{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:09:44Z","timestamp":1791212984123,"version":"4.1.0"},"reference-count":33,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,5,6]]},"abstract":"<jats:p>\n                    In Kenya, more than 10 million episodes of acute febrile illness are treated annually among children under 5 years. Most are clinically managed as malaria without parasitological confirmation. There is an unmet need to describe pathogen-specific etiologies of fever. We enrolled 370 febrile children and 184 healthy controls. We report demographic and clinical characteristics of patients with\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    , group A streptococcal (GAS) pharyngitis, and respiratory viruses (influenza A and B, respiratory syncytial virus [RSV], parainfluenza [PIV] types 1\u20133, adenovirus, human metapneumovirus [hMPV]), as well as those with undifferentiated fever. Of febrile children, 79.7% were treated for malaria. However,\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    was detected infrequently in both cases and controls (14\/268 [5.2%] versus 3\/133 [2.3%],\n                    <jats:italic>P<\/jats:italic>\n                    = 0.165), whereas 41% (117\/282) of febrile children had a respiratory viral infection, compared with 24.8% (29\/117) of controls (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.002). Only 9\/515 (1.7%) children had streptococcal infection. Of febrile children, 22\/269 (8.2%) were infected with &gt; 1 pathogen, and 102\/275 (37.1%) had fevers of unknown etiology. Respiratory viruses were common in both groups, but only influenza or parainfluenza was more likely to be associated with symptomatic disease (attributable fraction [AF] 67.5% and 59%, respectively). Malaria was overdiagnosed and overtreated. Few children presented to the hospital with GAS pharyngitis. An enhanced understanding of carriage of common pathogens, improved diagnostic capacity, and better-informed clinical algorithms for febrile illness are needed.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.14-0560","type":"journal-article","created":{"date-parts":[[2015,3,10]],"date-time":"2015-03-10T22:53:20Z","timestamp":1426028000000},"page":"1030-1037","source":"Crossref","is-referenced-by-count":36,"title":["Etiology of Pediatric Fever in Western Kenya: A Case\u2013Control Study of Falciparum Malaria, Respiratory Viruses, and Streptococcal Pharyngitis"],"prefix":"10.4269","volume":"92","author":[{"given":"Wendy P.","family":"O'Meara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Mott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremiah","family":"Laktabai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kabura","family":"Wamburu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Fields","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Armstrong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve 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