Quantifying the incidence of severe-febrile-illness hospital admissions in sub-Saharan Africa

Severe-febrile-illness (SFI) is a common cause of morbidity and mortality across sub-Saharan Africa (SSA). The burden of SFI in SSA is currently unknown and its estimation is fraught with challenges. This is due to a lack of diagnostic capacity for SFI in SSA, and thus a dearth of baseline data on the underlying etiology of SFI cases and scant SFI-specific causative-agent prevalence data. To highlight the public health significance of SFI in SSA, the authors of this study developed a Bayesian model to quantify the incidence of SFI hospital admissions in SSA.

Full paper: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220371

Dengue virus is one of the causative organisms of febrile illness in Nigeria but lack of diagnostic tools makes it one of the unreported causes of SFI. Dengue is mainly diagnosed for research purposes and not for routine diagnosis in febrile patients.

We need to do more in making diagnostic tools available

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For dengue, specifically, I think the shortcomings are twofold. First, most of the available tests that could actually be performed in a clinic only test for the IgG/IgM antibodies which is great except that it’s too late in the viral cycle to do anything clinically for a patient. It essentially can tell you, “Yes, you had dengue”. Second, the few antigen-based tests out there require cold chain, centralized laboratories, sophisticated equipment and/or higher levels of training for personnel. All of these put constraints on the healthcare system’s ability to detect dengue for most people, in most conditions.

In addition, there is a need for an SFI panel that can detect any of a number of different tests and provide clinicians with the differential diagnosis they need to adopt appropriate clinical care. This is what we’re working on but it’s a tough target scientifically and very difficult to distill down to a single testing platform.

@madhukar.pai thanks for posting on this important topic.

Jeff Takle