| Factors associated with pediatric febrile illnesses in 27 countries of Sub-Saharan Africa |
| Authors: |
Paddy Ssentongo, Vernon M. Chinchilli, Khush Shah, Thaddeus Harbaugh and Djibril M. Ba |
| Source: |
BMC Infectious Diseases , 23 |
| Topic(s): |
Child health
Fever
|
| Country: |
Africa
Benin
Burkina Faso
Burundi
Cameroon
Chad
Cote D'Ivoire
Congo Democratic Republic
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Malawi
Multiple African Countries
Mali
Mozambique
Namibia
Nigeria
Niger
Rwanda
Senegal
South Africa
Tanzania
Uganda
Zambia
Zimbabwe
Angola
|
| Published: |
JUN 2023 |
| Abstract: |
Background: Evidence on the relative importance of various factors associated with febrile illness in children and their heterogeneity across countries can inform the prevention, identification, and management of communicable diseases in resource-limited countries. The objective of the study is to assess the relative significance of factors associated with childhood febrile illness in 27 sub-Saharan African countries.
Methods: This cross-sectional study of 298,327 children aged 0 to 59 months assessed the strengths of associations of 18 factors with childhood fevers, using Demographic and Health Surveys (2010-2018) from 27 sub-Saharan African countries. A total of 7 child level factors (i.e., respiratory illness, diarrhea, breastfeeding initiation; vitamin A supplements; child's age; full vaccination; sex), 5 maternal factors (maternal education; maternal unemployment; antenatal care; maternal age, and maternal marriage status) and 6 household factors (household wealth; water source; indoor pollution, stool disposal; family planning needs and rural residence) were assessed. Febrile illness was defined as the presence of fever in 2 weeks preceding the survey.
Results: Among the 298,327 children aged 0 to 59 months included in the analysis, the weighted prevalence of fever was 22.65% (95% CI, 22.31%-22.91%). In the pooled sample, respiratory illness was the strongest factor associated with fever in children (adjusted odds ratio [aOR], 5.46; 95% CI, 5.26-5.67; P < .0001), followed by diarrhea (aOR, 2.96; 95% CI, 2.85-3.08; P < .0001), poorest households (aOR, 1.33; 95% CI,1.23-1.44; P < .0001), lack of maternal education (aOR, 1.25; 95% CI, 1.10-1.41; P < .0001), and delayed breastfeeding (aOR, 1.18; 95% CI, 1.14-1.22; P < .0001. Febrile illnesses were more prevalent in children older than >6 months compared to those 6 months and younger. Unsafe water, unsafe stool disposal, and indoor pollution were not associated with child fever in the pooled analysis but had a large country-level heterogeneity.
Conclusions: Major causes of fevers in sub-Saharan Africa could be attributed to respiratory infections and possibly viral infections, which should not be treated by antimalarial drugs or antibiotics. Point-of-care diagnostics are needed to identify the pathogenic causes of respiratory infections to guide the clinical management of fevers in limited-resource countries. |
| Web: |
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-023-08350-5 |
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