Tropical Medicine & Surgery

Abstract

Dealing with Acute Febrile Illness in the Resource Poor Tropics

Ranjan Premaratna

Diagnosis of infectious disease, similar to any other illness is based on history taking, examination, basic investigations and confirmatory diagnostics. However differences in clinical presentation based on evolution of aetiological agents or host factors, risk of exposure for re-emerging or emerging agents due to expanding human activities and travel has posed a great challenge on timely diagnoses of these illnesses especially in the resource poor tropical setting. Significant overlap of symptoms, signs and basic laboratory parameters of most of the tropical illnesses add to the challenge. Although confirmatory diagnostics are mandatory in the definitive diagnosis of tropical fevers their applicability, non-availability or non-accessibility has lead to a clinical based approach for the presumptive diagnosis of febrile illness. Such an approach may lead to inadequate clinical evaluation, delay in the diagnosis, and use of inappropriate antibiotics, extended morbidity and possibly avoidable mortality by other tropical diseases especially during busy disease outbreaks.