Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE)

Funding:  Department for International Development (DFID), 2017-2021

LSHTM investigators:  David Mabey (PI), Amit Bhasin, Chrissy Roberts, Clare Chandler, Heidi Hopkins, Coll Hutchison, John Bradley, Rashida Ferrand, Shunmay Yeung

Other UK and international collaborators: Quique Bassat, Vilada Chansamouth, John Crump, Ethel Dauya, Nick Feasey, David Lalloo, Hla Hla Win, Yoel Lubell, Mayfong Mayxay, Claudious Muserere, Paul Newton, Antonio Mario Sitoe, Wah Win Htike, Zaw Lynn Aung

Summary: Fever is one of the most common symptoms that leads to health-care seeking and hospital admission across sub-Saharan Africa and Asia. However, little is known about the causes of febrile illness in these regions. Without access to reliable diagnostic facilities, and without evidence on which to base treatment guidelines, in most cases treatment is empiric and too often results in overuse of antimicrobial medicines.

The FIEBRE study will help to address these information gaps, using a standard clinical, laboratory and social science protocol, in five representative sites – in Lao PDR, Malawi, Mozambique, Myanmar and Zimbabwe – with a high burden of infectious disease and few or no existing data. The study will rigorously investigate causes of febrile illness, and antibacterial resistance, in inpatients and outpatients of all ages. Qualitative work will describe how care-seekers, clinicians, and other stakeholders conceptualise fever, and appropriate antimicrobial use. The results of this study will enable us to design new, evidence-based algorithms for the management of febrile illness. Archived patient samples will provide a basis for future evaluation of novel diagnostics, and rational approaches to disease surveillance.

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