Etiology of Pediatric Fever in Western Kenya: A Case–Control Study of Falciparum Malaria, Respiratory Viruses, and Streptococcal Pharyngitis

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