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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000304
Brief Report: Clinical Science

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*,†

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Abstract

Abstract: A new Mozambican guideline for management of fever in HIV-infected adults requires malaria testing and systematic consideration of specific alternative diagnoses (eg, 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° 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 outcomes were bacterial blood stream infection, syndromically diagnosed tuberculosis, lower CD4+ T-lymphocyte count, no antiretroviral therapy, lower body mass index, lower hemoglobin, and nonprescription of antibiotics.

© 2014 by Lippincott Williams & Wilkins

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