Epidemiology of Febrile Illnesses in Three Hospitals in Southern Benin

<i>Background:</i> Fever remains one of the most frequent reasons for medical consultation. In low and middle resource settings, particularly in Benin, it is often presumed to be of infectious origin—most commonly malaria—due to the endemicity of the parasite. However, the gradual decline in malaria prevalence and the growing diversity of potential etiologies warrant a re-evaluation of the epidemiological profile of febrile illnesses in this context. This study aimed to describe the epidemiology of febrile illnesses in three hospitals located in southern Benin. <i>Methods:</i> A prospective descriptive study was conducted from October 9, 2023, to January 15, 2024, in the pediatric, internal medicine, and emergency departments of the National University Hospital Centre Hubert Koutoukou Maga (CNHU-HKM) in Cotonou, the Abomey-Calavi District Hospital, and the Ouidah District Hospital. The study included patients 308 presenting with fever upon admission or developing fever during hospitalization, defined as a temperature ≥ 38°C in individuals under 18 years and ≥ 37.6°C in those aged 18 years and older. For each participant, detailed interviews and complete clinical examinations were performed to collect sociodemographic and clinical data. Relevant laboratory findings were extracted from medical records. <i>Results:</i> A total of 308 febrile patients were enrolled. Males were predominant (54.22%), and the most represented age group was 31–40 years. The most common functional symptoms were asthenia (73.05%), anorexia (56.16%), and headache (51.30%). Neurological manifestations were the most frequent (38.69%), followed by pleuropulmonary (21.10%) and cutaneous signs (17.86%). Anemia was observed in 40.91% of patients, while leukocytosis occurred in 30.19%. Infectious diseases accounted for 79.22% of identified etiologies, dominated by malaria (50%), followed by bacterial infections. Acute cerebrovascular accidents were the leading non-infectious causes (5.84%). The main treatments included antimalarial and antibiotic therapies. The outcome was favorable in 78.57% of cases, while the case fatality rate was 10.06%. <i>Conclusion:</i> In southern Benin, fever remains predominantly of infectious origin, with malaria still representing the leading cause. However, the increasing proportion of bacterial and neurological etiologies highlights the need to strengthen diagnostic capacities for more accurate and effective management of febrile illnesses.