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Etiology of pediatric fever in western Kenya: a case-control study of falciparum malaria, respiratory viruses, and streptococcal pharyngitis.

Publication ,  Journal Article
O'Meara, WP; Mott, JA; Laktabai, J; Wamburu, K; Fields, B; Armstrong, J; Taylor, SM; MacIntyre, C; Sen, R; Menya, D; Pan, W; Nicholson, BP ...
Published in: Am J Trop Med Hyg
May 2015

In Kenya, more than 10 million episodes of acute febrile illness are treated annually among children under 5 years. Most are clinically managed as malaria without parasitological confirmation. There is an unmet need to describe pathogen-specific etiologies of fever. We enrolled 370 febrile children and 184 healthy controls. We report demographic and clinical characteristics of patients with Plasmodium falciparum, group A streptococcal (GAS) pharyngitis, and respiratory viruses (influenza A and B, respiratory syncytial virus [RSV], parainfluenza [PIV] types 1-3, adenovirus, human metapneumovirus [hMPV]), as well as those with undifferentiated fever. Of febrile children, 79.7% were treated for malaria. However, P. falciparum was detected infrequently in both cases and controls (14/268 [5.2%] versus 3/133 [2.3%], P = 0.165), whereas 41% (117/282) of febrile children had a respiratory viral infection, compared with 24.8% (29/117) of controls (P = 0.002). Only 9/515 (1.7%) children had streptococcal infection. Of febrile children, 22/269 (8.2%) were infected with > 1 pathogen, and 102/275 (37.1%) had fevers of unknown etiology. Respiratory viruses were common in both groups, but only influenza or parainfluenza was more likely to be associated with symptomatic disease (attributable fraction [AF] 67.5% and 59%, respectively). Malaria was overdiagnosed and overtreated. Few children presented to the hospital with GAS pharyngitis. An enhanced understanding of carriage of common pathogens, improved diagnostic capacity, and better-informed clinical algorithms for febrile illness are needed.

Duke Scholars

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Published In

Am J Trop Med Hyg

DOI

EISSN

1476-1645

Publication Date

May 2015

Volume

92

Issue

5

Start / End Page

1030 / 1037

Location

United States

Related Subject Headings

  • Tropical Medicine
  • Streptococcus pyogenes
  • Streptococcal Infections
  • Respiratory Tract Infections
  • Respiratory Syncytial Virus Infections
  • Pharyngitis
  • Paramyxoviridae Infections
  • Metapneumovirus
  • Male
  • Malaria, Falciparum
 

Citation

APA
Chicago
ICMJE
MLA
NLM
O’Meara, W. P., Mott, J. A., Laktabai, J., Wamburu, K., Fields, B., Armstrong, J., … Holland, T. L. (2015). Etiology of pediatric fever in western Kenya: a case-control study of falciparum malaria, respiratory viruses, and streptococcal pharyngitis. Am J Trop Med Hyg, 92(5), 1030–1037. https://doi.org/10.4269/ajtmh.14-0560
O’Meara, Wendy P., Joshua A. Mott, Jeremiah Laktabai, Kabura Wamburu, Barry Fields, Janice Armstrong, Steve M. Taylor, et al. “Etiology of pediatric fever in western Kenya: a case-control study of falciparum malaria, respiratory viruses, and streptococcal pharyngitis.Am J Trop Med Hyg 92, no. 5 (May 2015): 1030–37. https://doi.org/10.4269/ajtmh.14-0560.
O’Meara WP, Mott JA, Laktabai J, Wamburu K, Fields B, Armstrong J, et al. Etiology of pediatric fever in western Kenya: a case-control study of falciparum malaria, respiratory viruses, and streptococcal pharyngitis. Am J Trop Med Hyg. 2015 May;92(5):1030–7.
O’Meara, Wendy P., et al. “Etiology of pediatric fever in western Kenya: a case-control study of falciparum malaria, respiratory viruses, and streptococcal pharyngitis.Am J Trop Med Hyg, vol. 92, no. 5, May 2015, pp. 1030–37. Pubmed, doi:10.4269/ajtmh.14-0560.
O’Meara WP, Mott JA, Laktabai J, Wamburu K, Fields B, Armstrong J, Taylor SM, MacIntyre C, Sen R, Menya D, Pan W, Nicholson BP, Woods CW, Holland TL. Etiology of pediatric fever in western Kenya: a case-control study of falciparum malaria, respiratory viruses, and streptococcal pharyngitis. Am J Trop Med Hyg. 2015 May;92(5):1030–1037.

Published In

Am J Trop Med Hyg

DOI

EISSN

1476-1645

Publication Date

May 2015

Volume

92

Issue

5

Start / End Page

1030 / 1037

Location

United States

Related Subject Headings

  • Tropical Medicine
  • Streptococcus pyogenes
  • Streptococcal Infections
  • Respiratory Tract Infections
  • Respiratory Syncytial Virus Infections
  • Pharyngitis
  • Paramyxoviridae Infections
  • Metapneumovirus
  • Male
  • Malaria, Falciparum