Trends in Acute Undifferentiated Febrile Illness in Patients Seeking Treatment from a Tertiary Care Hospital of Central Kerala

Abstract

Reshmi Ramachandran1, Jeena Ramesh2, Bindhu Vasudevan3

BACKGROUND
Acute undifferentiated febrile illness (AUFI / AFI) is one of the most common
reasons for people seeking medical care globally. Investigation into the aetiology
and trends in AUFI cases are valuable public health data source. Absence of such
evidence-based data may result in unintended public health consequences.
Present study was undertaken to address the gap in period specific trends in AUFI
cases reported from the region.
METHODS
A record based descriptive study was done in patients treated with AUFI from
January 1st, 2015 to December 31st, 2019 in Government Medical College,
Ernakulam. Universal sampling technique was adopted, and the data was entered
in Microsoft Excel and analysed using Epi-Info software. Line diagram was
constructed to obtain the trends in AUFI cases over the five-year period. Chisquare
test was applied to find out the association between age group (paediatric
and others) and causative agents of AUFI.
RESULTS
A total of 7998 AUFI cases were included in this study. Highest number of AUFI
cases (1986) was reported in the year 2017. Under five age group was the most
common, 1564 (19.6 %). Majority of the AUFI were reported among males, 4947
(61.9 %). Undetermined fever was found to be the most common AUFI, 2188
(27.4 %). Dengue fever, 1993 (24.9 %) was the most diagnosed AUFI. Viral
aetiology was found to be the most common, 3895 (48.7 %) in both paediatric
and other age groups. No statistically significant association was found between
(P-value = 0.22) age group and organisms causing AUFI. There were 121 (1.5 %)
deaths reported among the AUFI cases during the five-year period. It was seen
that the case fatality due to AUFI was highest (2.41 %) in the year 2019.
CONCLUSIONS
A lack of consistent pattern in the aetiology of AUFI cases reported over the fiveyear
study period, calls for persistent vigil by the public health surveillance system
in the region, to identify any impending infectious disease outbreak at the earliest.
As this study is based on hospital-based surveillance record it can underestimate
the disease incidence.

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