Bacteraemia, Malaria, and Case Fatality Among Children Hospitalized With Fever in Dar es Salaam, Tanzania

Background: Febrile illness is the commonest cause of hospitalization in children four million genomes/µL) of P. falciparaum in plasma. Overall, in-hospital death was 4% (89/2146) and it was higher in children with bacteraemia (8%, 18/227) than malaria (2%, 4/194, P=0.007). Risk factors for death were bacteraemia (p=0.02), unconsciousness at admission (p<0.001) and admission at a tertiary hospital (p=0.003). Conclusions: Our study showed that bacteria and malaria contributed equally in causing blood stream infection (BSI), but bacteraemia caused higher in-hospital death. P. falciparum parasitaemia measured by qPCR is associated with clinical malaria severity. Antimicrobial resistance is rampant amongst the bacterial isolates which stresses the importance of strengthening diagnostic tools and antimicrobial stewardship programs.