Characteristics of acute febrile illness and determinants of illness recovery among adults presenting to Singapore primary care clinics

BMC Infectious Diseases

Research Article

Jenny Guek-Hong Low¹  Martin Linster²  Eng Eong Ooi²  Mahesh Moorthy²  Gavin J. D. Smith²  Yvonne CF Su²  Richard James Coker³  Zaw Myo Tun⁴  Clarence C. Tam⁵ 

[1] Department of Infectious Disease, Singapore General Hospital, Outram Road, 169608, Singapore, Singapore;Duke-National University of Singapore Medical School, 8 College Road, 169857, Singapore, Singapore;London School of Hygiene and Tropical Medicine, Keppel St, WC1E 7HT, London, UK;Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, 117549, Singapore, Singapore;Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, 117549, Singapore, Singapore;London School of Hygiene and Tropical Medicine, Keppel St, WC1E 7HT, London, UK;

关键词: Acute febrile illness;    Primary care;    Undifferentiated fever;   

DOI  :  10.1186/s12879-016-1958-4

 received in 2016-05-06, accepted in 2016-10-25,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundUndifferentiated acute febrile illness (AFI) is a common presentation among adults in primary care settings in Singapore but large gaps exist in the understanding of the characteristics of these patients. We studied clinical and epidemiological characteristics of AFI patients and factors associated with delayed recovery from AFI.MethodsWe performed a secondary data analysis using data from the Early DENgue infection and outcome (EDEN) study on 2046 adult patients presenting at 5 Singapore polyclinics between December 2007 and February 2013 with a history of fever (≥38 °C) for less than 72 h. We used an accelerated failure time model to investigate factors associated with delayed recovery from AFI.ResultsThe mean age of patients was 36.6 years, 65 % were male, 51 % were of Chinese ethnicity, and 75 % lived in public housing. Median illness duration was 5 days (interquartile range, 3–7). In multivariable analysis, the unemployed and white collar workers had longer illness duration compared with blue collar workers (time ratio (TR), 1.10; 95 % confidence interval (CI), 1.03–1.17 and TR, 1.08; 95 % CI, 1.02–1.15, respectively). Patients with more symptoms at initial consultation had slower recovery (TR, 1.03 per additional symptom; 95 % CI, 1.02–1.03). Other clinical factors were also associated with longer duration of illness, including use of analgesics (TR, 1.21; 95 % CI, 1.15–1.28); use of cough medicines (TR, 1.14; 95 % CI, 1.08–1.20); use of antibiotics (TR, 1.14; 95 % CI, 1.07–1.21); and hospitalization (TR, 1.59; 95 % CI, 1.39–1.82). Compared to patients with normal WBC count at first consultation, those with low WBC count had slower recovery (TR, 1.14; 95 % CI, 1.07–1.21), while the reverse was observed among patients with high WBC count (TR, 0.94; 95 % CI, 0.88–1.00).ConclusionsDifferences in illness duration among different types of employment may reflect differences in their underlying general health status. Early identification of factors delaying recovery could help triage management in a primary care setting. In-depth characterization of fever etiology in Singapore will improve surveillance and control activities.

【 授权许可】

CC BY   
© The Author(s). 2016