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