Joshi Rajnish, Colford John M, Reingold Arthur L, Kalantri Shriprakash
Division of Epidemiology, School of Public Health, University of California, Berkeley, California 94720, USA.
Am J Trop Med Hyg. 2008 Mar;78(3):393-9.
Nonmalarial acute undifferentiated fever (NMAUF) refers to a febrile illness with no indication of an organ-specific disease after diagnosis of malaria has been excluded. In developing countries, the empirical treatment of NMAUFs with antimalarial drugs continues even in the era of highly specific rapid diagnostic tests (RDTs) for malaria. We carried out a retrospective review of patients with fever admitted to a rural teaching hospital in central India. We categorized patients with NMAUF into different clinical syndromes and determined their demographic profile, inhospital course, and the pattern of antimalarial use. The study sample included 1,197 adult patients who were investigated for malaria; 1,053 (88%) of them had NMAUF, and use of further diagnostics in this group was limited. Despite one or more negative tests for malaria, many patients (39.9%, 95% CI 37.0-43.3) received antimalarial drugs. These results suggest a need for guidelines and training to improve empirical treatment of NMAUF.
非疟疾性急性未分化热（NMAUF）是指在排除疟疾诊断后，无器官特异性疾病迹象的发热性疾病。在发展中国家，即使在疟疾高度特异性快速诊断检测（RDT）的时代，对于NMAUFs仍继续使用抗疟药物进行经验性治疗。我们对印度中部一家农村教学医院收治的发热患者进行了回顾性研究。我们将NMAUF患者分为不同的临床综合征，并确定了他们的人口统计学特征、住院病程以及抗疟药物使用模式。研究样本包括1197名接受疟疾调查的成年患者；其中1053名（88%）患有NMAUF，该组进一步诊断的使用有限。尽管疟疾检测一项或多项为阴性，但许多患者（39.9%，95%CI 37.0 - 43.3）接受了抗疟药物治疗。这些结果表明需要制定指南和进行培训，以改善NMAUF的经验性治疗。
