Profil de la protéine C-réactive chez les enfants fébriles de 6 à 59 mois dans les zones endémiques du paludisme

Abstract

Introduction: C-reactive protein (CRP) is an inflammatory marker useful for the early detection of acute infections, but its effectiveness as a predictor of bacterial infections varies across regions. This study aims to evaluate the role of CRP in diagnosing febrile infections in outpatient settings in Burkina Faso.

Methods: The study is part of an initiative to reduce antibiotic prescriptions and improve the management of febrile children in primary care. Children aged 6 to 59 months presenting with fever or a history of fever in the past 7 days were randomized to receive a rapid diagnostic test (RDT) for malaria-detecting PfHRP2 and CRP. CRP values were categorized into four levels to assess the risk of bacterial infection.

Results: Among the 394 children included, 54.3% had positive PfHRP2 RDT. Of these, 33.2% had a CRP >80 mg/L compared to 10.4% among the children who tested negative. A CRP >80 mg/L was more common in children with a temperature >39.4ºC. PfHRP2-positive children had a higher rate of eligibility for antibiotics, regardless of CRP thresholds.

Conclusion: CRP shows potential in managing febrile illnesses in children aged 6 to 59 months. However, elevated CRP levels in malaria cases could lead to overprescription of antibiotics if interpreted alone.