Causes of non-malarial XXXX in outpatients in Tanzania.

@entity1 @entity1680 @entity55 @entity2348 @entity311 @entity221 @entity293 @entity582
OBJECTIVE: In sub-Saharan Africa, the use of @entity311 rapid diagnostic tests (mRDT) has raised awareness of alternative @entity221 causes in @entity1 but few studies have included adults. To address this gap, we conducted a study of mRDT-negative @entity221 aetiologies among @entity1 and adults in Tanzania. METHODS: A total of 1028 @entity1 aged 3 months to 50 years with a @entity221 and negative mRDT were enrolled from a Tanzanian hospital outpatient department. All had a physical examination and cultures from blood, nasopharynx/throat and urine. @entity1 were followed on Days 7 and 14 and @entity1 meeting WHO criteria for @entity55 were followed on Day 2 with chest radiology. RESULTS: Respiratory symptoms were the most frequent presenting complaint, reported by 20.3% of adults and 64.0% (339/530) of @entity1 . Of 38 X-rayed @entity1 meeting WHO @entity55 criteria, 47.4% had a normal X-ray. Overall, only 1.3% of 1028 blood cultures were positive. @entity1680 was the most prevalent pathogen isolated (7/13, 53.8%) and @entity1680 @entity1 reported @entity221 for a median of 7 days (range 2-14). @entity1 with @entity582 did not present with WHO symptoms requiring antibiotic treatment. Young @entity1 and adults had similar prevalences of positive urine cultures (24/428 and 29/498, respectively). CONCLUSION: Few outpatient fevers are caused by blood stream @entity2348 would be identified by current clinical guidelines although paediatric @entity582 may be more difficult to diagnose. While @entity55 may be overdiagnosed, @entity293 was relatively common. Our results emphasise the difficulty in identifying African @entity1 in need of antibiotics among the majority who do not.
