scholarly journals Acute Febrile Illness Among Children in Butajira, South–Central Ethiopia During the Typhoid Fever Surveillance in Africa Program

2019 ◽  
Vol 69 (Supplement_6) ◽  
pp. S483-S491 ◽  
Author(s):  
Mekonnen Teferi ◽  
Mulualem Desta ◽  
Biruk Yeshitela ◽  
Tigist Beyene ◽  
Ligia Maria Cruz Espinoza ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Febrile Illness ◽  
Incidence Rates ◽  
Acute Febrile Illness ◽  
Healthcare Facilities ◽  
South Central ◽  
Etiological Agents ◽  
Tract Infections ◽  
Pathogenic Agents ◽  
Malaria Microscopy

Abstract Background Clearly differentiating causes of fever is challenging where diagnostic capacities are limited, resulting in poor patient management. We investigated acute febrile illness in children aged ≤15 years enrolled at healthcare facilities in Butajira, Ethiopia, during January 2012 to January 2014 for the Typhoid Fever Surveillance in Africa Program. Methods Blood culture, malaria microscopy, and blood analyses followed by microbiological, biochemical, and antimicrobial susceptibility testing of isolates were performed. We applied a retrospectively developed scheme to classify children as malaria or acute respiratory, gastrointestinal or urinary tract infection, or other febrile infections and syndromes. Incidence rates per 100 000 population derived from the classification scheme and multivariate logistic regression to determine fever predictors were performed. Results We rarely observed stunting (4/513, 0.8%), underweight (1/513, 0.2%), wasting (1/513, 0.2%), and hospitalization (21/513, 4.1%) among 513 children with mild transient fever and a mean disease severity score of 12 (95% confidence interval [CI], 11–13). Blood cultures yielded 1.6% (8/513) growth of pathogenic agents; microscopy detected 13.5% (69/513) malaria with 20 611/µL blood (95% CI, 15 352–25 870) mean parasite density. Incidences were generally higher in children aged ≤5 years than >5 to ≤15 years; annual incidences in young children were 301.3 (95% CI, 269.2–337.2) for malaria and 1860.1 (95% CI, 1778.0–1946.0) for acute respiratory and 379.9 (95% CI, 343.6–420.0) for gastrointestinal tract infections. Conclusions We could not detect the etiological agents in all febrile children. Our findings may prompt further investigations and the reconsideration of policies and frameworks for the management of acute febrile illness.

Using Clinical Profiles and Complete Blood Counts to Differentiate Causes of Acute Febrile Illness during the 2009–11 Outbreak of Typhoid and Chikungunya in a Dengue Endemic Area

2020 ◽  
Vol 66 (5) ◽  
pp. 504-510
Author(s):  
Kamolwish Laoprasopwattana ◽  
Wannee Limpitikul ◽  
Alan Geater
Keyword(s):  
Typhoid Fever ◽  
Predictive Value ◽  
Nonstructural Protein ◽  
Specific Treatment ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Negative Results ◽  
Nonstructural Protein 1 ◽  
Clinical Profiles ◽  
Complete Blood Counts

Abstract Background and aims After the 2009–11 outbreak of typhoid and chikungunya (CHIK) in Thailand, an effort was made to use complete blood counts and clinical profiles to differentiate these diseases to facilitate earlier specific treatment. Methods Patients aged 2–15 years having fever on first visit ≤3 days without localizing signs were enrolled retrospectively. Typhoid fever was confirmed by hemoculture, dengue by nonstructural protein-1 or polymerase chain reaction (PCR), and CHIK by PCR. Febrile children with negative results for these infections were classified as other acute febrile illness (AFI). Results Of the 264 cases, 56, 164, 25 and 19 had typhoid fever, dengue viral infection (DVI), CHIK and other AFI, respectively. Arthralgia had sensitivity, specificity, positive predictive value (PPV) and negative predictive value of 0.96, 0.97, 0.80 and 0.99, respectively, to differentiate CHIK from the others. After excluding CHIK by arthralgia, the PPV of the WHO 1997 and 2009 criteria for DVI increased from 0.65 and 0.73 to 0.95 and 0.84, respectively. Children with one of myalgia, headache or leukopenia had sensitivity of 0.84, specificity of 0.76 and PPV of 0.92 to differentiate DVI from typhoid and other AFIs. Patients with one of abdominal pain, diarrhea or body temperature >39.5°C were more likely to have typhoid fever than another AFI with PPV of 0.90. Conclusion Using this flow chart can help direct physicians to perform more specific tests to confirm the diagnosis and provide more specific treatment. Nevertheless, clinical follow-up is the most important tool in unknown causes of febrile illness.

