ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
Measles Without Rash During Acute Febrile Illness Surveillance in Tanzania, 2023-2024.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Measles: An Updated Literature Review of the Host Response, Pathogenesis, Complications, Prevention Measures, and Recent Outbreaks.Current issues in molecular biology · 2026Review
- Factors associated with laboratory-confirmed measles cases during the 2023 and 2024 outbreaks in Tanzania-a mixed-methods study.Frontiers in public health · 2026Article
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13 authors.
Funding
Abstract
backgroundThe leading causes of fever requiring hospital admission in rural sub-Saharan Africa remain understudied, particularly using modern molecular diagnostics.
methodsWe enrolled 258 patients with acute fever (cases) and 48 controls admitted to 1 hospital in Tanzania for 1 year starting in February 2023. Blood was tested by blood culture, polymerase chain reaction (PCR) for 35 pathogens, and serology for 6 pathogens.
resultsThe leading pathogen detected in cases was measles, with 70 of 258 cases detected by PCR, 74 of 238 by immunoglobulin M serology, and 91 allowing either method. Other pathogens were detected in <5% of cases including, in descending order, Plasmodium, Schistosoma, and Bartonella, among others. Measles was the only pathogen clearly associated with cases versus controls. Of 91 measles cases, only 58 (64%) were clinically suspected and only 56 (62%) met the World Health Organization definition of a clinical measles case, largely because 27 (30%) measles cases did not have recorded rash. Outcomes were poorer for measles without rash versus with rash, with a longer hospital stay (mean, 5.5 vs 3.3 days; P = .010), less full recovery (48% vs 75%; P = .016), and high mortality (7% vs 2%; P = .20). Increased laboratory testing would have detected measles 2 months prior to the first clinical suspicion.
conclusionsMeasles was found to be the leading cause of fever during 1 year of acute febrile illness surveillance in rural Tanzania. Measles can present without notable rash in these settings and has poor outcomes. Increasing laboratory test availability and clinician suspicion for measles is a priority.
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