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

PLoS One. 2019 Jul 25;14(7):e0220371. doi: 10.1371/journal.pone.0220371. eCollection 2019.

Abstract

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, we developed a Bayesian model to quantify the incidence of SFI hospital admissions in SSA. Our estimates indicate a mean population-weighted SFI-inpatient-admission incidence rate of 18.4 (6.8-31.1, 68% CrI) per 1000 people for the year 2014, across all ages within areas of SSA with stable Plasmodium falciparum transmission. We further estimated a total of 16,200,337 (5,993,249-27,321,779, 68% CrI) SFI hospital admissions. This analysis reveals the significant burden of SFI in hospitals in SSA, but also highlights the paucity of pathogen-specific prevalence and incidence data for SFI in SSA. Future improvements in pathogen-specific diagnostics for causative agents of SFI will increase the abundance of SFI-specific prevalence and incidence data, aid future estimations of SFI burden, and enable clinicians to identify SFI-specific pathogens, administer appropriate treatment and management, and facilitate appropriate antibiotic use.

MeSH terms

  • Adolescent
  • Adult
  • Africa South of the Sahara / epidemiology
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Community-Acquired Infections / complications
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / epidemiology
  • Female
  • Fever / diagnosis
  • Fever / epidemiology*
  • Fever / etiology
  • Fever / pathology
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Malaria / complications
  • Malaria / diagnosis
  • Malaria / epidemiology
  • Male
  • Medical Overuse / statistics & numerical data
  • Middle Aged
  • Patient Admission / statistics & numerical data*
  • Prevalence
  • Severity of Illness Index
  • Young Adult

Grants and funding

The authors received no specific funding for this work.