Management of febrile illness in rural Guinea over a seven-year period: A retrospective study.
<h4>Introduction</h4>Febrile illnesses constitute a major clinical challenge in tropical settings. We aimed to assess the frequency, presentation and management of febrile illness at two health facilities in Forécariah, Guinea, with a focus on appropriateness of antibiotic prescription.&...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0001133 |
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| author | Karifa Kourouma Fassou Mathias Grovogui Alexandre Delamou Mahamoud Sama Chérif Brecht Ingelbeen Abdoul Habib Beavogui Johan van Griensven Emmanuel Bottieau |
| author_facet | Karifa Kourouma Fassou Mathias Grovogui Alexandre Delamou Mahamoud Sama Chérif Brecht Ingelbeen Abdoul Habib Beavogui Johan van Griensven Emmanuel Bottieau |
| author_sort | Karifa Kourouma |
| collection | DOAJ |
| description | <h4>Introduction</h4>Febrile illnesses constitute a major clinical challenge in tropical settings. We aimed to assess the frequency, presentation and management of febrile illness at two health facilities in Forécariah, Guinea, with a focus on appropriateness of antibiotic prescription.<h4>Materials and methods</h4>This was a retrospective study conducted in patient files in a health center and a district hospital. Proportions of antibiotic prescription were determined by age group and syndromes as well as appropriateness of antibiotic prescription using the WHO model list (2019).<h4>Results</h4>From 2014 to 2020, 23,583 of 62,185 (38.0%) visits were related to febrile illness. Most patients with fever were female (56.1%) and evaluated at the health center (81.0%). Gastrointestinal (40.6%) and respiratory syndromes (36.8%), and undifferentiated fever (30.0%) were the most common presentations. Malaria was confirmed in 61.3% of the cohort. Overall, the rate of antibiotic prescription was high (14,834/23,583, 62.9%), mostly among patients aged <5 years (5,285/7,566, 69.9%), those with respiratory (7,577/8,684, 87.3%) and gastrointestinal (6,324/9,585, 66.0%) syndromes. Moreover, 7,432/14,465 (51.4%) patients with malaria were also prescribed an antibiotic. Penicillin (42.0%), cotrimoxazole (26.3%) and quinolones (18.7%) were the most frequently prescribed antibiotics. Overall, appropriateness of antibiotic prescription was low (38.3%), and even more so in patients with respiratory (29.1%) and gastrointestinal (25.8%) syndromes.<h4>Conclusions</h4>Febrile illness is a major cause of consultation in rural Guinea. Rate of antibiotic prescription was high, even in confirmed malaria and was often considered inappropriate. There is a pressing need to investigate the etiological spectrum and improve the diagnostic approach of febrile illness in Guinea. |
| first_indexed | 2024-03-12T03:22:44Z |
| format | Article |
| id | doaj.art-1d7526976b1a4f1eb43dcafab4c5ab5b |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T03:22:44Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLOS Global Public Health |
| spelling | doaj.art-1d7526976b1a4f1eb43dcafab4c5ab5b2023-09-03T13:45:25ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-01210e000113310.1371/journal.pgph.0001133Management of febrile illness in rural Guinea over a seven-year period: A retrospective study.Karifa KouroumaFassou Mathias GrovoguiAlexandre DelamouMahamoud Sama ChérifBrecht IngelbeenAbdoul Habib BeavoguiJohan van GriensvenEmmanuel Bottieau<h4>Introduction</h4>Febrile illnesses constitute a major clinical challenge in tropical settings. We aimed to assess the frequency, presentation and management of febrile illness at two health facilities in Forécariah, Guinea, with a focus on appropriateness of antibiotic prescription.<h4>Materials and methods</h4>This was a retrospective study conducted in patient files in a health center and a district hospital. Proportions of antibiotic prescription were determined by age group and syndromes as well as appropriateness of antibiotic prescription using the WHO model list (2019).<h4>Results</h4>From 2014 to 2020, 23,583 of 62,185 (38.0%) visits were related to febrile illness. Most patients with fever were female (56.1%) and evaluated at the health center (81.0%). Gastrointestinal (40.6%) and respiratory syndromes (36.8%), and undifferentiated fever (30.0%) were the most common presentations. Malaria was confirmed in 61.3% of the cohort. Overall, the rate of antibiotic prescription was high (14,834/23,583, 62.9%), mostly among patients aged <5 years (5,285/7,566, 69.9%), those with respiratory (7,577/8,684, 87.3%) and gastrointestinal (6,324/9,585, 66.0%) syndromes. Moreover, 7,432/14,465 (51.4%) patients with malaria were also prescribed an antibiotic. Penicillin (42.0%), cotrimoxazole (26.3%) and quinolones (18.7%) were the most frequently prescribed antibiotics. Overall, appropriateness of antibiotic prescription was low (38.3%), and even more so in patients with respiratory (29.1%) and gastrointestinal (25.8%) syndromes.<h4>Conclusions</h4>Febrile illness is a major cause of consultation in rural Guinea. Rate of antibiotic prescription was high, even in confirmed malaria and was often considered inappropriate. There is a pressing need to investigate the etiological spectrum and improve the diagnostic approach of febrile illness in Guinea.https://doi.org/10.1371/journal.pgph.0001133 |
| spellingShingle | Karifa Kourouma Fassou Mathias Grovogui Alexandre Delamou Mahamoud Sama Chérif Brecht Ingelbeen Abdoul Habib Beavogui Johan van Griensven Emmanuel Bottieau Management of febrile illness in rural Guinea over a seven-year period: A retrospective study. PLOS Global Public Health |
| title | Management of febrile illness in rural Guinea over a seven-year period: A retrospective study. |
| title_full | Management of febrile illness in rural Guinea over a seven-year period: A retrospective study. |
| title_fullStr | Management of febrile illness in rural Guinea over a seven-year period: A retrospective study. |
| title_full_unstemmed | Management of febrile illness in rural Guinea over a seven-year period: A retrospective study. |
| title_short | Management of febrile illness in rural Guinea over a seven-year period: A retrospective study. |
| title_sort | management of febrile illness in rural guinea over a seven year period a retrospective study |
| url | https://doi.org/10.1371/journal.pgph.0001133 |
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