ArticleBMC infectious diseases2022
Clinical management and outcomes of acute febrile illness in children attending a tertiary hospital in southern Ethiopia.
Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 7 citations in OpenAlex.
- Practices and challenges related to management of chikungunya and non-malarial acute febrile illnesses in malaria-endemic areas of Afar region, Northeast Ethiopia.BMC health services research · 2026Article
- Antimalarial drug prescriptions and clinical outcomes of febrile children in Arba Minch City, South Ethiopia.Malaria journal · 2025Article
- Article
- Health facility-based prevalence of typhoid fever, typhus and malaria among individuals suspected of acute febrile illnesses in Southwest Region, Ethiopia.Frontiers in epidemiology · 2024Article
- Detection of dengue virus infection in children presenting with fever in Hawassa, southern Ethiopia.Scientific reports · 2023Article
- Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia.Scientific reports · 2022Article
- Timely health care seeking and first source of care for acute febrile illness in children in Hawassa, southern Ethiopia.PloS one · 2022Article
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Authors and funding
9 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of febrile illnesses is challenging in settings where diagnostic laboratory facilities are limited, and there are few published longitudinal data on children presenting with fever in such settings. We have previously conducted the first comprehensive study of infectious aetiologies of febrile children presenting to a tertiary care facility in Ethiopia. We now report on clinicians' prescribing adherence with guidelines and outcomes of management in this cohort.
methodsWe consecutively enrolled febrile children aged 2 months and under 13 years, who were then managed by clinicians based on presentation and available laboratory and radiologic findings on day of enrolment. We prospectively collected outcome data on days 7 and 14, and retrospectively evaluated prescribing adherence with national clinical management guidelines.
resultsOf 433 children enrolled, the most common presenting syndromes were pneumonia and acute diarrhoea, diagnosed in 177 (40.9%) and 82 (18.9%), respectively. Antibacterial agents were prescribed to 360 (84.7%) of 425 children, including 36 (34.0%) of 106 children without an initial indication for antibacterials according to guidelines. Antimalarial drugs were prescribed to 47 (11.1%) of 425 children, including 30 (7.3%) of 411 children with negative malaria microscopy. Fever had resolved in 357 (89.7%) of 398 children assessed at day 7, and in-hospital death within 7 days occurred in 9 (5.9%) of 153 admitted patients. Among children with pneumonia, independent predictors of persisting fever or death by 7 days were young age and underweight for age. Antibacterial prescribing in the absence of a guideline-specified indication (overprescribing) was more likely among infants and those without tachypnea, while overprescribing antimalarials was associated with older age, anaemia, absence of cough, and higher fevers.
conclusionOur study underscores the need for improving diagnostic support to properly guide management decisions and enhance adherence by clinicians to treatment guidelines.
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