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Background: With growing use of parasitological tests to detect malaria and decreasing incidence of the disease in Africa; it becomes necessary to increase the understanding of causes of non-malaria acute febrile illness (NMAFI) towards providing appropriate case management. This research investigates causes of NMAFI in pediatric out-patients in rural Guinea-Bissau. Methods: Children 0-5 years presenting acute fever (≥38°) or history of fever, negative malaria rapid diagnostic test (mRDT) and no signs of specific disease were recruited at the out-patient clinic of 3 health facilities in Bafatá province during 54 consecutive weeks (dry and rainy season). Medical history was recorded and blood, nasopharyngeal, stool and urine samples were collected and tested for the presence of 38 different potential aetiological causes of fever. Results: Samples from 741 children were analysed, the protocol was successful in determining a probable aetiological cause of acute fever in 544 (73.61%) cases. Respiratory viruses were the most frequently identified pathogens, present in the nasopharynx samples of 435 (58.86%) cases, followed by bacteria detected in 167 (22.60%) samples. Despite presenting negative mRDTs, P. falciparum was identified in samples of 24 (3.25%) patients. Conclusions: This research provides a description of the aetiological causes of NMAFI in West African context. Evidence of viral infections were more commonly found than bacteria or parasites.
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Introducción: el personal de salud (PS) tiene mayor riesgo de exposición/transmisión de enfermedades, siendo la vacunación un medio eficaz para reducirlo.Objetivos: evaluar estado de vacunación del lPS. Detectar factores de vacunación incompleta. Estado serológico (VHB, VHC, VIH).Material y métodos: estudio multicéntrico, observacional, descriptivo de corte transversal. Se encuestó 30 % del PS de 3 instituciones públi-cas y 2 privadas de Córdoba en marzo/abril de 2013. Recomendaciones Argentina: hepatitis B (HB), sarampión/rubéola (SR), difteria, tétanos, pertusis (dT/dTpa) e influenza. Análisis bivariado, prueba del Chi-cua-drado. Epidat 3.1.Resultados: total 676 encuestas. Esquema completo 20 % (estu-diantes 38 %, médicos 18 %, enfermeros 18 %, radiología 7 %, lim-pieza 5 %). Esquema vigente dT/dTpa: 78 %. Esquema HB: 64 %. In-fluenza 2012: 55 %. SR: 46 %. Motivos de vacunación incompleta: 28 % desconocía indicación, 23 % falta de interés, 2 % otros moti-vos, 2 % no acepta vacunación, 45 % no contestó. Conocen su con-dición serológica de VIH 63 %, VHB: 52 %, VHC: 44 %. Sector público (n = 546) vs privado (n = 130): esquema comple-to 21,24 % vs 14,61 % (p = 0,08). HB 66 % vs 54 % (p = 0,0099) dT/dTpa 81 % vs 65 % (p = 0,0001). SR 46 % vs 45 % (p = 0,87). Influenza 56 % vs 49 % (p = 0,12). Conclusión: el esquema de vacunación es incom-pleto en alto porcentaje de encuestados, principal-mente personal de limpieza; causa predominante: desconocimiento de indicación y desinterés. Ma-yor cobertura para dT/dTpa y HB. No hay diferen-cias entre sector público y privado respecto de es-quema completo. El sector público presenta mejor cobertura para HB y dT/dTpa, estadísticamente significativa. El test del VIH es el realizado con mayor frecuencia. Son necesarias campañas para concientizar y mejorar niveles de cobertura de vacunación
Introduction: Health personnel (HP) have higher risk of exposure/transmission of diseases, vaccination remains an effective means to reduce it.Objectives: Evaluate recommended vaccination in HP. Detect conditions of incomplete vaccination. Assess knowledge of their serological status: HBV, HCV, HIV.Material and Methods: Multicenter, observational, analitic, cross-sectional, conducted in 3 public hospitals and 2 private institutions Cba, Arg. We surveyed 10-30% of staff in each institution during March-April 2013. Recommendations Arg: Hepatitis B, Measles/Rubella (MR) Tetanus, diphtheria, pertussis (Td/Tdap) and Influenza. Bivariate analysis, using X2 test. Results: 676 surveys were completed. Complete vaccination: 20% (students 38%, physicians 18%, nurses 18%, lab 13%, radiology 7%, cleaners 5%). Current scheme for Td / Tdap: 78%. Hepatitis B:64%. Influenza vaccine: 55%, MR: 46%. Analysis by public (n=546) vs. private (n=130): Full scheme 21,24%vs14,61% (p=0.08). Hepatitis B 66%vs54%(p=0.0099). Td/Tdap 81%vs65% (p=0.0001). MR 46%vs45% (p=0.87). Influenza 56%vs49% (p=0.12). Causes of incomplete vaccination: 28% unknow this indication, 23% lack of interest. Know their serologic status: HIV 63%, HBV 52%, HCV 44%. Conclusion: High percentage of workers has incomplete vaccination.Lack of indication and lack of interest are the reasons most frequently detected. Better coverage for Td/Tdap and HB. Public or private sector does not predict better coverage but HB and Td/Tdapin public sector has a statistically significantly better coverag. Low percentage of respondents known their serological status. The HIV test is the most frequently performed. Designed campaigns are needed to increase vaccination coverageand to stimulating the knowledge of serological status of HP