scholarly journals Redefining typhoid diagnosis: what would an improved test need to look like?

2019 ◽  
Author(s):  
Richard Mather ◽  
Heidi Hopkins ◽  
Christopher M. Parry ◽  
Sabine Dittrich
Keyword(s):  
Typhoid Fever ◽  
Diagnostic Test ◽  
Clinical Medicine ◽  
Point Of Care ◽  
Treatment Algorithm ◽  
Febrile Illness ◽  
Diagnosis And Treatment ◽  
Acute Febrile Illness ◽  
Next Generation ◽  
Antibiotic Overuse

IntroductionTyphoid fever is one of the most common bacterial causes of acute febrile illness in the developing world, with an estimated 10.9 million new cases and 116.8 thousand deaths in 2017. Typhoid point-of-care (POC) diagnostic tests are widely used but have poor sensitivity and specificity, resulting in antibiotic overuse that has led to the emergence and spread of multidrug resistant strains. With recent advances in typhoid surveillance and detection, this is the ideal time to produce a target product profile (TPP) that guides product development and ensure that a next-generation test meets the needs of users in the resource-limited settings where typhoid is endemic.MethodsA structured literature review was conducted to develop a draft TPP for a next-generation typhoid diagnostic test with minimal and optimal desired characteristics for 36 test parameters. The TPP was refined using feedback collected from a Delphi survey of key stakeholders in clinical medicine, microbiology, diagnostics and public and global health.ResultsA next-generation typhoid diagnostic test should improve patient management through the diagnosis and treatment of infection with acute Salmonella enterica serovars Typhi or Paratyphi with a sensitivity ≥90% and specificity ≥95%. The test would ideally be used at the lowest level of the healthcare system in settings without a reliable power or water supply and provide results in less than 15 minutes at a cost of <$1.00 USD.ConclusionThis report outlines the first comprehensive TPP for typhoid fever and is intended to guide the development of a next-generation typhoid diagnostic test. An accurate POC test will reduce the morbidity and mortality of typhoid fever through rapid diagnosis and treatment and will have the greatest impact in reducing antimicrobial resistance if it is combined with diagnostics for other causes of acute febrile illness in a treatment algorithm.

scholarly journals Aetiology of acute febrile illness among children attending a tertiary hospital in southern Ethiopia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Techalew Shimelis ◽  
Birkneh Tilahun Tadesse ◽  
Fitsum W/Gebriel ◽  
John A. Crump ◽  
Gill Schierhout ◽  
...  
Keyword(s):  
Throat Swab ◽  
Demographic Data ◽  
Febrile Illness ◽  
Shigella Dysenteriae ◽  
Diffusion Method ◽  
Southern Ethiopia ◽  
Acute Febrile Illness ◽  
Bacterial Isolates ◽  
Cross Sectional ◽  
Tract Infections

