A study of pattern of acute febrile illnesses at COMS-TH, Bharatpur, Nepal

ObjectiveTo study the pattern of acute febrile illnesses in Central Nepal regarding its underlying etiology and its clinical outcome.MethodsThis study is a hospital based descriptive cross-sectional study during June to November, 2011 over a period of 6 months. All the febrile illnesses data were collected from medical outpatient and inpatient registried and then analysed. There were total 2 873 febrile patients, of whom 883 were inpatients whose data have been analysed.ResultsThe majority of febrile patients were distributed in August (788/2 873=27.43%) followed by July (708/2 873=24.64%). The age distribution ranged from 15 to 84 years with female predisposition (M:F=1:1.5). Majority of the febrile patients were in the 15–30 years age group (292/883=33.07%) followed by elderly (>60 years, 22.88%). Most of the febrile patients admitted in medical ward were diagnosed as respiratory tract infection followed by urinary tract infection, enteric fever, acute gastroenteritis. Of intensive care unit admitted febrile patients (n=187), sepsis with multi-organ dysfunction syndrome was the major diagnosis followed by acute meningoencephalitis. A total of 21 patients (2.37%) died of sepsis with multi-organ dysfunction syndrome followed by acute meningoencephalitis in 5 (0.56%), complicated malaria with acute respiratory distress syndrome in 1 (0.11%) and infective hepatitis with encephalopathy in 1 (0.11%).ConclusionsAcute febrile illnesses mostly viral in origin involving respiratory tracts are more common during monsoon months with lots of mortalities and morbidities. They pose a major threat to the public due to their endemicity as many of them remain undiagnosed or if at all, very late. Early and planned activity of the government and non-government local bodies, epidemic preparedness against susceptible outbreaks including efficient public health awareness are the keys to minimize the hazards.