Relative Contribution of Bacteraemia and Malaria to Acute Fever Without Localizing Signs of Infection in Under-five Children

Six-hundred-and-forty-two previously healthy children aged 1 month to 5 years with fever of acute onset, without localizing signs of infection, were prospectively recruited over 1 year. Sixty-three per cent had malaria, 4 per cent bacteraemia, and 7 per cent malaria and bacteraemia. Neither infectio...

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Bibliographic Details
Published in:Journal of tropical pediatrics (1980) 1992-12, Vol.38 (6), p.295-298
Main Authors: Akpede, George O., Abiodun, Phillip O., Sykes, Roger M.
Format: Article
Language:English
Subjects:
Acute Disease
Age Factors
Bacteremia - complications
Biological and medical sciences
Child, Preschool
Emergency Service, Hospital
Fever - etiology
Gram-Negative Bacterial Infections - complications
Gram-Positive Bacterial Infections - complications
Human protozoal diseases
Humans
Infant
Infectious diseases
Malaria
Malaria, Falciparum - complications
Medical sciences
Nigeria
Parasitic diseases
Prospective Studies
Protozoal diseases
Staphylococcal Infections - complications
Tropical medicine
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Summary:Six-hundred-and-forty-two previously healthy children aged 1 month to 5 years with fever of acute onset, without localizing signs of infection, were prospectively recruited over 1 year. Sixty-three per cent had malaria, 4 per cent bacteraemia, and 7 per cent malaria and bacteraemia. Neither infection was identified in 27 per cent. Malaria was the predominant infection irrespective of season, temperature on presentation, or age (except under 6 months). Although Gram-negative bacteraemia was overall commoner than Grampositive bacteraemia, Staphylococcus aureus was the commonest single organism (43 per cent) in bacteraemk patients. The prevalence of malaria increased with age while that of bacteraemia decreased with age (P < 0.0005). The prevalence of an identifiable infection increased with the temperature on presentation (P< 0.025). It is concluded that although malaria is the predominant infection in previously healthy under-5 children with acute fever without specific localizing signs of infection, bacteraemia (alone or associated with malaria) occur with an importantly high frequency. It is recommended that while presumptive treatment for malaria is justified in such children, evaluation for bacteraemia should be given consideration.
ISSN:0142-6338
1465-3664
DOI:10.1093/tropej/38.6.295