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. 2022 Feb 15:9:730082.
doi: 10.3389/fped.2021.730082. eCollection 2021.

A Prospective Cohort Study of the Clinical Predictors of Bacteremia in Under-Five Children With Acute Undifferentiated Fever Attending a Secondary Health Facility in Northwestern Nigeria

Taofik Oluwaseun Ogunkunle  1 , Timothy Olanrewaju Adedoyin  2 , Samuel Kolade Ernest  2 , Fatimah Hassan-Hanga  3 , Abdulazeez Imam  4 , Rasaq Olaosebikan  5 , Stephen K Obaro  6
Affiliations

A Prospective Cohort Study of the Clinical Predictors of Bacteremia in Under-Five Children With Acute Undifferentiated Fever Attending a Secondary Health Facility in Northwestern Nigeria

Taofik Oluwaseun Ogunkunle et al. Front Pediatr. .

Abstract

Background: Children with acute febrile illness with no localizing signs often receive antibiotics empirically in most resource-poor settings. However, little is known about the burden of bacteremia in this category of patients, and an appraisal is thus warranted. This will guide clinical practice and promote rational antibiotics use.

Methods: We prospectively followed up 140 under-five children who presented with acute undifferentiated fever at the emergency/outpatient pediatric unit of a secondary healthcare facility. Baseline clinical and laboratory information was obtained and documented in a structured questionnaire. We compared baseline characteristics between participants with bacteremia and those without bacteremia. We further fitted a multivariable logistic regression model to identify factors predictive of bacteremia among the cohort.

Result: The prevalence of bacteremia was 17.1%, and Salmonella Typhi was the most frequently (40.9%) isolated pathogen. The majority (78.6%) of the study participants were managed as outpatients. The participants who required admission were four times more likely to have bacteremia when compared to those managed as outpatients (AOR 4.08, 95% CI 1.19 to 14.00). There is a four times likelihood of bacteremia (AOR 4.75, 95% CI 1.48 to 15.29) with a fever duration of beyond 7 days. Similarly, participants who were admitted with lethargy were six times more likely to have bacteremia (AOR 6.20, 95% CI 1.15 to 33.44). Other significant predictors were tachypnea and lymphopenia.

Conclusion: Among under-five children with acute undifferentiated fever, longer duration of fever, lethargy, inpatient care, tachypnea, and lymphopenia were the significant predictors of bacteremia.

Keywords: Salmonella; acute undifferentiated fever; bacteraemia; lethargy; lymphopenia; under-five children.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Summary of subject recruitment and outcome.
Figure 2
Figure 2
Cluster bar chart showing the relationship between the duration of fever and the occurrence of bacteremia.
See this image and copyright information in PMC

References

    1. Long SS. Diagnosis and management of undifferentiated fever in children. J Infect. (2016) 20:1–9. 10.1016/j.jinf.2016.04.025 - DOI - PubMed
    1. Kashinkunti MD, Gundikeri SK, Dhananjaya M. Acute undifferentiated febrile illness- clinical spectrum and outcome from a tertiary care teaching hospital of north Karnataka. Int J Biol Med Res. (2013) 3:3399–402.
    1. Al-Eissa YA, Sameeh SG, Al-Zamil FA, Al-Salloum AA, Al-Omair AO, Al-Nasser MN. Pattern of febrile illnesses in children seen at a pediatric ambulatory care setting. J Fam Community Med. (2000) 7:61–5. - PMC - PubMed
    1. Díez-Padrisa N, Bassat Q, Roca A. Serum biomarkers for the diagnosis of malaria, bacterial and viral infections in children living in malaria-endemic areas. Drugs Today. (2011) 47:63–75. 10.1358/dot.2011.47.1.1534821 - DOI - PubMed
    1. Egbe CA, Enabulele OI. Aetiologic agents of fevers of unknown origin among patients in Benin City, Nigeria. Malays J Med Sci. (2014) 21:37–43. - PMC - PubMed

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