A Center of Excellence for Biomedical Research and Training in Africa


Febrile Illness Evaluation in a Broad Range of Endemicities

FIEBRE study

Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE)

Co-principal investigators: Katharina Kranzer and Rashida Ferrand

Funder: UKAid from the Department for International Development

Project precis:

FIEBRE is a multi-disciplinary project, led by the London School of Hygiene & Tropical Medicine, that is investigating the leading causes of fever in children and adults attending primary care health services and those admitted to district hospitals in Laos, Malawi, Mozambique, Myanmar and Zimbabwe. This is the largest study of its kind, aiming to tackle antimicrobial resistance and develop a ‘blueprint’ for treatment.

By identifying the treatable and preventable causes of febrile illness in the five countries, and how patients with fever are cared for, the researchers aim to design new evidence-based guidelines for the management of fever. This will ensure patients receive drugs that give them the best chance of recovery, as well as help stop the spread of antimicrobial resistance.

The BRTI is the Zimbabwe arm of this multicentre study and the team were the first site to start recruiting patients in June 2018 following successful joint training with laboratory science, clinical epidemiology and social science staff from the Malawi site.

Another part of the study will involve interviews and focus group discussions with local adults and families, prescribers, and workers who generate and implement clinical guidelines. (see http://brti.co.zw/index.php/fiebre-study/ )

For more information about the study see the FIEBRE website (https://www.lshtm.ac.uk/fiebre).

Project period: March 2017 – March 2021


Febrile illness evaluation in a broad range of endemicities - Social Science Study

Febrile illness evaluation in a broad range of endemicities - Social Science Study                                                              

Principal Investigators: Dr Clare Chandler, Dr Justin Dixon and Salome Manyau (PhD Candidate)

The FIEBRE social science study, sponsored by the London School of Hygiene and Tropical Medicine, aims to explore the connections between fever and antimicrobial use (AMU) in Zimbabwe, across a variety of formal and informal settings including clinics, hospitals, pharmacies, markets and homes. By conducting social research, we aim to broaden the debates around AMU and febrile illness from individual decision-making to the wider social and economic processes that give antimicrobials their prominence in everyday life.  In doing so, we will offer valuable insights towards devising ways of better using antimicrobials in fever case management and for limiting the impact of antimicrobial resistance (AMR) on care, lives and livelihoods. Three key themes will form the starting point for our investigations:

Fever. Fever is defined clinically as an abnormally high body temperature. But it is important to know how fever is actually experienced, conceptualized and acted upon in order to understand its utility as a category in fever case management.

Care. Antimicrobials often take the form of care in everyday life. They are objects that ‘care’ for our sick and vulnerable. It is important to further our understanding of how AMU is linked to institutional, ethical and everyday forms of care

Pharmaceuticals and Markets. Our use of antimicrobials is shaped by the multitude of contexts within which they are prescribed, sold and traded. It is important to explore both the nature and scale of markets that antimicrobials are traded in, and how these markets are shaped by specific historical, social, economic and regulatory factors (e.g. exploring the factors that shape and influence access and use of medicines).

The FIEBRE social science study is conducted by the London School of Hygiene and Tropical Medicine, in collaboration with the Biomedical Research and Training Institute. For further information, see the following websites:


URL:  http://amr.lshtm.ac.uk/2017/04/19/febrile-illness-etiologies-broad-range-endemicities-fiebre/

BRTI website: http://brti.co.zw/

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With the contributions from a dedicated and professional staff complement, BRTI has achieved  20 years of continuing growth. From its inception in 1995, the BRTI has strived to become a a centre for excellence in health research and training in Africa. We are confident that the philosophy behind the formation of BRTI, that African scientists must take responsibility for improving their own working environment, was correct. We predict that, in spite of a degree of economic uncertainty in Zimbabwe, the gains that have been made during these years can be consolidated and expanded. We look forward to the future with confidence.

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