Short communication: Non-malaria related acute fever, a preliminary study from Kinshasa the Democratic Republic of the Congo

Abstract

Background: Fever is a key symptom that motivates medical consultation mainly in tropical areas. This study aimed to assess non-malaria cases among those attending a primary health care facility with acute fever in Kinshasa suburb. Methods: Participants were screened independently with rapid diagnostic test and microscopy. Dried blood spots were analyzed by PCR, which was considered as golden standard for malaria diagnosis. A sub-population benefited from blood culture to screen non-specific bacterial infections. Results: 296 patients were enrolled. Malaria was detected in 44.6%, 38.5% and 37.2% respectively by rapid diagnostic test, microscopy and PCR. Blood culture was positive for 5/151 patients (3.3%), essentially those aged under 5 years (4/5). Sleeping under mosquito net was protective against malaria (p=0.026). In the sub-group assessed for blood culture, 94/ 151 patients (62.3 %) had neither unspecific bacterial infection nor malaria. Conclusion: Neither malaria nor unspecific bacterial infection was responsible of the acute fever in more than half of the patients. These findings suggest that diagnostic tests (including viral agents) and diagnostic algorithms are paramount for the management of non-malaria acute fever.