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Acute Febrile Illnesses | Etiologies of Fever Among Adults in Dar es Salaam

Acute Febrile Illnesses research study

What is the primary objective of this study?

Following the decline of malaria in Sub-Saharan Africa, clinicians face febrile patients in whom an alternative diagnosis has to be made. This situation has led to an overuse of antibiotics by clinicians. It is crucial to increase knowledge on etiologies and risk factors of outpatient febrile illness in order to improve their management. This present proposal aims to investigate the etiologies of fever among adult patients attending an outpatient department in urban Tanzania. It also aims to assess the clinical significance of nasopharyngeal (NP) respiratory viruses and bacteria documentation in this setting. Third, it aims to compare the spectrum of infections in this population with that of children included in the same setting in a previous study. The last objective is to assess diabetes mellitus (DM) as a risk factor for infection and exposure to indoor air pollution (IAP) as a risk factor for acute respiratory infections (ARI) in adults in Tanzania. The investigators hypothesize that acute respiratory infections are the main cause of adult febrile illness in a urban low-income setting and that use of quantitative molecular assays on naso-oropharyngeal samples can improve the diagnosis of pneumonia. The investigators also think that the spectrum of infections is different between children and adults, mainly due to a high HIV prevalence in adults. The investigators also hypothesize that experiencing IAP and/ or DM is a risk factor for infections in adults.

Who is eligible to participate?

Inclusion Criteria: - Temperature >=38°C - History of fever for less than 8 days - First consultation for the present problem Exclusion Criteria: - Refusal of HIV screening - Main complaint is injury or trauma - Antibiotic treatment in the last 7 days - Within 6 weeks after delivery - Hospitalization during the last month

Which medical condition, disease, disorder, syndrome, illness, or injury is researched?

Acute Febrile Illnesses

Study Interventions

Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.

Study Arms

Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.

Adults with feverEvery adult with fever will be screened for different infectious diseases and for nasopharyngeal respiratory viruses and bacteria

Healthy volonteersFor every adult with fever included with a diagnosis of pneumonia, a healthy volunteer will be included. These healthy volunteers will be screened for nasopharyngeal respiratory viruses and bacteria.

Study Status

Completed

Start Date: July 2013

Completed Date: July 2014

Phase:

Type: Observational [Patient Registry]

Design:

Primary Outcome: Proportion of patients with each disease among all febrile patients, overall and stratified by HIV status

Secondary Outcome: Proportion of febrile patients with acute respiratory infection infected with a certain respiratory pathogen, compared to the proportion of healthy controls infected with the same pathogen.

Study sponsors, principal investigator, and references

Principal Investigator: Valerie D'Acremont, MD PhD

Lead Sponsor:

Collaborator: Ifakara Health Institute

More information:https://clinicaltrials.gov/show/NCT01947075

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