Management of febrile illness in rural Guinea over a seven-year period: A retrospective study.
Journal
PLOS global public health
ISSN: 2767-3375
Titre abrégé: PLOS Glob Public Health
Pays: United States
ID NLM: 9918283779606676
Informations de publication
Date de publication:
2022
2022
Historique:
received:
02
02
2022
accepted:
08
09
2022
entrez:
24
3
2023
pubmed:
25
3
2023
medline:
25
3
2023
Statut:
epublish
Résumé
Febrile illnesses constitute a major clinical challenge in tropical settings. We aimed to assess the frequency, presentation and management of febrile illness at two health facilities in Forécariah, Guinea, with a focus on appropriateness of antibiotic prescription. This was a retrospective study conducted in patient files in a health center and a district hospital. Proportions of antibiotic prescription were determined by age group and syndromes as well as appropriateness of antibiotic prescription using the WHO model list (2019). From 2014 to 2020, 23,583 of 62,185 (38.0%) visits were related to febrile illness. Most patients with fever were female (56.1%) and evaluated at the health center (81.0%). Gastrointestinal (40.6%) and respiratory syndromes (36.8%), and undifferentiated fever (30.0%) were the most common presentations. Malaria was confirmed in 61.3% of the cohort. Overall, the rate of antibiotic prescription was high (14,834/23,583, 62.9%), mostly among patients aged <5 years (5,285/7,566, 69.9%), those with respiratory (7,577/8,684, 87.3%) and gastrointestinal (6,324/9,585, 66.0%) syndromes. Moreover, 7,432/14,465 (51.4%) patients with malaria were also prescribed an antibiotic. Penicillin (42.0%), cotrimoxazole (26.3%) and quinolones (18.7%) were the most frequently prescribed antibiotics. Overall, appropriateness of antibiotic prescription was low (38.3%), and even more so in patients with respiratory (29.1%) and gastrointestinal (25.8%) syndromes. Febrile illness is a major cause of consultation in rural Guinea. Rate of antibiotic prescription was high, even in confirmed malaria and was often considered inappropriate. There is a pressing need to investigate the etiological spectrum and improve the diagnostic approach of febrile illness in Guinea.
Identifiants
pubmed: 36962689
doi: 10.1371/journal.pgph.0001133
pii: PGPH-D-22-00169
pmc: PMC10021211
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e0001133Informations de copyright
Copyright: © 2022 Kourouma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Déclaration de conflit d'intérêts
The authors declare that they have no competing interests.
Références
PLoS One. 2015 Jun 30;10(6):e0127962
pubmed: 26126200
Am J Trop Med Hyg. 2015 Jul;93(1):178-80
pubmed: 25918207
BMC Public Health. 2016 Aug 22;16:724
pubmed: 27545670
Health Policy Plan. 2016 Mar;31(2):250-8
pubmed: 26045328
Infect Dis Ther. 2021 Sep;10(3):1645-1664
pubmed: 34173960
Int J Clin Pract. 2017 Dec;71(12):
pubmed: 29178350
BMC Health Serv Res. 2017 Dec 13;17(1):822
pubmed: 29237494
BMC Infect Dis. 2019 Mar 27;19(1):288
pubmed: 30917795
Med Sante Trop. 2013 May 1;23(2):189-92
pubmed: 23797761
Am J Trop Med Hyg. 2020 Aug;103(2):887-893
pubmed: 32588795
Int J Infect Dis. 2020 Jan;90:71-76
pubmed: 31655112
BMJ Glob Health. 2021 Oct;6(10):
pubmed: 34607893
PLoS Negl Trop Dis. 2015 Dec 03;9(12):e0004040
pubmed: 26633014
PLoS One. 2019 Jul 25;14(7):e0220371
pubmed: 31344116
Clin Microbiol Infect. 2018 Aug;24(8):808-814
pubmed: 29454844
PLoS One. 2016 Jan 28;11(1):e0146054
pubmed: 26821179
Malar J. 2022 Jan 24;21(1):23
pubmed: 35073934
PLoS One. 2019 Sep 26;14(9):e0222651
pubmed: 31557170
Am J Trop Med Hyg. 2021 Apr 23;104(6):1955-1959
pubmed: 33891560
N Engl J Med. 2020 Feb 20;382(8):727-733
pubmed: 31978945
Lancet Infect Dis. 2010 Jun;10(6):417-32
pubmed: 20510282
N Engl J Med. 2014 Feb 27;370(9):809-17
pubmed: 24571753
Front Pediatr. 2021 May 28;9:626386
pubmed: 34123960
PLoS One. 2018 Mar 5;13(3):e0193353
pubmed: 29505584
Bull World Health Organ. 2008 Feb;86(2):132-9
pubmed: 18297168