Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE): protocol for a multisite prospective observational study of the causes of fever in Africa and Asia. Issue 7 (21st July 2020)

• Record Type: Journal Article
• Authors: Hopkins, Heidi; Bassat, Quique; Chandler, Clare IR; Crump, John A; Feasey, Nicholas A; Ferrand, Rashida A; Kranzer, Katharina; Lalloo, David G; Mayxay, Mayfong; Newton, Paul N; Mabey, David
• Other Names: author non-byline.; Amos Benjamin author non-byline.; Bell David author non-byline.; Blacksell Stuart D author non-byline.; Bradley John author non-byline.; Chandler Clare IR author non-byline.; Chansamouth Vilada author non-byline.; Chimenya Mabvuto author non-byline.; Craig Scott B author non-byline.; Dance David AB author non-byline.; Dauya Ethel author non-byline.; Lamballerie Xavier de author non-byline.; Graves Stephen R author non-byline.; Green Edward W author non-byline.; Haigh Kate A author non-byline.; Handley Becca L author non-byline.; Hibberd Martin L author non-byline.; Hutchison Coll D author non-byline.; Jones Jayne author non-byline.; Kain Kevin C author non-byline.; Lal Pankaj author non-byline.; Lal Sham author non-byline.; Lubell Yoel author non-byline.; MacPherson Eleanor author non-byline.; Marlais Tegwen author non-byline.; Maurer Florian P author non-byline.; Olaru Ioana D author non-byline.; Parry Christopher M author non-byline.; Roberts Chrissy h author non-byline.; Stenos John author non-byline.; Tembe Nelson author non-byline.; Ussher James E author non-byline.; Valente Marta author non-byline.; Vitorino Pio author non-byline.; Voice Marie A author non-byline.; Joseph Wheat L author non-byline.; Dixon Justin author non-byline.; Dubot-Pérès Audrey author non-byline.; Durkin Michelle M author non-byline.; Fink Colin author non-byline.; Fitzgerald Felicity C author non-byline.;
• Is Part Of: BMJ open. Volume 10:Issue 7(2020)
• Publication Date: 2020-07-21
• Subjects: epidemiology -- infectious diseases -- public health -- tropical medicine -- diagnostic microbiology; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2019-035632
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Introduction: Fever commonly leads to healthcare seeking and hospital admission in sub-Saharan Africa and Asia. There is only limited guidance for clinicians managing non-malarial fevers, which often results in inappropriate treatment for patients. Furthermore, there is little evidence for estimates of disease burden, or to guide empirical therapy, control measures, resource allocation, prioritisation of clinical diagnostics or antimicrobial stewardship. The Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) study seeks to address these information gaps. Methods and analysis: FIEBRE investigates febrile illness in paediatric and adult outpatients and inpatients using standardised clinical, laboratory and social science protocols over a minimum 12-month period at five sites in sub-Saharan Africa and Southeastern and Southern Asia. Patients presenting with fever are enrolled and provide clinical data, pharyngeal swabs and a venous blood sample; selected participants also provide a urine sample. Laboratory assessments target infections that are treatable and/or preventable. Selected point-of-care tests, as well as blood and urine cultures and antimicrobial susceptibility testing, are performed on site. On day 28, patients provide a second venous blood sample for serology and information on clinical outcome. Further diagnostic assays are performed at international reference laboratories. Blood and pharyngeal samples from matched community controls enable calculation of AFs, and surveys of treatment seeking allow estimation of the incidence of common infections. Additional assays detect markers that may differentiate bacterial from non-bacterial causes of illness and/or prognosticate illness severity. Social science research on antimicrobial use will inform future recommendations for fever case management. Residual samples from participants are stored for future use. Ethics and dissemination: Ethics approval was obtained from all relevant institutional and national committees; written informed consent is obtained from all participants or parents/guardians. Final results will be shared with participating communities, and in open-access journals and other scientific fora. Study documents are available online (https://doi.org/10.17037/PUBS.04652739 ).