Mapping the aetiology of non-malarial febrile illness in Southeast Asia through a systematic review--terra incognita impairing treatment policies

Autor: Jun Nakagawa, Eva Christophel, David Bell, Paul N. Newton, Richard Cooksey, Iveth J. González, Philippe J Guerin, Didier Menard, Nathalie Acestor
Přispěvatelé: Malaria/Acute Febrile Syndrome Programme, Foundation for Innovative New Diagnostics (FIND), Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], WorldWide Antimalarial Resistance Network (WWARN), University of Oxford [Oxford]-Churchill Hospital Oxford Centre for Haematology, Wellcome Trust-Mahosot-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Institut Pasteur du Cambodge, Réseau International des Instituts Pasteur (RIIP), Malaria, Other Vector-borne and Parasitic Diseases, Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)
Jazyk: angličtina
Rok vydání: 2012
Předmět:
medicine.medical_specialty
Veterinary medicine
Viral Diseases
Health Screening
Fever
Systematic Reviews
Non-Clinical Medicine
Clinical Research Design
030231 tropical medicine
lcsh:Medicine
Disease
Global Health
Dengue fever
Dengue Fever
Body of knowledge
Dengue
03 medical and health sciences
0302 clinical medicine
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
medicine
Humans
030212 general & internal medicine
Intensive care medicine
Health Systems Strengthening
lcsh:Science
Disease burden
Asia
Southeastern
Multidisciplinary
Health Care Policy
Geography
business.industry
lcsh:R
Febrile illness
Tropical Diseases (Non-Neglected)
medicine.disease
3. Good health
Malaria
Infectious Diseases
Etiology
Medicine
lcsh:Q
Public Health
business
Terra incognita
Research Article
Neglected Tropical Diseases
Zdroj: PLoS ONE
PLoS ONE, Public Library of Science, 2012, 7 (9), pp.e44269. ⟨10.1371/journal.pone.0044269⟩
PLoS ONE, Vol 7, Iss 9, p e44269 (2012)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0044269⟩
Popis: International audience; BACKGROUND: An increasing use of point of care diagnostic tests that exclude malaria, coupled with a declining malaria burden in many endemic countries, is highlighting the lack of ability of many health systems to manage other causes of febrile disease. A lack of knowledge of distribution of these pathogens, and a lack of screening and point-of-care diagnostics to identify them, prevents effective management of these generally treatable contributors to disease burden. While prospective data collection is vital, an untapped body of knowledge already exists in the published health literature. METHODS: Focusing on the Mekong region of Southeast Asia, published data from 1986 to 2011 was screened to for frequency of isolation of pathogens implicated in aetiology of non-malarial febrile illness. Eligibility criteria included English-language peer-reviewed studies recording major pathogens for which specific management is likely to be warranted. Of 1,252 identified papers, 146 met inclusion criteria and were analyzed and data mapped. RESULTS: Data tended to be clustered around specific areas where research institutions operate, and where resources to conduct studies are greater. The most frequently reported pathogen was dengue virus (n = 70), followed by Orientia tsutsugamushi and Rickettsia species (scrub typhus/murine typhus/spotted fever group n = 58), Leptospira spp. (n = 35), Salmonella enterica serovar Typhi and Paratyphi (enteric fever n = 24), Burkholderia pseudomallei (melioidosis n = 14), and Japanese encephalitis virus (n = 18). Wide tracts with very little published data on aetiology of fever are apparent. DISCUSSION AND CONCLUSIONS: This mapping demonstrates a very heterogeneous distribution of information on the causes of fever in the Mekong countries. Further directed data collection to address gaps in the evidence-base, and expansion to a global database of pathogen distribution, is readily achievable, and would help define wider priorities for research and development to improve syndromic management of fever, prioritize diagnostic development, and guide empirical therapy.
Databáze: OpenAIRE
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