Abstract Background The diagnosis of non-malarial aetiologies, which now represent the majority of febrile illnesses, has remained problematic in settings with limited laboratory capacity. We aimed to describe common aetiologies of acute febrile illness among children in a setting where malaria transmission has declined. Methods A prospective cross-sectional study was conducted among children aged at least 2 months and under 13 years presenting with fever (temperature of ≥37.5 °C or a history of fever in the past 48 h) to Hawassa Comprehensive Specialized Hospital, southern Ethiopia, from May 2018 through February 2019. Clinical and demographic data were gathered for consecutive participants, and malaria microscopy, HIV testing, and blood and urine cultures were performed regardless of clinical presentation. Additionally, stool analyses (culture and rotavirus/adenovirus RDT) and throat swab for group A Streptococcus (GAS) and urine Streptococcus pneumoniae were performed by RDTs for children with specific conditions. The antimicrobial susceptibility of bacterial isolates was determined using disc diffusion method. Results During the study period 433 children were recruited, median age 20 months (range, 2 months – 12 years) and 178 (41.1%) female. Malaria was diagnosed in 14 (3.2%) of 431 children, and 3 (0.7%) had HIV infection. Bacteraemia or fungaemia was detected in 27 (6.4%) of 421 blood cultures, with Staphylococcus aureus isolated in 16 (3.8%). Urinary tract infections (UTIs) were detected in 74 (18.4%) of 402, with Escherichia coli isolated in 37 (9.2%). Among 56 children whose stool specimens were tested, 14 (25%) were positive for rotavirus, 1 (1.8%) for Salmonella Paratyphi A, and 1 (1.8%) for Shigella dysenteriae. Among those with respiratory symptoms, a throat swab test for GAS and urine test for S. pneumoniae were positive in 28 (15.8%) of 177 and 31 (17.0%) of 182, respectively. No test was positive for a pathogen in 266 (61.4%) of 433 participants. Bacterial isolates were frequently resistant to ampicillin, trimethoprim-sulfamethoxazole, tetracycline, and amoxicillin and clavulanic acid. Conclusion Our results showed low proportions of malaria and bacteraemia among febrile children. In contrast, the frequent detection of UTI emphasize the need to support enhanced diagnostic capacity to ensure appropriate antimicrobial intervention.

scholarly journals Infectious Etiologies of Acute Febrile Illness among Patients Seeking Health Care in South-Central Cambodia

2012 ◽  
Vol 86 (2) ◽  
pp. 246-253 ◽  
Author(s):  
Matthew R. Kasper ◽  
Patrick J. Blair ◽  
Sok Touch ◽  
Buth Sokhal ◽  
Chadwick Y. Yasuda ◽  
...  
Keyword(s):  
Health Care ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
South Central

scholarly journals Antibiotic trends in acute febrile illness

2017 ◽  
Vol 6 (2) ◽  
pp. 334
Author(s):  
Riyaz Ahmed Siddiqui ◽  
Tanaji R. Shende ◽  
Y. Dhoble ◽  
Archana S. Borkar
Keyword(s):  
Urinary Tract Infection ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Respiratory Tract Infections ◽  
Febrile Illness ◽  
Unknown Origin ◽  
Acute Febrile Illness ◽  
Pyrexia Of Unknown Origin ◽  
Tract Infections

Background: Acute febrile illness has various etiologies. Different antimicrobials are used for different causes of fever to treat and there are interpersonal variations in prescription of antimicrobials. Therefore this study aims at to analyze the trends in the antimicrobial prescription in patients of acute febrile illness due to various etiologies in the medicine department of a tertiary care hospital.Methods: It is a record based observational study that was carried out at NKP salve institute of medical sciences and RC, Nagpur. 200 case record files of patients admitted with a diagnosis of acute febrile illness in the dept. of Medicine due to various etiologies were analyzed. Antibiotics prescribed for various causes of acute febrile illness like respiratory tract infections, urinary tract infection, gastrointestinal infection, malarial infections, septicemia, meningitis, pyrexia of unknown origin etc. were noted and data was analyzed for prescription pattern of antimicrobials.Results: Out of 200 patients of febrile illness the common clinical conditions for which antibiotics were prescribed were respiratory tract infections (upper respiratory tract infection 25.5% and lower respiratory tract infection 14%), acute gastroenteritis (20%), and urinary tract infection (13.5%) followed by, pyrexia of unknown origin (8.5%), viral fever (8%), malaria (7%), hepatitis A (1.5%), meningitis (1%) and rickettsial infection (1%). The commonly prescribed antibiotics were ceftriaxone in (19.37%) and cefixime (15.93%) followed by coamoxiclav (12.5%), azithromycin (11.87%), doxycycline (10.31%), ofloxacin and ornidazole (8.43%), levofloxacin (6.25%), ofloxacin (4.68%), ciprofloxacin (1.87%), artesunate (3.75%), artemether and lumefantrine (4.37%) and valacyclovir (0.625%).Conclusions: Our study concluded that most common disease for which antibiotics prescribed were respiratory tract infection and gasterointestinal infections. Most common antibiotic used were third generation cephalosporins especially ceftriaxone and cefixime.

