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Non-malarial febrile illness

Guest edited by: Philippe Guerin


Non-malarial Febrile illness (NMFI) is one of the most common reasons for healthcare visits globally, with hundreds of millions of cases of fever in children under four presenting at health facilities every year. In malaria-endemic countries, malaria was historically assumed to be the cause of fever, however, the advent of rapid diagnostic tests, combined with intensified malaria control activities over the last decade, has substantially reduced incidence rates and it is now clear that most acute fever cases are of non-malarial aetiology. 

Diseases such as typhoid, leptospirosis, rickettsioses, community-acquired bacteraemia, as well as COVID-19 and others are among the important causes of fever that require specific treatment approaches, but these currently cannot be diagnosed accurately in the vast majority of healthcare settings in resource limited settings.

In order to map the main causes of fever in all malaria-endemic regions, researchers associated with the WorldWide Antimalarial Network (WWARN) and the Infectious Diseases Data Observatory (IDDO) at the University of Oxford, UK; Foundation for Innovative New Diagnostics (FIND), Switzerland; the London School of Hygiene & Tropical Medicine (LSHTM), UK; University of Hong Kong, China; Fundação Oswaldo Cruz (Fiocruz), Brazil; University of Otago, New Zealand and the MORU Tropical Health Network - Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU) and Cambodia-Oxford Medical Research Unit (COMRU); have conducted thorough systematic reviews of the published literature for all malaria-endemic regions  (Africa, China, Latin America, Southern-Asia, and South-Eastern Asia) to provide a comprehensive analysis of the literature available to date. 

In this collection, BMC Medicine presents this series of systematic reviews that aim to evaluate the causes of non-malarial febrile illnesses in these regions. The results of these large-scale reviews have been incorporated into an open access, online database, the NMFI Surveyor, that supports an interactive map where the data can be visualised around the world. The tool can filter data by country, microorganism type, patient age, sample type, pathogen family, genus and species, study year, geographic region and sub-region. To view the map and learn more about this collection, please visit the IDDO site

The responsibility for all final editorial decisions on the content for this collection was with the Chief Editor.

  1. In the absence of definitive diagnosis, healthcare providers are likely to prescribe empirical antibacterials to those who test negative for malaria. This problem is of critical importance in Southern Asia (SA...

    Authors: Poojan Shrestha, Prabin Dahal, Chinwe Ogbonnaa-Njoku, Debashish Das, Kasia Stepniewska, Nigel V. Thomas, Heidi Hopkins, John A. Crump, David Bell, Paul N. Newton, Elizabeth A. Ashley and Philippe J. Guérin
    Citation: BMC Medicine 2020 18:299
  2. In malaria-endemic countries, febrile episodes caused by diseases other than malaria are a growing concern. However, limited knowledge of the prevalent etiologic agents and their geographic distributions restr...

    Authors: José Moreira, Janaina Barros, Oscar Lapouble, Marcus V. G. Lacerda, Ingrid Felger, Patricia Brasil, Sabine Dittrich and Andre M. Siqueira
    Citation: BMC Medicine 2020 18:294
  3. The availability of reliable point-of-care tests for malaria has heralded a paradigm shift in the management of febrile illnesses away from presumptive antimalarial therapy. In the absence of a definitive diag...

    Authors: Jeanne Elven, Prabin Dahal, Elizabeth A. Ashley, Nigel V. Thomas, Poojan Shrestha, Kasia Stepniewska, John A. Crump, Paul N. Newton, David Bell, Hugh Reyburn, Heidi Hopkins and Philippe J. Guérin
    Citation: BMC Medicine 2020 18:279