title: Bacteremia Among Febrile Ugandan Children Treated with Antimalarials Despite a Negative Malaria Test.
abstract: Bacteremia may be inappropriately treated as malaria in children admitted with a febrile illness in Africa. We determined the prevalence, clinical features, and spectrum of bacteremia among febrile children younger than 5 years of age admitted with a negative malaria test, but prescribed antimalarials at a referral hospital in Jinja, Uganda. After initial evaluation, a blood sample was drawn from 250 children for a complete blood count and bacterial culture. Of 250 samples cultured, 15 grew organisms presumed to be skin contaminants, and of the remaining 235 samples, 45 (19.1%) had bacteremia. Staphylococcus aureus (42%), non-typhoidal Salmonella (24%), Pseudomonas aeruginosa (11%), and Streptococcus pneumoniae (9%) were the most common bacterial isolates. On multivariate analysis, history of weight loss (odds ratio [OR] = 2.75; 95% confidence interval [CI] = 1.27-5.95), presence of pulmonary crackles (OR = 3.63; 95% CI = 1.40-9.45), and leukocytosis (OR = 2.21; 95% CI = 1.09-4.47) were independent predictors of bacteremia. At a referral hospital in Uganda, bacteremia was a remarkably common finding in children with febrile illness who were treated for malaria despite negative malaria test results.
authors.forename: Afizi
authors.initials: A
authors.lastname: Kibuuka
authors.forename: Pauline
authors.initials: P
authors.lastname: Byakika-Kibwika
authors.forename: Jane
authors.initials: J
authors.lastname: Achan
authors.forename: Adoke
authors.initials: A
authors.lastname: Yeka
authors.forename: Joan N
authors.initials: JN
authors.lastname: Nalyazi
authors.forename: Arthur
authors.initials: A
authors.lastname: Mpimbaza
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Rosenthal
authors.forename: Moses R
authors.initials: MR
authors.lastname: Kamya
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D016470:Bacteremia / Q000453:epidemiology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005334:Fever / Q000175:diagnosis*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012475:Salmonella / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014454:Uganda / Q000453:epidemiology
chemical_list: D000962:Antimalarials