Etiologies of Fever Among Adults in Dar es Salaam

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01947075
Recruitment Status : Completed
First Posted : September 20, 2013
Last Update Posted : August 21, 2014
Ifakara Health Institute
Information provided by (Responsible Party):
Valérie D'Acremont, Swiss Tropical & Public Health Institute

September 13, 2013
September 20, 2013
August 21, 2014
July 2013
July 2014   (Final data collection date for primary outcome measure)
Proportion of patients with each disease among all febrile patients, overall and stratified by HIV status [ Time Frame: 1 year ]
Description of the distribution of causes of fever based on pre-defined case definitions for each disease.
Same as current
Complete list of historical versions of study NCT01947075 on Archive Site
Proportion of febrile patients with acute respiratory infection infected with a certain respiratory pathogen, compared to the proportion of healthy controls infected with the same pathogen. [ Time Frame: 1 year ]
Nasopharyngeal respiratory viruses and bacteria documentation (presence/absence as well as pathogen loads) will be compared between patients with acute respiratory infection and a control group of healthy volunteers
Same as current
Strength of association between each febrile disease and diabetes mellitus and between acute respiratory infections and indoor air pollution [ Time Frame: 1 year ]
Screening of diabetes mellitus and screening of exposure to indoor air pollution will be performed among patients with fever. The strength of association between diabetes and each type of febrile disease and exposure to indoor air pollution and acute respiratory infections will be measured.
Same as current
Etiologies of Fever Among Adults in Dar es Salaam
Etiologies of Acute Febrile Illness Among Adults Attending an Outpatient Department in Dar es Salaam

Following the decline of malaria in Sub-Saharan Africa, clinicians face febrile patients in whom an alternative diagnosis has to be made. This situation has led to an overuse of antibiotics by clinicians. It is crucial to increase knowledge on etiologies and risk factors of outpatient febrile illness in order to improve their management.

This present proposal aims to investigate the etiologies of fever among adult patients attending an outpatient department in urban Tanzania. It also aims to assess the clinical significance of nasopharyngeal (NP) respiratory viruses and bacteria documentation in this setting. Third, it aims to compare the spectrum of infections in this population with that of children included in the same setting in a previous study. The last objective is to assess diabetes mellitus (DM) as a risk factor for infection and exposure to indoor air pollution (IAP) as a risk factor for acute respiratory infections (ARI) in adults in Tanzania.

The investigators hypothesize that acute respiratory infections are the main cause of adult febrile illness in a urban low-income setting and that use of quantitative molecular assays on naso-oropharyngeal samples can improve the diagnosis of pneumonia. The investigators also think that the spectrum of infections is different between children and adults, mainly due to a high HIV prevalence in adults. The investigators also hypothesize that experiencing IAP and/ or DM is a risk factor for infections in adults.

Not Provided
Observational [Patient Registry]
Observational Model: Cohort
Time Perspective: Prospective
30 Days
Retention:   Samples With DNA
Whole blood Serum Sputa Urine
Probability Sample
Every consecutive adult with temperature ≥38°C attending the outpatient department of Mwananyamala Hospital will be screened for inclusion. Additional inclusion criteria are fever of ≤1 week duration and first consultation for the present problem. Exclusion criteria are refusal of HIV screening, main complaint is injury or trauma, antibiotic treatment during the previous week (apart from cotrimoxazole prophylaxis), delivery within the previous 6 weeks and hospitalization during the last month. Medical history will be taken (including exposure to IAP) and clinical examination will be done in a standardized way.
Acute Febrile Illnesses
Not Provided
  • Adults with fever
    Every adult with fever will be screened for different infectious diseases and for nasopharyngeal respiratory viruses and bacteria
  • Healthy volonteers
    For every adult with fever included with a diagnosis of pneumonia, a healthy volunteer will be included. These healthy volunteers will be screened for nasopharyngeal respiratory viruses and bacteria.
Boillat-Blanco N, Mbarack Z, Samaka J, Mlaganile T, Mamin A, Genton B, Kaiser L, Calandra T, D'Acremont V. Prognostic value of quickSOFA as a predictor of 28-day mortality among febrile adult patients presenting to emergency departments in Dar es Salaam, Tanzania. PLoS One. 2018 Jun 14;13(6):e0197982. doi: 10.1371/journal.pone.0197982. eCollection 2018.

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
July 2014
July 2014   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Temperature >=38°C
  • History of fever for less than 8 days
  • First consultation for the present problem

Exclusion Criteria:

  • Refusal of HIV screening
  • Main complaint is injury or trauma
  • Antibiotic treatment in the last 7 days
  • Within 6 weeks after delivery
  • Hospitalization during the last month
Sexes Eligible for Study: All
18 Years and older   (Adult, Older Adult)
Contact information is only displayed when the study is recruiting subjects
Fever Study
Adult Fever Study ( Other Identifier: SwissTPH )
Not Provided
Not Provided
Valérie D'Acremont, Swiss Tropical & Public Health Institute
Swiss Tropical & Public Health Institute
Ifakara Health Institute
Principal Investigator: Valerie D'Acremont, MD PhD Swiss Tropical & Public Health Institute
Swiss Tropical & Public Health Institute
August 2014