Institut de Recherche en Science de la Sante-Unite de Recherche Clinique de Nanoro, Nanoro, Burkina Faso.
Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam, The Netherlands.
Infect Dis Poverty. 2018 May 31;7(1):60. doi: 10.1186/s40249-018-0442-3.
Fever remains a major public health problem. In Burkina Faso, more than half of febrile children are considered not to be infected by malaria. This study prospectively assessed probable (treatable) causes of fever in Burkinabe children.
A prospective study was conducted among febrile children (≥37.5 °C) under 5 years of age presenting at four health facilities and one referral hospital in rural Burkina Faso. From each participant, blood was collected for malaria microscopy and culture, urine for dipstick testing and culturing if tested positive for leucocytes and nitrite, stool for rotavirus/adenovirus testing, culture and parasitology, and a nasopharyngeal swab for culture.
In total 684 febrile children were included in the study. Plasmodium falciparum malaria was found in 49.7% (340/684) of the participants and non-malaria infections in 49.1% (336/684) of children. The non-nalaria infections included gastro-intestinal infections (37.0%), common bacterial pathogens of nasopharynx (24.3%), bacterial bloodstream infections (6.0%) and urinary tract infections (1.8%). Nearly 45% (154/340) of the malaria infected children were co-infected with non-nalaria infections, but only 3.2% (11/340) of these co-infections could be considered as a possible alternative cause of fever. In contrast, in the malaria microscopy negative children 18.0% (62/344) of the infections could be the probable cause of the fever. Pathogens were not isolated from 23.7% (162/684) of the febrile cases.
Malaria remains the most common pathogen found in febrile children in Burkina Faso. However, a relative high number of febrile children had non-malaria infections. The correct diagnosis of these non-malaria fevers is a major concern, and there is an urgent need to develop more point-of-care diagnostic tests and capacities to identify and treat the causes of these fevers.
发热仍是一个主要的公共卫生问题。在布基纳法索，超过一半的发热儿童被认为没有感染疟疾。本研究前瞻性评估了布基纳法索发热儿童可能（可治疗）的病因。
在布基纳法索农村的四个卫生机构和一家转诊医院，对 5 岁以下发热儿童（≥37.5°C）进行前瞻性研究。对每个参与者采集血液进行疟疾显微镜检查和培养，尿液进行尿试纸检查和培养（如果白细胞和亚硝酸盐检测阳性），粪便进行轮状病毒/腺病毒检测、培养和寄生虫学检查，鼻咽拭子进行培养。
共有 684 名发热儿童纳入研究。49.7%（340/684）的参与者中发现恶性疟原虫疟疾，49.1%（336/684）的儿童中非疟疾感染。非疟疾感染包括胃肠道感染（37.0%）、鼻咽常见细菌病原体（24.3%）、菌血症（6.0%）和尿路感染（1.8%）。近 45%（154/340）的疟疾感染儿童合并非疟疾感染，但这些合并感染中只有 3.2%（11/340）可被认为是发热的可能替代病因。相比之下，在疟疾显微镜检查阴性的儿童中，18.0%（62/344）的感染可能是发热的可能原因。684 例发热病例中，23.7%（162/684）未分离出病原体。
疟疾仍是布基纳法索发热儿童最常见的病原体。然而，相当数量的发热儿童存在非疟疾感染。正确诊断这些非疟疾发热是一个主要关注点，迫切需要开发更多的即时诊断检测和能力，以识别和治疗这些发热的病因。
