Patient Flow for febrile adults in cohort 1 (2207–2008) and cohort 2 (2011–2012) admitted to Mawenzi Regional Hospital (MRH) and Kilimanjaro Christian Medical Center (KCMC).

<p>Patient Flow for febrile adults in cohort 1 (2207–2008) and cohort 2 (2011–2012) admitted to Mawenzi Regional Hospital (MRH) and Kilimanjaro Christian Medical Center (KCMC).</p

Diagnoses, treatments, and outcomes of febrile adults in cohort 1 (2007–2008) and cohort 2 (2011–2012) admitted to Mawenzi Regional Hospital (MRH) and Kilimanjaro Christian Medical Centre (KCMC).

<p>Significant results are marked in bold.</p><p>* Significance tests for comparisons between cohorts determined by Kruskal-Wallis test for continuous variables and Pearson's chi-square test for categorical variables.</p>†<p>Adjusted for hospital location.</p>‡<p>Presenting symptoms of stiff neck or convulsions, positive cultures arriving in time to influence clinical decisions or discharge diagnosis with strong indication for antibacterials.</p>§<p>Unable to calculate adjusted means because of small sample size.</p>¶<p>Adjusted for hospital location and known HIV-serostatus.</p

Demographics of health care utilization study population compared to Tanzania 2002 Population and Housing Census, Moshi Urban and Moshi Rural Districts, combined.

*<p>Ref 7.</p

Africa, Tanzania and Kilimanjaro Region.

<p>Moshi Rural District shown in dark gray and Moshi Urban District in black in the Kilimanjaro Region inset.</p

Surveillance pyramid.

<p>Multipliers were applied to account for incomplete assessments at various levels of the surveillance pyramid.</p

Reported health care seeking behavior among household survey respondents and calculated multipliers, Moshi Urban and Moshi Rural Districts, Tanzania, 2011.

<p>KCMC = Kilimanjaro Christian Medical Centre, MRH = Mawenzi Regional Hospital.</p>*<p>Number of respondents who chose KCMC as their first or second choice for health care in response to respective questions.</p>†<p>Number of respondents who chose MRH as their first or second choice for health care in response to respective questions.</p>‡<p>Inverse of proportion of respondents who select KCMC for care in response to respective questions.</p>§<p>Inverse of proportion of respondents who select MRH for care in response to respective questions.</p

Leptospirosis incidence estimates, Moshi Urban and Moshi Rural Districts, Tanzania 2007–2008.

<p>KCMC = Kilimanjaro Christian Medical Centre, MRH = Mawenzi Regional Hospital, MAT = microscopic agglutination test.</p>*<p>Cases adjusted by ‘MAT sensitivity multiplier,’ MAT specificity, ‘KCMC multiplier,’ and KCMC referral adjustment.</p>†<p>Cases adjusted by ‘MAT sensitivity multiplier,’ MAT specificity and ‘MRH multiplier’.</p>‡<p>No. for the ≥15 years age group represents the mean of the KCMC adjusted case no. and MRH adjusted case no. No. for the 0 to <5 years and 5 to <15 years age groups equal the KCMC adjusted case no. since fever surveillance was not conducted in these groups at MRH.</p>§<p>‘Paired sera multiplier’ applied to estimates using confirmed cases only.</p>¶<p>Only KCMC data used for this estimate since MRH data represents a limited age range.</p>#<p>(Annual estimated cases/population) *100,000.</p

Confirmed and probable leptospirosis cases, Moshi Urban and Moshi Rural Districts residents, Kilimanjaro Christian Medical Center (KCMC) and Mawenzi Regional Hospital (MRH), Tanzania 2007–2008.

<p>KCMC = Kilimanjaro Christian Medical Centre, MRH = Mawenzi Regional Hospital.</p>*<p>Confirmed or probable cases based on testing of paired sera. For adjusted case calculations these cases were multiplied by a ‘MAT sensitivity multiplier’ of 1.00.</p>†<p>Probable cases based on testing of acute serum only. For adjusted case calculations these cases were multiplied by a ‘MAT sensitivity multiplier’ of 2.05.</p

Calculation of the proportion of hospitalized infants and children, and adolescents and adults, with specific etiologies of febrile illness, northern Tanzania, 2007–8.

<p>Due to changing denominators for individual diagnostic tests, the proportion with no diagnosis is calculated as the proportion without a positive result from any test. Bloodstream infections are those diagnosed predominantly by blood culture, including organisms such as <i>Salmonella enterica</i>, <i>Streptococcus pneumoniae</i>, <i>Cryptococcus neoformans</i>, and <i>Mycobacterium tuberculosis</i>. Bacterial zoonoses, including brucellosis, leptospirosis, Q fever, and rickettsioses were diagnosed predominantly by serology, based on a 4-fold or greater rise in antibody titer between an acute and convalescent sample.</p

Laboratory confirmed causes of febrile illness among infants and children (panel A) and adolescents and adults (panel B) hospitalized in northern Tanzania, 2007–8*.

<p>*In instances that diagnostic test results were not available for all participants, the proportion positive from <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002324#pntd-0002324-t001" target="_blank">Table 1</a> was applied to the whole study population. Pie graphs do not account for concurrent infections. A complete listing of specific bacterial, mycobacterial, and fungal bloodstream infections is available elsewhere <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002324#pntd.0002324-Crump1" target="_blank">[7]</a>, <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002324#pntd.0002324-Crump2" target="_blank">[8]</a>.</p