Etiologies of Fever in Children Under 3 Months of Age at The University Teaching Hospital of Bouake (Cote D'ivoire)

Introduction: Fever poses a problem of diagnosis and management in infants under three months of age in an emergency setting. The objective of the study was to identify the causes of fever for early management and improved prognosis.

Methods: This was a retrospective and descriptive study conducted in pediatrics at the Bouaké University Teaching Hospital from January to December 2018. It included all children under 3 months of age hospitalized in the department for fever confirmed by a thermometer. The variables studied were epidemiological and diagnostic.

Results: 2619 children under 3 months of age were recorded, of whom 771 (339 boys, 372 girls) had fever, i.e. 29.4%. Fever had been present for less than 5 days in 79.7% of the children, and the main associated signs were refusal to suckle (16.5%), respiratory difficulty (14.2%), and constant crying (11.8%). The causes of fever identified in newborns were infection (97.6%) and induced fever (2.4%). The main bacteria of maternal-fetal infection were Streptococcus agalactiae 58.3% and Escherichia coli 36.7% and those of postnatal infection were Staphylococcus aureus (46.4%) and Klebsiella sp and Klebsiella pneumoniae (25%). In infants aged 1-3 months the cause of fever was acute respiratory infection in 46.5% and malaria in 20.4%. The bacteria found in respiratory infections were Staphylococcus aureus (38.5%), Streptococcus pneumoniae (30.8%), Klebsiella pneumoniae (15.4%) and Haemophilus influenzae (7.7%).

Conclusion: In the febrile infant of less than three month, it is necessary to think in priority of a bacterial infection and malaria. The probabilistic treatment must take into account the main germs identified according to age group. Pregnancy monitoring, hygiene education of parents, use of the long-lasting insecticide-treated mosquito net, strengthening the capacity of the service for diagnosis, adherence to asepsis and hospital hygiene by health personnel are priority measures to be undertaken to improve the diagnosis and prognosis of febrile infants.

Keywords: Infant, Fever, Etiologies, Ivory Coast.