30 May 2025

In the remote corners of Chattogram Division in Bangladesh, a simple fever can be a death sentence. Limited access to care, delays in seeking help, and widespread self-medication are factors putting rural communities at risk. A new qualitative study dives deep into the challenges of managing acute febrile illness in these areas, drawing insights from interviews with local and international stakeholders.
The research reveals a fragile healthcare system strained by referral barriers, under-resourced emergency care, and reliance on community health workers who often lack the tools and training to respond to febrile illness beyond malaria. In the health centres, undiagnosed fevers are often treated with guesswork and unnecessary antibiotics, which fuels antimicrobial resistance.
This study makes the case for a more integrated approach – one that strengthens triage and referral systems, empowers frontline health workers with diagnostic tools and digital innovations, and removes the financial and logistical barriers that prevent timely care. As infectious disease patterns are shifting and rural health needs are evolving, we need to rethink how febrile illness in these communities is managed. Text: Marco Liverani