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Comparing actual and perceived causes of fever among community members in a low malaria transmission setting in northern T anzania
Author(s) -
Hertz Julian T.,
Munishi O. Michael,
Sharp Joanne P.,
Reddy Elizabeth A.,
Crump John A.
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12191
Subject(s) - tanzania , malaria , etiology , medicine , fever of unknown origin , transmission (telecommunications) , q fever , pediatrics , immunology , geography , engineering , electrical engineering , environmental planning
Objective To compare actual and perceived causes of fever in northern T anzania. Methods In a standardised survey, heads of households in 30 wards in M oshi, T anzania, were asked to identify the most common cause of fever for children and for adults. Responses were compared to data from a local hospital‐based fever aetiology study that used standard diagnostic techniques. Results Of 810 interviewees, the median (range) age was 48 (16, 102) years and 509 (62.8%) were women. Malaria was the most frequently identified cause of fever, cited by 353 (43.6%) and 459 (56.7%) as the most common cause of fever for children and adults, respectively. In contrast, malaria accounted for 8 (2.0%) of adult and 6 (1.3%) of paediatric febrile admissions in the fever aetiology study. Weather was the second most frequently cited cause of fever. Participants who identified a non‐biomedical explanation such as weather as the most common cause of fever were more likely to prefer a traditional healer for treatment of febrile adults (OR 2.7, P < 0.001). Bacterial zoonoses were the most common cause of fever among inpatients, but no interviewees identified infections from animal contact as the most common cause of fever for adults; two (0.2%) identified these infections as the most common cause of fever for children. Conclusions Malaria is perceived to be a much more common cause of fever than hospital studies indicate, whereas other important diseases are under‐appreciated in northern T anzania. Belief in non‐biomedical explanations of fever is common locally and has important public health consequences.