scholarly journals Dengue Typhoid Co-infection: a New Threat

2019 ◽  
Vol 10 (1) ◽  
pp. 96-97
Author(s):  
Md Mahmudur Rahman Siddiqui ◽  
Quazi Tarikul Islam ◽  
Mohammad Shahidul Islam
Keyword(s):  
Public Health ◽  
Developing Countries ◽  
Typhoid Fever ◽  
Dengue Fever ◽  
Clinical Diagnosis ◽  
Clinical Presentation ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Medical College ◽  
Common Clinical Presentation

Acute febrile illness is the most common clinical presentation among patients attending to doctor in developing countries. In Bangladesh, dengue and typhoid fever have emerged as major public health problems. Co-infection with both these diseases is rarely reported and are known to present with overlapping symptoms making the clinical diagnosis difficult. The exact incidence of dengue and typhoid co-infection is not known. Here we report a case of co-infection of dengue fever with typhoid fever. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 96-97

scholarly journals Redefining typhoid diagnosis: what would an improved test need to look like?

2019 ◽  
Vol 4 (5) ◽  
pp. e001831
Author(s):  
Richard G Mather ◽  
Heidi Hopkins ◽  
Christopher M Parry ◽  
Sabine Dittrich
Keyword(s):  
Typhoid Fever ◽  
Diagnostic Test ◽  
Clinical Medicine ◽  
Point Of Care ◽  
Treatment Algorithm ◽  
Febrile Illness ◽  
Diagnosis And Treatment ◽  
Acute Febrile Illness ◽  
Next Generation ◽  
Antibiotic Overuse

IntroductionTyphoid fever is one of the most common bacterial causes of acute febrile illness in the developing world, with an estimated 10.9 million new cases and 116.8 thousand deaths in 2017. Typhoid point-of-care (POC) diagnostic tests are widely used but have poor sensitivity and specificity, resulting in antibiotic overuse that has led to the emergence and spread of multidrug-resistant strains. With recent advances in typhoid surveillance and detection, this is the ideal time to produce a target product profile (TPP) that guides product development and ensure that a next-generation test meets the needs of users in the resource-limited settings where typhoid is endemic.MethodsA structured literature review was conducted to develop a draft TPP for a next-generation typhoid diagnostic test with minimal and optimal desired characteristics for 36 test parameters. The TPP was refined using feedback collected from a Delphi survey of key stakeholders in clinical medicine, microbiology, diagnostics and public and global health.ResultsA next-generation typhoid diagnostic test should improve patient management through the diagnosis and treatment of infection with acute Salmonella enterica serovars Typhi or Paratyphi with a sensitivity ≥90% and specificity ≥95%. The test would ideally be used at the lowest level of the healthcare system in settings without a reliable power or water supply and provide results in <15 min at a cost of <US$1.00.ConclusionThis report outlines the first comprehensive TPP for typhoid fever and is intended to guide the development of a next-generation typhoid diagnostic test. An accurate POC test will reduce the morbidity and mortality of typhoid fever through rapid diagnosis and treatment and will have the greatest impact in reducing antimicrobial resistance if it is combined with diagnostics for other causes of acute febrile illness in a treatment algorithm.

