ISSN	1198-743X
DOIs	https://doi.org/10.1016/j.cmi.2020.05.029
Publication status	Published - 2021

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Kaboré, B., Post, A., Lompo, P., Bognini, J. D., Diallo, S., Kam, B. T. D., Rahamat-Langendoen, J., Wertheim, H. F. L., van Opzeeland, F., Langereis, J. D., de Jonge, M. I., Tinto, H., Jacobs, J., van der Ven, A. J., & de Mast, Q. (2021). Aetiology of acute febrile illness in children in a high malaria transmission area in West Africa. Clinical Microbiology and Infection, 27(4), 590-596. https://doi.org/10.1016/j.cmi.2020.05.029

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title = "Aetiology of acute febrile illness in children in a high malaria transmission area in West Africa",

abstract = "OBJECTIVES: Areas with declining malaria transmission in sub-Saharan Africa have recently witnessed important changes in the aetiology of childhood acute febrile illness (AFI). We describe the aetiology of AFI in a high malaria transmission area in rural Burkina Faso.METHODS: In a prospective hospital-based diagnostic study, children aged 3 months to 15 years with AFI were recruited and assessed using a systematic diagnostic protocol, including blood cultures, whole blood PCR on a selection of bacterial pathogens, malaria diagnostics and a multiplex PCR on nasopharyngeal swabs targeting 21 viral and 4 bacterial respiratory pathogens.RESULTS: A total of 589 children with AFI were enrolled from whom an infectious disease was considered in 575 cases. Acute respiratory tract infections, malaria and invasive bacterial infections (IBI) accounted for 179 (31.1%), 175 (30.4%) and 75 (13%) of AFI cases respectively; 16 (21.3%) of IBI cases also had malarial parasitaemia. A viral pathogen was demonstrated from the nasopharynx in 157 children (90.7%) with respiratory tract symptoms. Of all children with viral respiratory tract infections, 154 (92.4% received antibiotics, whereas no antibiotic was provided in 13 (17%) of IBI cases.CONCLUSIONS: Viral respiratory infections are a common cause of childhood AFI in high malaria transmission areas, next to malaria and IBI. These findings highlight the importance of interventions to improve targeted treatment with antimicrobials. Most patients with viral infections received antibiotics unnecessarily, while a considerable number with IBI did not receive antibiotics.",

author = "B Kabor{\'e} and A Post and P Lompo and Bognini, {J D} and S Diallo and Kam, {B T D} and J Rahamat-Langendoen and Wertheim, {H F L} and {van Opzeeland}, F and Langereis, {J D} and {de Jonge}, {M I} and H Tinto and J Jacobs and {van der Ven}, {A J} and {de Mast}, Q",

year = "2021",

doi = "10.1016/j.cmi.2020.05.029",

language = "English",

volume = "27",

pages = "590--596",

journal = "Clinical Microbiology and Infection",

issn = "1198-743X",

publisher = "Elsevier",

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Kaboré, B, Post, A, Lompo, P, Bognini, JD, Diallo, S, Kam, BTD, Rahamat-Langendoen, J, Wertheim, HFL, van Opzeeland, F, Langereis, JD, de Jonge, MI, Tinto, H, Jacobs, J, van der Ven, AJ & de Mast, Q 2021, 'Aetiology of acute febrile illness in children in a high malaria transmission area in West Africa', Clinical Microbiology and Infection, vol. 27, no. 4, pp. 590-596. https://doi.org/10.1016/j.cmi.2020.05.029

TY - JOUR

T1 - Aetiology of acute febrile illness in children in a high malaria transmission area in West Africa

AU - Kaboré, B

AU - Post, A

AU - Lompo, P

AU - Bognini, J D

AU - Diallo, S

AU - Kam, B T D

AU - Rahamat-Langendoen, J

AU - Wertheim, H F L

AU - van Opzeeland, F

AU - Langereis, J D

AU - de Jonge, M I

AU - Tinto, H

AU - Jacobs, J

AU - van der Ven, A J

AU - de Mast, Q

PY - 2021

Y1 - 2021

N2 - OBJECTIVES: Areas with declining malaria transmission in sub-Saharan Africa have recently witnessed important changes in the aetiology of childhood acute febrile illness (AFI). We describe the aetiology of AFI in a high malaria transmission area in rural Burkina Faso.METHODS: In a prospective hospital-based diagnostic study, children aged 3 months to 15 years with AFI were recruited and assessed using a systematic diagnostic protocol, including blood cultures, whole blood PCR on a selection of bacterial pathogens, malaria diagnostics and a multiplex PCR on nasopharyngeal swabs targeting 21 viral and 4 bacterial respiratory pathogens.RESULTS: A total of 589 children with AFI were enrolled from whom an infectious disease was considered in 575 cases. Acute respiratory tract infections, malaria and invasive bacterial infections (IBI) accounted for 179 (31.1%), 175 (30.4%) and 75 (13%) of AFI cases respectively; 16 (21.3%) of IBI cases also had malarial parasitaemia. A viral pathogen was demonstrated from the nasopharynx in 157 children (90.7%) with respiratory tract symptoms. Of all children with viral respiratory tract infections, 154 (92.4% received antibiotics, whereas no antibiotic was provided in 13 (17%) of IBI cases.CONCLUSIONS: Viral respiratory infections are a common cause of childhood AFI in high malaria transmission areas, next to malaria and IBI. These findings highlight the importance of interventions to improve targeted treatment with antimicrobials. Most patients with viral infections received antibiotics unnecessarily, while a considerable number with IBI did not receive antibiotics.

AB - OBJECTIVES: Areas with declining malaria transmission in sub-Saharan Africa have recently witnessed important changes in the aetiology of childhood acute febrile illness (AFI). We describe the aetiology of AFI in a high malaria transmission area in rural Burkina Faso.METHODS: In a prospective hospital-based diagnostic study, children aged 3 months to 15 years with AFI were recruited and assessed using a systematic diagnostic protocol, including blood cultures, whole blood PCR on a selection of bacterial pathogens, malaria diagnostics and a multiplex PCR on nasopharyngeal swabs targeting 21 viral and 4 bacterial respiratory pathogens.RESULTS: A total of 589 children with AFI were enrolled from whom an infectious disease was considered in 575 cases. Acute respiratory tract infections, malaria and invasive bacterial infections (IBI) accounted for 179 (31.1%), 175 (30.4%) and 75 (13%) of AFI cases respectively; 16 (21.3%) of IBI cases also had malarial parasitaemia. A viral pathogen was demonstrated from the nasopharynx in 157 children (90.7%) with respiratory tract symptoms. Of all children with viral respiratory tract infections, 154 (92.4% received antibiotics, whereas no antibiotic was provided in 13 (17%) of IBI cases.CONCLUSIONS: Viral respiratory infections are a common cause of childhood AFI in high malaria transmission areas, next to malaria and IBI. These findings highlight the importance of interventions to improve targeted treatment with antimicrobials. Most patients with viral infections received antibiotics unnecessarily, while a considerable number with IBI did not receive antibiotics.

U2 - 10.1016/j.cmi.2020.05.029

DO - 10.1016/j.cmi.2020.05.029

M3 - A1: Web of Science-article

C2 - 32505586

SN - 1198-743X

VL - 27

SP - 590

EP - 596

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

IS - 4

ER -

Aetiology of acute febrile illness in children in a high malaria transmission area in West Africa

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