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FIEBRE aims to design new evidence-based guidelines to manage fever, thereby ensuring that patients get drugs that give them the best chance of recovery, and thereby help stop the spread of antimicrobial resistance (AMR), a major global health problem.

Pills and a thermometer

On 8 March 2018, the London School of Hygiene & Tropical Medicine (LSHTM) announced the start of a major new global study, the 4-year Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) project.

By identifying the leading causes of fever in sub-Saharan Africa and Asia and how fever patients are cared for, FIEBRE aims to design new evidence-based guidelines to manage fever, thereby ensuring that patients get drugs that give them the best chance of recovery, and thereby help stop the spread of antimicrobial resistance (AMR), a major global health problem.

Funded by UKAid from DFID, FIEBRE will be conducted by LSHTM with the Liverpool School of Tropical Medicine, the Universities of Oxford, Barcelona, and Otago, as well as partner institutions within five study countries – Laos, Malawi, Mozambique, Myanmar and Zimbabwe.

MORU’s Lao PDR Unit, LOMWRU, and the Microbiology Laboratory team within Mahosot Hospital, Vientiane, will work with Vientiane Provincial Hospital for the Laos arm of this multicentre study. In addition, Yoel Lubell of MORU MAEMOD will coordinate the biomarker investigations, so that by its end, the study will have a better idea as to which biomarkers best distinguish between viral and bacterial infections, and which (if any) can predict severe outcomes.

“There is an urgent need to understand the aetiologies of fevers across Asia and Africa with consensus protocols to facilitate between country comparisons, that have so far eluded us, to inform patient treatment policies,” explained Oxford Prof Paul Newton, LOWMRU Director. “We will work to recruit and diagnose inpatients and outpatients to improve our understanding of the causes of fever in the Mekong River valley and how these compare with other countries and to work for these results to be translated into health policy.”

David Mabey, Professor of Communicable Diseases at the LSHTM and Principal Investigator of the FIEBRE project, said: “The world has made great strides in tackling malaria. Surprisingly, there has been limited research on other potential causes of febrile illness, such as infections by bacteria, viruses, and fungi, and the WHO does not provide specific guidance on the management of non-malarial fevers.

“We want to identify the treatable and preventable causes of fever in children and adults in Africa and Asia, and to identify those most at risk of different infections. Our goal is to develop guidelines that can be a blueprint for the effective management of patients with fever in different settings.”

Read the full LSHTM story announcing the FIEBRE study Major new project to reveal leading causes of fever in sub-Saharan Africa and Asia.