Management of febrile illness in rural Guinea over a seven-year period: A retrospective study.

Autor:	Kourouma K; Centre National de Formation et de Recherche en Santé Rurale de Maferinyah (CNFRSR) Forécariah, Maferinyah, Guinea., Grovogui FM; Centre National de Formation et de Recherche en Santé Rurale de Maferinyah (CNFRSR) Forécariah, Maferinyah, Guinea., Delamou A; Centre National de Formation et de Recherche en Santé Rurale de Maferinyah (CNFRSR) Forécariah, Maferinyah, Guinea.; Africa Centre of Excellence for Prevention and Control of Transmissible Diseases (CEA-PCMT), University Gamal Abdel Nasser of Conakry, Conakry, Guinea., Chérif MS; Centre National de Formation et de Recherche en Santé Rurale de Maferinyah (CNFRSR) Forécariah, Maferinyah, Guinea.; Regional Direction of Health, Faranah, Guinea., Ingelbeen B; Department of Public Health, Institute of Tropical Medicine (ITM), Antwerp, Belgium., Beavogui AH; Centre National de Formation et de Recherche en Santé Rurale de Maferinyah (CNFRSR) Forécariah, Maferinyah, Guinea., van Griensven J; Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp, Belgium., Bottieau E; Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp, Belgium.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2022 Oct 12; Vol. 2 (10), pp. e0001133. Date of Electronic Publication: 2022 Oct 12 (Print Publication: 2022).
DOI:	10.1371/journal.pgph.0001133
Abstrakt:	Introduction: 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. Materials and Methods: 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). Results: 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. Conclusions: 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. Competing Interests: The authors declare that they have no competing interests. (Copyright: © 2022 Kourouma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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