International Journal of Medicine and Medical Sciences
Subscribe to IJMMS
Full Name*
Email Address*

Article Number - 21182F963402


Vol.9(4), pp. 33-40 , April 2017
DOI: 10.5897/IJMMS2016.1259
ISSN: 2006-9723



Full Length Research Paper

The assessment of fever in under-five children in the Ekounou Health Area of Yaounde, Cameroon: Usefulness of rapid diagnostic tests



Barbara Mma Atogho Tiedeu*
  • Barbara Mma Atogho Tiedeu*
  • Faculty of Science, University of Yaounde I, Cameroon.
  • Google Scholar
Liliane Mekue Tadjouo
  • Liliane Mekue Tadjouo
  • Faculty of Science, University of Yaounde I, Cameroon.
  • Google Scholar
Olivia Achonduh-Atijegbe
  • Olivia Achonduh-Atijegbe
  • Faculty of Science, University of Yaounde I, Cameroon.
  • Google Scholar
Olivier Tresor Donfack Sontsa
  • Olivier Tresor Donfack Sontsa
  • Faculty of Science, University of Yaounde I, Cameroon.
  • Google Scholar
Jean Claude Mbanya
  • Jean Claude Mbanya
  • Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon.
  • Google Scholar
Wilfred Fon Mbacham
  • Wilfred Fon Mbacham
  • Faculty of Science, University of Yaounde I, Cameroon.
  • Google Scholar







 Received: 25 July 2016  Accepted: 23 November 2016  Published: 30 April 2017

Copyright © 2017 Author(s) retain the copyright of this article.
This article is published under the terms of the Creative Commons Attribution License 4.0


Improper diagnosis and management of febrile patients results in the persistence of malaria and other conditions with similar symptoms. The algorithm established here with Rapid Diagnostic Tests (RDTs) will help in the follow-up and treatment of fever patients according to the guidelines on Integrated Management of Childhood Illness (IMCI). This study aimed at determining the causes of fever in children and at valorizing the use of RDTs for the diagnosis of febrile diseases. Fifty children with fever, aged between 0 and 5 years, were recruited in a cross-sectional study at the Ekounou Baptist Clinic in Yaounde. RDTs were used to assess for the four common causes of febrile illness in the area. Microscopy was done and the Plasmodium species were confirmed by nested Polymerase Chain Reaction (PCR). Of the 50 febrile children, none was rubella seropositive, while 8% had malaria, 22% had toxoplasmosis infection, 8% had Salmonella typhi, 14% had a malaria-typhoid fever co-infection, 4% had a malaria-toxoplasmosis co-infection, 6% had a malaria-toxoplasmosis-typhoid fever co-infection, and 38% were negative for all the suspected common causes of fever in the health district. The overall frequencies of occurrence attributed 32% to malaria, 32% to toxoplasmosis and 28% to typhoid fever. Among all the positive malaria cases (n=16 (32%)) Plasmodium falciparum, Plasmodium malariae and Plasmodium ovale were identified by nested PCR. Malaria RDT results agreed significantly with the microscopy (kappa=0.81; p<0.0001) and PCR (kappa=0.84; p<0.0001) results; and the microscopy results also concurred significantly with the PCR results (kappa=0.77; p<0.0001). Malaria was not the exclusive cause of fever. Toxoplasmosis was found to occur in the same proportion as malaria (32%) in the study population. S. typhi was the third most important infection. Therefore RDTs are appropriate tools for the management of childhood febrile diseases.

Key words: Fever, malaria, toxoplasmosis, typhoid, rubella, rapid diagnostic test (RDT), Cameroon.

Achonduh OA, Ekollo MAH, Atogho-Tiedeu B, Mbulli IA, Achinko D, Masumbe NP, Mbacham WF (2013). Predominance of Plasmodium malariae-falciparum co-infection by molecular speciation in Bangolan, North West Region of Cameroon. J. Life Sci. 7(6):599-606.

 

Amexo M, Tolhurst R, Barnish G, Bates I (2004). Malaria misdiagnosis: effects on the poor and vulnerable. Lancet 9948:1896-1898.
Crossref

 

Asad Y, Abuodeh, Basem S, Hatter (2006). Concurrent malaria and toxoplasmosis. A case report. J. Res. Med. Sci. 56:48-50.

 

Barnish G, Bates I, Iboro J (2004). Newer drug combinations for malaria. Br. Med. J. 328:1511-1512.
Crossref

 

Bastiaens GJ, Schaftenaar E, Ndaro A, Keuter M, Bousema T, Shekalaghe SA (2011). Malaria diagnostic testing and treatment practices in three different Plasmodium falciparum transmission settings in Tanzania: before and after a government policy change. Malar. J. pp. 10:76.

