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Major gaps in understanding of causes of fever in low and middle income countries

Thursday, 9 July 2015

A systematic review involving researchers from the Centre of International Health and Department of Pathology, Christchurch, has highlighted limitations in understanding the causes of severe febrile illness around the world.

Prof John CrumpWith declines in malaria incidence around the world, and increasing use of malaria diagnostic kits, many healthcare workers are facing an increasing proportion of patients with fever due to other causes. Professor John Crump, study author and lead researcher at the Centre for International Health, noted that many lower and middle income countries lack the appropriate clinical facilities and laboratory equipment to accurately diagnose causes of fever, potentially leading to the wrong treatment being used for patients with severe febrile illness.

Researchers at the University of Otago and colleagues at the London School of Hygiene and Tropical Medicine conducted a comprehensive review of published research into the causes of severe febrile illness in low and middle income countries, covering around 55,000 patients, finding that only 28.5% of patients had confirmed malaria.

The research highlights that a wide range of pathogens cause fever, and shows gaps in knowledge exist about where in the world these diseases occur and the burden of these diseases in different countries. High quality research into the geographic distribution of these pathogens and the diseases they cause is needed to guide health professionals, noted the study authors. “If they know that, for example, typhoid fever is very common in that area, then they know it’s likely that the patient has typhoid, and treat them accordingly”, stated Professor Crump.