A Combined Syndromic Approach to Examine Viral, Bacterial, and Parasitic Agents among Febrile Patients: A Pilot Study in Kilombero, Tanzania

Hercik, Christine; Cosmas, Leonard; Mogeni, Ondari D.; Wamola, Newton; Kohi, Wanze; Houpt, Eric; Liu, Jie; Ochieng, Caroline; Onyango, Clayton; Fields, Barry; Mfinanga, Sayoki; Montgomery, Joel M.

We detected multiple agents in a significant proportion of febrile participants (96; 50%). Of those agents commonly codetected, we detected Plasmodium, H. influenzae, and M. catarrhalis as the most frequent combination among febrile patients (9; 7.8%). These findings are consistent with a recent study in understanding the etiology of AFI among children in the northeastern part of Tanzania, whereby coinfections were observed in about a quarter of all febrile patients. 40 The coexistence of multiple infectious organisms can serve as an obstacle in developing fever management guidelines, particularly in poor rural areas of sub-Saharan Africa where patients tend to suffer from numerous kinds of concurrent infections. 40 While this study provided a preliminary landscape of the range of biological agents copresenting among febrile patients, a deeper understanding of both the prevalence as well as clinical ramifications of this circumstance will be critical for developing appropriate care and treatment guidelines for these individuals.