An infection cocktail: malaria, dengue, chikungunya and Japanese encephalitis

2018 ◽  
Vol 49 (1) ◽  
pp. 42-43
Author(s):  
Nishanth Dev
Keyword(s):  
Japanese Encephalitis ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Healthcare Facilities ◽  
Laboratory Parameters ◽  
Vector Borne Diseases ◽  
Altered Sensorium ◽  
First Case ◽  
Significant Burden ◽  
Vector Borne

Vector-borne diseases cause a significant burden on healthcare facilities. An increasing number of cases reported with multiple co-infections only add to the ordeal. The presence of co-infection may modify clinical and laboratory parameters significantly making diagnosis and treatment a challenge. Cases of malaria and dengue with other infections such as chikungunya, leptospirosis and hepatitis have been reported previously. We report a case of acute febrile illness with altered sensorium which was eventually diagnosed to have quadruple infection with malaria, dengue, chikungunya and Japanese encephalitis. This may be the first case with four concurrent vector-borne infections, all of which are transmitted by mosquitoes.

scholarly journals Prediction of disease severity in young children presenting with acute febrile illness in resource-limited settings: a protocol for a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e045826
Author(s):  
Arjun Chandna ◽  
Endashaw M Aderie ◽  
Riris Ahmad ◽  
Eggi Arguni ◽  
Elizabeth A Ashley ◽  
...  
Keyword(s):  
Observational Study ◽  
Prediction Model ◽  
Prospective Observational Study ◽  
Model Building ◽  
Venous Blood ◽  
Febrile Illness ◽  
Nasopharyngeal Swab ◽  
Acute Febrile Illness ◽  
Clinical Prediction ◽  
Open Access Journals

IntroductionIn rural and difficult-to-access settings, early and accurate recognition of febrile children at risk of progressing to serious illness could contribute to improved patient outcomes and better resource allocation. This study aims to develop a prognostic clinical prediction tool to assist community healthcare providers identify febrile children who might benefit from referral or admission for facility-based medical care.Methods and analysisThis prospective observational study will recruit at least 4900 paediatric inpatients and outpatients under the age of 5 years presenting with an acute febrile illness to seven hospitals in six countries across Asia. A venous blood sample and nasopharyngeal swab is collected from each participant and detailed clinical data recorded at presentation, and each day for the first 48 hours of admission for inpatients. Multianalyte assays are performed at reference laboratories to measure a panel of host biomarkers, as well as targeted aetiological investigations for common bacterial and viral pathogens. Clinical outcome is ascertained on day 2 and day 28.Presenting syndromes, clinical outcomes and aetiology of acute febrile illness will be described and compared across sites. Following the latest guidance in prediction model building, a prognostic clinical prediction model, combining simple clinical features and measurements of host biomarkers, will be derived and geographically externally validated. The performance of the model will be evaluated in specific presenting clinical syndromes and fever aetiologies.Ethics and disseminationThe study has received approval from all relevant international, national and institutional ethics committees. Written informed consent is provided by the caretaker of all participants. Results will be shared with local and national stakeholders, and disseminated via peer-reviewed open-access journals and scientific meetings.Trial registration numberNCT04285021.

scholarly journals Differential Laboratory Diagnosis of Acute Fever in Guinea: Preparedness for the Threat of Hemorrhagic Fevers

2021 ◽  
Vol 18 (11) ◽  
pp. 6022
Author(s):  
Vladimir G. Dedkov ◽  
N’Faly Magassouba ◽  
Olga A. Stukolova ◽  
Victoria A. Savina ◽  
Jakob Camara ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Febrile Illness ◽  
Laboratory Diagnosis ◽  
Acute Febrile Illness ◽  
Causative Pathogen ◽  
Hemorrhagic Fevers ◽  
Wide Range ◽  
Causative Agents ◽  
Pathognomonic Sign

Acute febrile illnesses occur frequently in Guinea. Acute fever itself is not a unique, hallmark indication (pathognomonic sign) of any one illness or disease. In the infectious disease context, fever’s underlying cause can be a wide range of viral or bacterial pathogens, including the Ebola virus. In this study, molecular and serological methods were used to analyze samples from patients hospitalized with acute febrile illness in various regions of Guinea. This analysis was undertaken with the goal of accomplishing differential diagnosis (determination of causative pathogen) in such cases. As a result, a number of pathogens, both viral and bacterial, were identified in Guinea as causative agents behind acute febrile illness. In approximately 60% of the studied samples, however, a definitive determination could not be made.

Sign in / Sign up

Export Citation Format

Share Document