J. Evid. Based Med. Healthc., pISSN- 2349-2562, eISSN- 2349-2570/ Vol. 3/Issue 97/Dec. 05, 2016 Page 5340 NONMALARIAL ACUTE UNDIFFERENTIATED FEVER- DIAGNOSTIC UNCERTAINTY AND OVERTREATMENT WITH ANTIMALARIALS

Abstract

Madhuri Meena1, Rameshwar Prasad Gupta2, Subhash Chand Jain3, Uma Shankar Shukla4

BACKGROUND
Nonmalarial Acute Undifferentiated Fever (NMAUF) means a febrile illness with no indication of an organ-specific disease after exclusion of diagnosis of malaria. Empirical treatment of NMAUFs with antimalarial drugs continues despite the availability of highly specific Rapid Diagnostic Tests (RDTs) for malaria.
MATERIALS AND METHODS
This retrospective study was conducted in patients with fever admitted to Jhalawar Medical College Hospital, Jhalawar, Rajasthan. We categorised patients with NMAUF into different clinical syndromes and determined the pattern of antimalarial use. 1523 adult patients were investigated for malaria, 1355 (88.97%) of them had NMAUF.
RESULTS
Having negative tests for malaria, many patients (38.16%, 95% CI (31.0-39.5)) received antimalarial drugs. These results suggest a need to improve empiric treatment for NMAUF.
CONCLUSION
Most of the hospitalised patients with acute febrile illness do not have malaria, but received antimalarial therapy. There is a need to develop rapid antigen based tests, detection of pathogens responsible for NMAUFs, so that definitive causative organisms can be identified.

image