ArticlePLoS neglected tropical diseases2013
Etiology of severe non-malaria febrile illness in Northern Tanzania: a prospective cohort study.
Article in PLoS neglected tropical diseases, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 282 papers, 9 of them syntheses that pooled it.
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Who cites it
282 citing papers in PubMed, 9 syntheses or guidelines pooled it, 431 citations in OpenAlex.
- Etiologies of community-acquired febrile illness identified by TaqMan Array Card qPCR on blood samples: a systematic review and meta-analysis.Journal of clinical microbiology · 2026Pooled it
- Neglected etiologies of prolonged febrile illnesses in tropical and subtropical regions: A systematic review.PLoS neglected tropical diseases · 2024Pooled it
- Prevalence of fever of unidentified aetiology in East African adolescents and adults: a systematic review and meta-analysis.Infectious diseases of poverty · 2023Pooled it
- A systematic review and meta-analysis of the epidemiology of Leptospirosis in HIV uninfected and in people living with HIV from the Southern African Development Community.PLoS neglected tropical diseases · 2022Pooled it
- Epidemiology of leptospirosis in Tanzania: A review of the current status, serogroup diversity and reservoirs.PLoS neglected tropical diseases · 2021Pooled it
- Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Africa, 1980-2015.BMC medicine · 2020Pooled it
- Zoonotic causes of febrile illness in malaria endemic countries: a systematic review.The Lancet. Infectious diseases · 2020Pooled it
- Aetiology and outcomes of sepsis in adults in sub-Saharan Africa: a systematic review and meta-analysis.Critical care (London, England) · 2019Pooled it
- Diagnostic accuracy of leptospirosis whole-cell lateral flow assays: a systematic review and meta-analysis.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2019Pooled it
- Causes of death after biannual azithromycin treatment: A community-level randomized clinical trial.PloS one · 2021Trial
- Prevalence and speciation of brucellosis in febrile patients from a pastoralist community of Tanzania.Scientific reports · 2020Trial
- Trial
- Universal versus conditional day 3 follow-up for children with non-severe unclassified fever at the community level in Ethiopia: A cluster-randomised non-inferiority trial.PLoS medicine · 2018Trial
- Trial
- Dengue virus infection.Nature reviews. Disease primers · 2026Review
- Age-Related and Seasonal Variation in Malaria and Other Causes of Fever and Their Association With Clinical Outcomes in Southern Angola: A Hospital-Based Study.Tropical medicine & international health : TM & IH · 2026Article
- Brucellosis in the One Health Context: Gaps in Diagnosis, Control, and Global Epidemiology.Journal of epidemiology and global health · 2026Review
- Measles Without Rash During Acute Febrile Illness Surveillance in Tanzania, 2023-2024.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Cow Milk Risk Factors Associated With Bacterial Contaminations Along Dairy Value Chain in Lushoto and Handeni Districts, Tanzania.Veterinary medicine and science · 2026Article
- Crimean-Congo Hemorrhagic Fever Virus in Africa: Epidemiological Trends, Transmission Ecology, Hotspot Heterogeneity, and Preparedness Challenges-A Narrative Review.Tropical medicine and infectious disease · 2026Review
222 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 8 institutions in 5 countries.
Funding
Abstract
introductionThe syndrome of fever is a commonly presenting complaint among persons seeking healthcare in low-resource areas, yet the public health community has not approached fever in a comprehensive manner. In many areas, malaria is over-diagnosed, and patients without malaria have poor outcomes. METHODS AND
findingsWe prospectively studied a cohort of 870 pediatric and adult febrile admissions to two hospitals in northern Tanzania over the period of one year using conventional standard diagnostic tests to establish fever etiology. Malaria was the clinical diagnosis for 528 (60.7%), but was the actual cause of fever in only 14 (1.6%). By contrast, bacterial, mycobacterial, and fungal bloodstream infections accounted for 85 (9.8%), 14 (1.6%), and 25 (2.9%) febrile admissions, respectively. Acute bacterial zoonoses were identified among 118 (26.2%) of febrile admissions; 16 (13.6%) had brucellosis, 40 (33.9%) leptospirosis, 24 (20.3%) had Q fever, 36 (30.5%) had spotted fever group rickettsioses, and 2 (1.8%) had typhus group rickettsioses. In addition, 55 (7.9%) participants had a confirmed acute arbovirus infection, all due to chikungunya. No patient had a bacterial zoonosis or an arbovirus infection included in the admission differential diagnosis.
conclusionsMalaria was uncommon and over-diagnosed, whereas invasive infections were underappreciated. Bacterial zoonoses and arbovirus infections were highly prevalent yet overlooked. An integrated approach to the syndrome of fever in resource-limited areas is needed to improve patient outcomes and to rationally target disease control efforts.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.