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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000304
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Management of Fever in Ambulatory HIV-infected Adults in Resource-Limited Settings: Prospective Observational Evaluation of a New Mozambican Guideline.

Brentlinger, Paula E. MD, MPH; Silva, Wilson P. PhD; Buene, Manuel BS; Morais, Luis MS; Valverde, Emilio MD, PhD; Vermund, Sten H. MD, PhD; Moon, Troy D. MD, MPH

Published Ahead-of-Print
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A new Mozambican guideline for management of fever in HIV-infected adults requires malaria testing and systematic consideration of specific alternative diagnoses (e.g. tuberculosis and bacterial infections) in addition to malaria. We conducted a prospective observational study of the guideline's performance. Of 258 HIV-infected subjects with axillary temperature >= 37.5[degrees] C or history of fever, 76.0% improved, 13.6% died or were hospitalized, and 10.5% were lost to follow-up. In multivariate analyses, factors associated with adverse outcome were bacterial blood stream infection, syndromically diagnosed tuberculosis, lower CD4+ T-lymphocyte count, no antiretroviral therapy, lower body mass index, lower hemoglobin, and non-prescription of antibiotics.

(C) 2014 by Lippincott Williams & Wilkins


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