 

Bisoffi Z, Sirima BS, Angheben A, Lodesani C, Gobbi F, Tinto H, Van Den EJ (2009). Rapid malaria diagnostic tests vs. clinical management of malaria in rural Burkina Faso: safety and effect on clinical decisions. A randomized trial. Trop. Med. Intern. Health.14:491-498.
Crossref

 

Boonma P, Christensen PR, Suwanarusk R, Price RN, Russell B, Lek-Uthai U (2007).Comparison of three molecular methods for the detection and speciation of Plasmodium vivax and Plasmodium falciparum. Malar. J. pp. 6:124.

 

Bousema JT, Drakeley CJ, Mens PF, Arens T, Houben R, Omar SA, Gouagna LC, Schallig H, Sauerwein RW (2008). Increased Plasmodium falciparum gametocyte production in mixed infections with P. malariae. Am. J. Trop. Med. Hyg. 78:442-448.

 

Bouyou-Akotet M, Mawili-Mboumba DP, Kendjo E (2009). Evidence of decline of malaria in the General Hospital of Libreville, Gabon from 2000 to 2008. Malar. J. pp. 8:300.

 

Cheesbrough M (1998). Medical laboratory manual for tropical countries: Introduction to the laboratory and physiology. Clin. Chem. Parasitol. pp.1:167.

 

Delacollette C, D'Souza C, Christophe E (2009). Malaria trends and challenges in the greater Mekong subregion. Southeast Asian J. Trop. Med. Pub. Health. 40:674-691.

 

Faucher JF, Makoutode P, Abiou G, Béhéton T, Houzé P, Ouendo E, Houzé S, Deloron P, Cot M (2010). Can treatment of malaria be restricted to parasitologically confirmed malaria? A school-based study in Benin in children with and without fever. Malar. J.pp. 9:104.

 

Greenwood BM, Armstrong JRM (1998). Comparison of two simple methods for determining malaria parasite density. Trans. Roy. Soc. Trop. Med. Hyg. 85:186-188.
Crossref

 

Hogh B, Marbiah NT, Burghaus PA, Andersen PK (1995). Relationship between maternally derived anti-Plasmodium falciparum antibodies and risk of infection and disease in infants living in an area of Liberia, West Africa, in which malaria is highly endemic. Infect. Immunol. 63:4034-4038.

 

Ikeh EI, Teclaire NN (2008). Prevalence of malaria parasitaemia and associated factors in febrile under-5 children seen in primary health care centers in Jos, North Central Nigeria. Nigerian Postgrad. Med. J. 15:65-69.

 

Institut National de la Statistique (INS) (2010). Enquête camerounaise auprès des ménages (ECAM III). P 16.

 

Mangham LJ, Cundill B, Achonduh OA, Ambebila JN, Lele AK, Metoh TN, Ndive SN, Ndong IC, Nguela RL, Nji AM, Orang-Ojong B, Pamen-Ngako J, Wiseman V, Mbacham WF. (2012). Malaria prevalence and treatment of febrile patients at health facilities and medicine retailers in Cameroon. Trop. Med. Intern. Health 17(3):330-342.

 

Mazigo HD, Mbacham W, Ambrose EE, Kidenya BR, Kweka EJ (2011). Confirmed malaria cases among children under five with fever or history of fever in rural Tanzania. BioMed Central Res. Pediat. pp.4:359.

 

McKenzie EF, Prudhomme WA, Magill AJ, Russ FJ, Permpanich B, Lucas C, Gasser RA, Jr, Wongsrichanalai C (2005). White blood cell counts and malaria. J. Infect. Dis. 192(2):323-330.
Crossref

 

Michelson AD, Lammi AT (1984). Haemolytic anaemia associated with acquired toxoplasmosis. Australian Paed. J. 20(4):333-335.
Crossref

 

Msellem MI, Martensson A, Rotlland G, Bhattarai A, Stromberg J, Kahigwa E, Garcia M, Petzold M, Olumese P, Ali A, Bjorkman A (2009). Influence of a rapid malaria diagnostic test on treatment and health outcome in fever patients, Zanzibar: a crossover validation study. PlosMed. pp.6:100070
Crossref

 

Nankabirwa J, Zurovac D, Njogu JN, Rwakimari JB, Counihan H, Snow RW, Tibenderana JK (2009). Malaria misdiagnosis in Uganda – implications for policy change. Malar. J. pp.8:66.

