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The aetiology of non-malarial febrile illness in children in the malaria-endemic Niger Delta Region of Nigeria

https://doi.org/10.1016/S2222-1808(13)60012-2Get rights and content

Abstract

Objective

Febrile illnesses are common in childhood and differentiating the causes could be challenging in areas of perennial malaria transmission. To determine the proportion of non-malarial febrile illness in children, the aetiological agents and their antimicrobial sensitivity pattern.

Methods

Blood, urine, throat swab and ear swab samples were obtained from 190 febrile children aged 6 months to 11 years. Malaria parasite was detected by microscopic examination of thick and thin Giemsa-stained films. Smears from ear and throat swabs and urine specimen were cultured on appropriate media. Bacterial isolates were identified by Gram staining, morphology and biochemical tests. Antibiotic susceptibility was tested using the Kirby-Bauer disc diffusion method.

Results

The prevalence of non-malarial febrile illnesses was 45.26% (95% CI: 38.21–52.31). Twenty-four patients (12.6%) had at least one sample that was bacterial culture positive. Samples from 62 patients (32.6%) were negative for both malaria parasite and bacterial culture. Urinary tract infection was responsible for 8.42%, otitis media 7.89% and pharyngitis 5.78% of the fevers. E.coli, S. aureus and S. pneumoniae were the commonest isolates from urine, ear swab and throat swab samples respectively. S. pneumoniae was responsible for all the positive throat cultures. Bacterial isolates exhibited different degrees of susceptibility to the antibiotics tested, but susceptibility of most of the isolates to oxacillin and cloxacillin was generally poor.

Conclusions

Bacterial infections are responsible for a significant proportion of non-malarial febrile illnesses, and diagnostic facilities should be strengthened to detect other causes of febrile illness outside malaria.

References (21)

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Foundation Project: NDU/Educational Trust Fund, grant no. SRGC/10-11/013.

Peer reviewer Liwang Cui, Professor, Department of Entomology, Penn State University, University Park, PA 16802, USA. Tel: +1 8248637663 Fax: +1 8148653048 E-mail: [email protected]

Comments In this study, the author probed into the other causes of non-malarial febrile illnesses and found that bacteria are often associated with the febrile illnesses. In addition, their sensitivity studies also revealed that the choice of antibiotics needs to be screened so that effective treatments can be administered. Although bacteria are found in some patients, it is not clear whether these are the causes of the illnesses. It is unknown whether these patients were treated with antibiotics and what are the outcomes of the treatments.

Available online 28 Feb 2013

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