INTRODUCTION:Fever commonly leads to healthcare seeking and hospital admission in sub-Saharan Africa and Asia. There is only limited guidance for clinicians managing non-malarial fevers, which often results in inappropriate treatment for patients. Furthermore, there is little evidence for estimates of disease burden, or to guide empirical therapy, control measures, resource allocation, prioritisation of clinical diagnostics or antimicrobial stewardship. The Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) study seeks to address these information gaps. METHODS AND ANALYSIS:FIEBRE investigates febrile illness in paediatric and adult outpatients and inpatients using standardised clinical, laboratory and social science protocols over a minimum 12-month period at five sites in sub-Saharan Africa and Southeastern and Southern Asia. Patients presenting with fever are enrolled and provide clinical data, pharyngeal swabs and a venous blood sample; selected participants also provide a urine sample. Laboratory assessments target infections that are treatable and/or preventable. Selected point-of-care tests, as well as blood and urine cultures and antimicrobial susceptibility testing, are performed on site. On day 28, patients provide a second venous blood sample for serology and information on clinical outcome. Further diagnostic assays are performed at international reference laboratories. Blood and pharyngeal samples from matched community controls enable calculation of AFs, and surveys of treatment seeking allow estimation of the incidence of common infections. Additional assays detect markers that may differentiate bacterial from non-bacterial causes of illness and/or prognosticate illness severity. Social science research on antimicrobial use will inform future recommendations for fever case management. Residual samples from participants are stored for future use. ETHICS AND DISSEMINATION:Ethics approval was obtained from all relevant institutional and national committees; written informed consent is obtained from all participants or parents/guardians. Final results will be shared with participating communities, and in open-access journals and other scientific fora. Study documents are available online (https://doi.org/10.17037/PUBS.04652739).

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简介:发烧通常会导致撒哈拉以南非洲和亚洲的医疗保健和住院治疗。对于管理非疟疾发烧的临床医生,只有很少的指导,这通常会导致患者的治疗不当。此外,几乎没有证据可以估算疾病负担,或指导经验疗法,控制措施,资源分配,临床诊断或抗菌药物管理的优先次序。广泛流行病的高热病评估(FIEBRE)研究旨在解决这些信息空白。
方法和分析:FIEBRE采用标准的临床,实验室和社会科学方案,在撒哈拉以南非洲,东南亚和南亚的五个地区,采用标准的临床,实验室和社会科学方案,调查了儿科和成人门诊及住院患者的发热性疾病。招收发烧患者,并提供临床数据,咽拭子和静脉血样本;选定的参与者还提供尿液样本。实验室评估针对可治疗和/或可预防的感染。现场进行了选定的即时护理测试,以及血液和尿液培养以及抗菌素敏感性测试。在第28天,患者需要提供第二次静脉血样本以进行血清学检查和临床结果信息。在国际参考实验室进行进一步的诊断测定。来自匹配的社区对照的血液和咽部样本可以计算房颤,寻求治疗的调查可以估计常见感染的发生率。额外的检测方法可检测可能使细菌与非细菌引起疾病和/或预测疾病严重程度的标志物。关于抗菌药物使用的社会科学研究将为将来的发烧病例管理提供建议。来自参与者的残留样本将被存储以备将来使用。
道德与传播:道德获得了所有相关机构和国家委员会的批准;获得所有参与者或父母/监护人的书面知情同意。最终结果将与参与社区以及开放获取期刊和其他科学论坛共享。研究文件可在线获得(https://doi.org/10.17037/PUBS.04652739)。

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