Etiologies of Fever Among Adults in Dar es Salaam

Sponsor

Swiss Tropical & Public Health Institute (Other)

Overall Status

Completed

CT.gov ID

NCT01947075

Collaborator

Ifakara Health Institute (Other)

538

Enrollment

Location

Duration (Months)

44.9

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

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.

Condition or Disease	Intervention/Treatment	Phase
Acute Febrile Illnesses

Study Design

Study Type:

Observational [Patient Registry]

Actual Enrollment :

538 participants

Observational Model:

Cohort

Time Perspective:

Prospective

Official Title:

Etiologies of Acute Febrile Illness Among Adults Attending an Outpatient Department in Dar es Salaam

Study Start Date :

Jul 1, 2013

Actual Primary Completion Date :

Jul 1, 2014

Actual Study Completion Date :

Jul 1, 2014

Arms and Interventions

Arm	Intervention/Treatment
Adults with fever Every adult with fever will be screened for different infectious diseases and for nasopharyngeal respiratory viruses and bacteria
Healthy volonteers For 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.

Outcome Measures

Primary Outcome Measures

Proportion of patients with each disease among all febrile patients, overall and stratified by HIV status [1 year]
Description of the distribution of causes of fever based on pre-defined case definitions for each disease.

Secondary Outcome Measures

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. [1 year]
Nasopharyngeal respiratory viruses and bacteria documentation (presence/absence as well as pathogen loads) will be compared between patients with acute respiratory infection and a control group of healthy volunteers

Other Outcome Measures

Strength of association between each febrile disease and diabetes mellitus and between acute respiratory infections and indoor air pollution [1 year]
Screening of diabetes mellitus and screening of exposure to indoor air pollution will be performed among patients with fever. The strength of association between diabetes and each type of febrile disease and exposure to indoor air pollution and acute respiratory infections will be measured.