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London School of Hygiene & Tropical Medicine Malaria Centre

Malaria research in epidemiology

CONFIA: causes of Non-malarial Fever in Afghanistan.

LSHTM investigators:
Amy Mikhail, Toby Leslie, Chris Whitty, Hugh Reyburn & Mark Rowland.
Funding body:
The Bill & Melinda Gates Foundation through the ACT Consortium.

In many areas of the world there has been a welcome reduction in malaria transmission. The result is that fewer cases who present with a fever have malaria.

This makes diagnosis of both malaria and non-malaria cases important for patient care.  It is often no known what the cause of the fever is when it is not malaria but when the symptoms in the patient resemble (and are often indistinguishable from) malaria.

The CONFIA project began enrolling patients in February 2012. It aims to identify as many of the non-malarial causes of fever as possible. These may be attributable to a range of viral, parasitic and bacterial diseases. The patients are enrolled in the study if they do not have malaria (their malaria negative status is confirmed with a malaria rapid diagnostic test). After taking a detailed history and physical examination, blood, respiratory and urine samples are taken from the patient and assessed using a range of laboratory techniques including culture, serological and molecular methods to screen for causative pathogens. The spectrum of diseases identified will be examined in light of their reported exposure factors and clinical data. Once there is a better understanding of non-malarial causes of fever, additional research can be undertaken to assist in improving treatment for fever when a malaria parasite test is negative and for providing information for control of the alternative causes of disease.

The project will be completed in December 2012 and results will be reported shortly thereafter.