Identification Of Pathogens Potentially Associated With Non-Malarial Fever In Children: A Pilot Study In Peri-Urban Dakar, Senegal

Fever is one of the most common reasons for pediatric consultation in Africa. Malaria incidence has now dropped considerably, yet etiologies of non-malarial febrile diseases are poorly documented. This pilot study aimed to 1) identify pathogens potentially associated with non-malarial fever in children younger than 10 years in the suburbs of Dakar and 2) describe the epidemiological characteristics of these patients. During the study period, all eligible children (< 10 years of age, body temperature 3 38 degrees C, negative result for the malaria rapid diagnostic test, living in Guediawaye/Pikine for the previous four calendar months, not receiving any anti-infectious treatment since the onset of fever, and with parent's consent to participate) presenting to the health post in Medina Gounass located in Guediawaye on Mondays and Fridays were included. In total, 106 children participated in the study, and PCR from nasopharyngeal swabs, hemoculture, C-reactive protein, blood cell counts, and quantitative buffy coat from blood samples and coproculture from stool samples were performed. In 70 (66%) children, at least one pathogen was isolated. Viruses were identified in 55 children, most commonly enteroviruses, rhinoviruses, and adenoviruses, and dengue virus was identified in three children. Only five children had bacterial infections, and 10 had bacterial and viral coinfections. Ninety-seven children (92%) received prescription for antibiotics. Many strains of bacteria were found to be resistant to several antibiotics. Despite limitations, this pilot study showed that pathogens potentially associated with non-malarial fever in children younger than 10 years near Dakar were predominantly viruses, most commonly upper respiratory infections, although bacteria accounted for a small proportion.In Africa, fever is one of the most frequent reasons for pediatric consultation and has been traditionally associated with malaria. As a result of improved malaria control in subSaharan African countries, the incidence of malaria has considerably decreased, leading to a reduction in the proportion of febrile illnesses attributable to malaria.1 However, the etiologies of non-malarial febrile diseases, including typhoid fever, pneumococcal bacteremia, influenza, yellow fever, dengue fever, or tick-borne fever (like borreliosis),2,3 are poorly documented because of the unavailability and/or high cost of diagnostic tests. For several decades, the public health measures introduced