Febrile Illness in Guinea

Study Overview
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Brief Summary
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To date, the underlying causes of community-acquired fever, particularly non-malarial fever, are insufficiently documented in Guinea. Moreover, diagnostic capacity is limited, leading to inadequate prescription of antibiotics and antimalarials, as well as substantial delay in outbreak recognition. Thus, the investigators undertook a prospective observational multi-centric cohort study of febrile patients presenting at the emergency and outpatient department of selected health centers, districts and regional hospitals in four ecologically distinct sentinel health districts in Guinea.

Official Title
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Multidisciplinary Surveillance and Investigation of Febrile Illness in Guinea

Conditions
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Febrile Illness

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥2 months old Documented fever (axillary temperature >37.5°C) at presentation or fever reported within the prior 24 hours Availability for follow-up for 21 days Willingness and ability of the patient or culturally acceptable representative to give informed consent for participation in the study Exclusion Criteria: History of hospitalization (for > 48 hours within the last 14 days) at any health facility

Ages Eligible for Study
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Minimum Age: 2 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pattern of symptoms and laboratory results at presentation and during follow-up | Proportion will be estimated | Day 0 and day 21 | 
| Syndromic and/or etiologic diagnoses as established at day 21 | Proportion will be estimated | Day 0 | 
| Pattern and duration of antibiotic use (and other treatments) | Proportion and mean or median will be estimated | Day 0 | 
| Immediate or secondary hospital admissions and of secondary/unscheduled visits | Proportion will be estimated | Day 0 and day 21 | 
| Participants alive (with or without symptoms) or dead at day 21. | Survival or mortality rate will be estimated | Day 21 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| White blood cells and C-reactive protein levels at baseline and association with syndromic/etiologic diagnoses and with patient outcome at day 21 | Mean or median level will be estimated | Day 0 | 
| Association of seasonal, geographical, demographic, clinical and first-line laboratory variables (malaria RDT and smear, biochemistry) with presenting syndromes/main etiologies | OR or RR will be estimated as appropriate | Day 0 | 
| Confirmed arboviral pathogens and identification of epidemiological/clinical/laboratory predictors | Proportions will be estimated | Day 0 | 
| Cases fulfilling any of the case definitions of the 20 epidemic-prone infections under surveillance as compared to the final diagnosis and proportion of them timely reported to health authorities | Proportions will be estimated | Day 0 |