You get what you look for: emerging infections in a malaria-endemic zone
Though malaria has long been recognized as the preeminent contributor to childhood mortality in sub-Saharan Africa, recent encouraging data have documented a decline in the burden of disease due to malaria, including in Kenya. Therefore it is expected that other pathogens are emerging in relative importance as contributors to pediatric febrile illnesses and their associated morbidity and mortality. Consequently, it is likely that current empiric treatment
algorithms, which focus on antimalarial administration, may not lead to appropriate therapy in many cases. Unfortunately, there is a lack of epidemiologic data describing other infectious etiologies of acute febrile illness, especially among children. We propose a study to describe the prevalence of other key pathogens in patients presenting with fever to a rural district hospital in western Kenya. We hypothesize that non-malarial pathogens, including group A streptococcus, respiratory viruses, and rickettsia, are responsible for a significant proportion of febrile illnesses, and many of these pathogens would not be optimally treated according to current WHO IMCI
guidelines. If true, this work would help prioritize investment in diagnostic tests, and it would also pave the way for larger projects to test alternative algorithms that could lead to improved case management of pediatric febrile illnesses.