Aetiological profile of fever in neonatal and paediatric population in hospital setting

Authors

  • Amitabh Dwivedi Department of Pediatrics, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20190738

Keywords:

Aetiology, Dengue, Fever, Malaria, Neonates, Pediatric population, Viral fever

Abstract

Background: Febrile illness in children is a common cause of admission to hospital globally, with significant associated morbidity and mortality. Dengue, malaria, scrub typhus, typhoid and leptospirosis have been identified as major causes of acute undifferentiated febrile illness in Thailand, Malaysia, and Nepal. Climate variation, over population and urbanization may all contribute to the emergence and reemergence of infections in tropical regions like Tamil Nadu. The objectives of this study were to describe the aetiology of fever in hospitalized neonatal and Pediatric population. A descriptive study was designed.

Methods: A prospective observational study was conducted. All children from 0 to 18 years admitted as in-patients. Sample size was calculated to be 650. Basic laboratory tests were done in all cases.

Results: Out of a total of 650 children maximum number (40.7% n=265) of patients had short duration of fever between 1 to 3 days. Majority (56%) of patients had temperature between 100.4 to 101F. Only 5 children were confirmed to have malaria. Maximum number of pus cells found was 80 to 100 in 3 children in urine examination. Total Infectious cases were 631 (97.07%).

Conclusions: Infectious aetiology was more common than non-infectious aetiology. Among all aetiologies, viral fever particularly dengue was the most common aetiology. Enteric fever was the second most common infectious cause of fever after viral fever.  Short febrile illness (1 to 5 days) was the most common type of fever in children admitted in hospital. In neonates, the most common cause of fever was probable sepsis followed by dehydration fever.

References

Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379(9832):2151-61.

Bhutta Z, Ali S, Cousens S, Ali T, Haider B, Rizvi A et al. Interventions to address maternal, newborn, and child survival: what difference can integrated primary health care strategies make?. Lancet. 2008;372(9642):972-89.

Peacock SJ, Newton PN. Public health impact of establishing the cause of bacterial infections in rural Asia. Transactions Royal Society Tropical Med Hygiene. 2008;102(1):5-6.

Deen J, von Seidlein L, Andersen F, Elle N, White N, Lubell Y. Community-acquired bacterial bloodstream infections in developing countries in south and southeast Asia: a systematic review. Lancet Infectious Dis. 2012;12(6):480-7.

World Health Organization. The 10 leading causes of death by broad income group (2008). Fact sheet. 2011; (310).

Chaturvedi H, Mahanta J, Pandey A. Treatment-seeking for febrile illness in north-east India: an epidemiological study in the malaria endemic zone. Malaria J. 2009;8(1):301.

Leelarasamee A, Chupaprawan C, Chenchittikul M, Udompanthurat S. Etiologies of acute undifferentiated febrile illness in Thailand. J Med Assoc Thai. 2004;87(5):464-7

Sripanidkulchai R, Lumbiganon P. Etiology of obscure fever in children at a university hospital in northeast Thailand. Southeast Asian J Tropical Med Public Health. 2005;36(5):1243.

Murdoch DR, Woods CW, Zimmerman MD, Dull PM, Belbase RH, Keenan AJ, et al. The etiology of febrile illness in adults presenting to Patan hospital in Kathmandu, Nepal. Am J Tropical Med hygiene. 2004;70(6):670-5.

Ellis RD, Fukuda MM, McDaniel P, Welch K, Nisalak A, Murray CK, et al. Causes of fever in adults on the Thai-Myanmar border. Am J Tropical Med Hygiene. 2006;74(1):108-13.

Pradutkanchana J, Pradutkanchana S, Kemapanmanus M, Wuthipum N, Silpapojakul K. The etiology of acute pyrexia of unknown origin in children after a flood. Southeast Asian J Trop Med Public Health. 2003;34(1):175-8.

Mushtaq MB, Qadri MI, Rashid A. Concurrent infection with dengue and malaria: an unusual presentation. Case Reports Med. 2013;2013.

Ittyachen AM, Ramachandran R. Study of acute febrile illness: a 10-year descriptive study and a proposed algorithm from a tertiary care referral hospital in rural Kerala in Southern India. Tropical Doctor. 2015 ;45(2):114-7.

Singh PK, Dhiman RC. Climate change and human health: Indian context. J Vector Borne Dis. 2012;49(2):55.

Singh R. A study of Etiological Pattern in an Epidemic of Acute Febrile Illness During Monsoon in a Tertiary Health Care Institute of Uttarakhand, India. J Clinical Diagnostic Res. 2014.

Chheng K, Carter MJ, Emary K, Chanpheaktra N, Moore CE, Stoesser N, et al. A prospective study of the causes of febrile illness requiring hospitalization in children in Cambodia. Plos One. 2013;8(4):e60634.

Das D, Das B, Roy A, Singh T. Common Infectious Etiologies of Acute Febrile Illness in a Remote Geographical Location: Could Scrub Typhus be the Most Common Cause?. Brit J Medicine and Med Res. 2015;10(10):1-10.

Abrahamsen SK, Haugen CN, Rupali P, Mathai D, Langeland N, Eide GE, et al. Fever in the tropics: aetiology and case-fatality-a prospective observational study in a tertiary care hospital in South India. BMC Infectious Dis. 2013;13(1):1.

Mittal G. Aetiologies of Acute Undifferentiated Febrile illness in Adult Patients-an Experience from a Tertiary Care Hospital in Northern India. J Clinical Diagnostic Research. 2015.

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Published

2019-02-23

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Original Research Articles