Vector-Borne Disease is a Common Cause of Hospitalized Febrile Illness in India
| Autor: | Chhaya Valvi, Vandana Kulkarni, Aarti Kinikar, Ivan Marbaniang, Renu Bharadwaj, Dileep Kadam, Savita Kanade, George E. Nelson, Jonathan Sachs, Anju Kagal, Usha Balasubramanian, Yukari C. Manabe, Priyanka Raichur, Jonathan M. Zenilman, Matthew L Robinson, Anita Basavaraj, Amita Gupta, Sandhya Khadse, Vidya Mave |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Time Factors Adolescent 030231 tropical medicine India Mosquito Vectors Dengue fever Dengue Young Adult 03 medical and health sciences 0302 clinical medicine Virology Animals Humans Medicine Prospective Studies 030212 general & internal medicine Young adult Child Prospective cohort study business.industry Infant Articles Middle Aged medicine.disease Malaria Hospitalization Pneumonia Infectious Diseases Child Preschool Bacteremia Etiology Chikungunya Fever Female Parasitology business Meningitis |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene. 98:1526-1533 |
| ISSN: | 1476-1645 0002-9637 |
| Popis: | Acute febrile illness (AFI) is a major cause of morbidity and mortality in India and other resource-limited settings, yet systematic etiologic characterization of AFI has been limited. We prospectively enrolled adults (N = 970) and children (age 6 months to 12 years, N = 755) admitted with fever from the community to Sassoon General Hospital in Pune, India, from July 2013 to December 2015. We systematically obtained a standardized clinical history, basic laboratory testing, and microbiologic diagnostics on enrolled participants. Results from additional testing ordered by treating clinicians were also recorded. A microbiological diagnosis was found in 549 (32%) participants; 211 (12%) met standardized case definitions for pneumonia and meningitis without an identified organism; 559 (32%) were assigned a clinical diagnosis in the absence of a confirmed diagnosis; and 406 (24%) had no diagnosis. Vector-borne diseases were the most common cause of AFI in adults including dengue (N = 188, 19%), malaria (N = 74, 8%), chikungunya (N = 15, 2%), and concurrent mosquito-borne infections (N = 23, 2%) occurring most frequently in the 3 months after the monsoon. In children, pneumonia was the most common cause of AFI (N = 214, 28%) and death. Bacteremia was found in 68 (4%) participants. Central nervous system infections occurred in 58 (6%) adults and 64 (8%) children. Etiology of AFI in India is diverse, highly seasonal, and difficult to differentiate on clinical grounds alone. Diagnostic strategies adapted for season and age may reduce diagnostic uncertainty and identify causative organisms in treatable, fatal causes of AFI. |
| Databáze: | OpenAIRE |
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