 

Nnedu NO, Rimel B, Terry C, Jalloh-Vos H, Baryon B, Bausch GD (2010). Syndromic diagnosis of malaria in rural Sierra Leone and proposed additions to the national integrated management of childhood illness guidelines for fever. Am. J. Trop. Med. Hyg. 82:525-528.
Crossref

 

Oladipo OO, Wellington AO (2013). Overdiagnosis and overtreatment of malaria in children with fever in Lagos, Nigeria. Improv. Sci. Res. Network – Infect. Dis. 5:1-6.

 

Prasad N, Murdoch DR, Reyburn H, Crump JA (2015) Etiology of Severe Febrile Illness in Low- and Middle-Income Countries: A Systematic Review. PLoS ONE 10(6):e0127962.
Crossref

 

Programme National de Lutte contre le Paludisme-(PNLP) (2011). Plan stratégique national de lutte contre le paludisme au Cameroun.

 

Redd SC, Bloland PB, Kazembe PN, Patrick E, Tembenu R, Campbell CC (1992). Usefulness of clinical case-definitions in guiding therapy for African children with malaria or pneumonia. Lancet 340:1140-1143.
Crossref

 

Reyburn H, Mbakilwa H, Mwangi R, Mwerinde O, Olomi R, Drakeley C, Whitty CJM (2007). Rapid diagnostic tests compared with malaria microscopy for guiding outpatient treatment of febrile illness in Tanzania: randomized trial. British Med. J. pp. 334:403.

 

Rimon MM, Kheng S, Hoyer S, Thach V, Ly S, Permin AE, Pieche S (2003). Malaria dipsticks beneficial for ICI in Cambodia. Southeast Asian J. Trop. Med. Pub. Health 8:536-543.

 

Satoguina J, Walther B, Drakeley C (2009). Comparison of surveillance methods applied to a situation of low malaria prevalence at rural sites in the Gambia and Guinea Bissau. Malar. J. pp. 8:4-6.

 

Sayang C, Soula G, Tahar R, Basco L, De Gazin P, Moyou-Somo R, Delmont J (2009). Use of a Histidine-Rich Protein 2-based rapid diagnostic test for malaria by health personnel during routine consultation of febrile outpatients in a peripheral health facility in Yaoundé, Cameroon. Am. J. Trop. Med. Hyg. 81:343-347.

 

Snounou G, Viriyakosol S, Jarra W, Thaithong S, Brown KN (1993). Identification of the four human malaria parasite species in field samples by the polymerase chain reaction and detection of high prevalence of mixed infections. Mol. Biochem. Parasitol. 58:283-292.
Crossref

 

Swartout TD, Counihan H, Senga RK, Van den Broek I (2007). Paracheck-Pf accuracy and recently treated Plasmodium falciparum infections: Is there a risk of over-diagnosis? Malar. J. pp. 6:58.

 

Wang SJ, Lengeler C, Smith TA, Vounatsou P, Diadie DA, Pritroipa X, Convelbo N, Kientga M, Tanner M (2005). Rapid urban malaria appraisal (RUMA) I: Epidemiology of urban malaria in Ouagadougou. Malar. J. pp. 4:43.

 

Tarimo DS, Minjas JN, Bygberg IC (2001). Malaria diagnosis and treatment under the strategy of the integrated management of childhood illness (IMCI): Relevance of laboratory support from the rapid immunochromatographic tests of ICT Malaria Pf/Pv and OptiMal-IT. Ann. Trop. Med. Parasitol. 95:437-444.
Crossref

 

World Health Organization (WHO) (2008). Roll Back Malaria. World Malaria Report WHO/HTM/GMP/2008.1.

 


APA Tiedeu, B. M. A., Tadjouo, L. M., Achonduh-Atijegbe, O., Sontsa, O. T. D., Mbanya, J. C., & Mbacham, W. F. (2017). The assessment of fever in under-five children in the Ekounou Health Area of Yaounde, Cameroon: Usefulness of rapid diagnostic tests. International Journal of Medicine and Medical Sciences, 9(4), 33-40.
Chicago Barbara Mma Atogho Tiedeu, Liliane Mekue Tadjouo, Olivia Achonduh-Atijegbe, Olivier Tresor Donfack Sontsa, Jean Claude Mbanya, and Wilfred Fon Mbacham,. "The assessment of fever in under-five children in the Ekounou Health Area of Yaounde, Cameroon: Usefulness of rapid diagnostic tests." International Journal of Medicine and Medical Sciences 9, no. 4 (2017): 33-40.
MLA Barbara Mma Atogho Tiedeu, et al. "The assessment of fever in under-five children in the Ekounou Health Area of Yaounde, Cameroon: Usefulness of rapid diagnostic tests." International Journal of Medicine and Medical Sciences 9.4 (2017): 33-40.
   
DOI 10.5897/IJMMS2016.1259
URL http://academicjournals.org/journal/IJMMS/article-abstract/21182F963402

Subscription Form