title: Non-malaria fevers in a high malaria endemic area of Ghana.
abstract: The importance of fevers not due to malaria [non-malaria fevers, NMFs] in children in sub-Saharan Africa is increasingly being recognised. We have investigated the influence of exposure-related factors and placental malaria on the risk of non-malaria fevers among children in Kintampo, an area of Ghana with high malaria transmission.
  
  
  
  Between 2008 and 2011, a cohort of 1855 newborns was enrolled and followed for at least 12 months. Episodes of illness were detected by passive case detection. The primary analysis covered the period from birth up to 12 months of age, with an exploratory analysis of a sub-group of children followed for up to 24 months.
  
  
  
  The incidence of all episodes of NMF in the first year of life (first and subsequent) was 1.60 per child-year (95 % CI 1.54, 1.66). The incidence of NMF was higher among infants with low birth weight [adjusted hazard ratio (aHR) 1.22 (95 % CI 1.04-1.42) p = 0.012], infants from households of poor socio-economic status [aHR 1.22 (95 % CI 1.02-1.46) p = 0.027] and infants living furthest from a health facility [aHR 1.20 (95 % CI 1.01-1.43) p = 0.037]. The incidence of all episodes of NMF was similar among infants born to mothers with or without placental malaria [aHR 0.97 (0.87, 1.08; p = 0.584)].
  
  
  
  The incidence of NMF in infancy is high in the study area. The incidence of NMF is associated with low birth weight and poor socioeconomic status but not with placental malaria.
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P. O. Box, 200, Kintampo, Brong Ahafo Region, Ghana. kwakupoku.asante@kintampo-hrc.org.
authors.forename: Kwaku Poku
authors.initials: KP
authors.lastname: Asante
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P. O. Box, 200, Kintampo, Brong Ahafo Region, Ghana.|London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
authors.forename: Seth
authors.initials: S
authors.lastname: Owusu-Agyei
authors.affiliation: London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Cairns
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P. O. Box, 200, Kintampo, Brong Ahafo Region, Ghana.
authors.forename: Ellen
authors.initials: E
authors.lastname: Boamah
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P. O. Box, 200, Kintampo, Brong Ahafo Region, Ghana.
authors.forename: Grace
authors.initials: G
authors.lastname: Manu
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P. O. Box, 200, Kintampo, Brong Ahafo Region, Ghana.
authors.forename: Mieks
authors.initials: M
authors.lastname: Twumasi
authors.affiliation: Department of Pathology, University of Ghana Medical School, College of Health, Accra, Ghana.
authors.forename: Richard
authors.initials: R
authors.lastname: Gyasi
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P. O. Box, 200, Kintampo, Brong Ahafo Region, Ghana.
authors.forename: George
authors.initials: G
authors.lastname: Adjei
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P. O. Box, 200, Kintampo, Brong Ahafo Region, Ghana.
authors.forename: Kingsley
authors.initials: K
authors.lastname: Kayan
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P. O. Box, 200, Kintampo, Brong Ahafo Region, Ghana.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mahama
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, P. O. Box, 200, Kintampo, Brong Ahafo Region, Ghana.
authors.forename: David Kwame
authors.initials: DK
authors.lastname: Dosoo
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, P. O. Box LG 581, Ghana.
authors.forename: Kwadwo
authors.initials: K
authors.lastname: Koram
authors.affiliation: London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
authors.forename: Brian
authors.initials: B
authors.lastname: Greenwood
authors.affiliation: London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chandramohan
mesh_terms: D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000401:mortality; D005869:Ghana / Q000453:epidemiology; D006268:Health Facilities; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008288:Malaria / Q000453:epidemiology*; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors; D012923:Social Class
keywords: Cohort study; Fever epidemiology; Ghana; Malaria; Non malaria fevers