Animal contact and paediatric acute febrile illness in Greater Accra Region, Ghana

OBJECTIVE: To examine the association between animal contact (primarily dogs and cats) and non-malarial fever, as well as with secondary symptoms of headache, nausea, vomiting, and cough, in 687 children in Greater Accra Region, Ghana. DESIGN: Cross-sectional study of acute febrile illness among children aged 1–15 years old between October 2016 and August 2017. SETTING: Ledzokuku-Krowor Municipal Assembly (LEKMA) Hospital, Teshie, Greater Accra Region. PARTICIPANTS: The study included children with acute fever, defined as a measured temperature of greater than 37.5°C, occurring less than seven days before the hospital visit, and afebrile children as controls. MAIN OUTCOME MEASURES: Measured fever, self-reported fever, and secondary symptoms, each adjusting for patient household characteristics. RESULTS: Animal contact was neither associated with measured fever (OR = 1.04, 95% CI 0.73–1.49) nor with self-reported fever (OR = 0.97, 95% CI 0.68–1.39). Animal contact was associated with headache (OR = 3.26, 95% CI 2.23–4.77, P < .01) and nausea (OR = 3.05, 95% CI 1.99–4.68, P < .01), but not with vomiting or cough. Additional models that used alternate inclusion criteria to define non-malarial fever yielded similar results. Several bacterial zoonoses that could plausibly have been transmitted by dogs and cats were diagnosed in the study population. CONCLUSION: These findings suggest the need for future studies to evaluate animal contact as a risk factor for bacterial zoonoses that may serve as an etiological driver of acute febrile illness. FUNDING: no external funding