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Ferdousi T, Dutta AK, Chowdhury MAH, Islam K, Islam MT, Islam MZ, Bulbul MRH, Khan AI, Qadri F. Role of TaqMan array card in determining causative organisms of acute febrile illness in hospitalized patients. J Clin Lab Anal 2023; 37:e24948. [PMID: 37496432 PMCID: PMC10492456 DOI: 10.1002/jcla.24948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/23/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Acute febrile illness (AFI) is a prevalent disease in developing countries that is difficult to diagnose due to the diversity of infectious organisms and the poor quality of clinical diagnosis. TaqMan array card (TAC) can detect up to 35 AFI-associated organisms in 1.5 h, addressing diagnostic demands. In this study, we aimed to evaluate the role of TAC in determining the causative organisms in hospitalized AFI patients. METHODS The study had a cross-sectional design and enrolled 120 admitted patients with persistent fever for three or more days from the medicine ward of Chittagong Medical College Hospital (CMCH) and Bangladesh Institute of Tropical and Infectious Diseases Hospital (BITID). Blood samples were collected and then subjected to automated BacT/Alert blood culture, microbial culture, TAC assay, and typhoid/paratyphoid test. RESULTS The total number of study participants was 120, among them 48 (40%) samples showed a positive result in TAC card, 29 (24.16%) were TP positive and nine (7.51%) were culture positive. The number of organisms detected by the TAC card was 13 bacteria, three viruses, one protozoan, and one fungus. The sensitivity and specificity of the TAC assay for different bacterial pathogen compared to blood culture was 44.44%, and 90.99%, respectively. In contrast, the TP test had a sensitivity and specificity of 100% and 80%, respectively, compared to the blood culture test. CONCLUSION TAC can be a handful tool for detecting multiple organisms in AFI with high specificity which can facilitate early diagnosis of different pathogens contributing to AFI.
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Affiliation(s)
- Tabassum Ferdousi
- Bangladesh Institute of Tropical and Infectious DiseasesChattogramBangladesh
| | | | | | - Kamrul Islam
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Md. Taufiqul Islam
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Md. Zahirul Islam
- Institute for Developing Science and Health Initiatives (ideSHi)DhakaBangladesh
| | | | - Ashraful Islam Khan
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Firdausi Qadri
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
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Geography and prevalence of rickettsial infections in Northern Tamil Nadu, India: a cross-sectional study. Sci Rep 2022; 12:20798. [PMID: 36460687 PMCID: PMC9718799 DOI: 10.1038/s41598-022-21191-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/23/2022] [Indexed: 12/03/2022] Open
Abstract
Rickettsial infections and Q fever are a common cause of acute febrile illness globally. Data on the role of climate and altitude on the prevalence of these infections in lacking from Southern India. In this study, we determined the sero-prevalence of scrub typhus (ST), spotted fever (SF), murine typhus (MT) and Q Fever (QF) in 8 eight geographical regions of North Tamil Nadu by detecting IgG antibodies using ELISA. Totally we tested 2565 people from 86 localities. Among the 27.3% positives, approximately 5% were IgG positive for two or more infections. Sero-prevalence to rickettsioses and Q fever was highest for individuals from rural areas and increased with age (> 30 years). Those in the Nilgiris highlands (wetter and cooler) and Erode, which has the most land under irrigation, demonstrated the least exposure to rickettsioses and Q fever. Lowland plains (AOR: 8.4-22.9; 95% CI 3.1-55.3) and highland areas up to 1000 m (AOR: 6.1-10.3; 95% CI 2.4-23.9) showed the highest risk of exposure to scrub typhus. For spotted fever, the risk of exposure was highest in Jawadhi (AOR:10.8; 95% CI 2.6-44.3) and Kalrayan (AOR:16.6; 95% CI 4.1-66.2). Q fever positivity was most likely to be encountered in Salem (AOR: 5.60; 95% CI 1.01-31.08) and Kalrayan hills (AOR:12.3; 95% CI 2.9-51.6). Murine typhus risk was significant only in Tiruvannamalai (AOR:24.2; 95% CI 3.3-178.6). Our study suggests that prevalence of rickettsial infections and Q fever is low in areas which receive rainfall of ≥ 150 cm/year, with average minimum and maximum temperatures between 15 and 25 °C and elevation in excess of 2000 m. It is also less in well irrigated lowlands with dry climate. These preliminary findings need confirmation by active surveillance in these areas.
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Das P, Rahman MZ, Banu S, Rahman M, Chisti MJ, Chowdhury F, Akhtar Z, Palit A, Martin DW, Anwar MU, Namwase AS, Angra P, Kato CY, Ramos CJ, Singleton J, Stewart-Juba J, Patel N, Condit M, Chung IH, Galloway R, Friedman M, Cohen AL. Acute febrile illness among outpatients seeking health care in Bangladeshi hospitals prior to the COVID-19 pandemic. PLoS One 2022; 17:e0273902. [PMID: 36048788 PMCID: PMC9436081 DOI: 10.1371/journal.pone.0273902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/18/2022] [Indexed: 11/19/2022] Open
Abstract
Understanding the distribution of pathogens causing acute febrile illness (AFI) is important for clinical management of patients in resource-poor settings. We evaluated the proportion of AFI caused by specific pathogens among outpatients in Bangladesh. During May 2019-March 2020, physicians screened patients aged ≥2 years in outpatient departments of four tertiary level public hospitals. We randomly enrolled patients having measured fever (≥100.4°F) during assessment with onset within the past 14 days. Blood and urine samples were tested at icddr,b through rapid diagnostic tests, bacterial culture, and polymerase chain reaction (PCR). Acute and convalescent samples were sent to the Centers for Disease Control and Prevention (USA) for Rickettsia and Orientia (R/O) and Leptospira tests. Among 690 patients, 69 (10%) had enteric fever (Salmonella enterica serotype Typhi orSalmonella enterica serotype Paratyphi), 51 (7.4%) Escherichia coli, and 28 (4.1%) dengue detected. Of the 441 patients tested for R/O, 39 (8.8%) had rickettsioses. We found 7 (2%) Leptospira cases among the 403 AFI patients tested. Nine patients (1%) were hospitalized, and none died. The highest proportion of enteric fever (15%, 36/231) and rickettsioses (14%, 25/182) was in Rajshahi. Dhaka had the most dengue cases (68%, 19/28). R/O affected older children and young adults (IQR 8-23 years) and was detected more frequently in the 21-25 years age-group (17%, 12/70). R/O was more likely to be found in patients in Rajshahi region than in Sylhet (aOR 2.49, 95% CI 0.85-7.32) between July and December (aOR 2.01, 1.01-5.23), and who had a history of recent animal entry inside their house than not (aOR 2.0, 0.93-4.3). Gram-negative Enterobacteriaceae were the most common bacterial infections, and dengue was the most common viral infection among AFI patients in Bangladeshi hospitals, though there was geographic variability. These results can help guide empiric outpatient AFI management.
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Affiliation(s)
- Pritimoy Das
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - M. Ziaur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sayera Banu
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mahmudur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Fahmida Chowdhury
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Zubair Akhtar
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Anik Palit
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Daniel W. Martin
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Mahabub Ul Anwar
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Angella Sandra Namwase
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Pawan Angra
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Cecilia Y. Kato
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Carmen J. Ramos
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Joseph Singleton
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Jeri Stewart-Juba
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Nikita Patel
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Marah Condit
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Ida H. Chung
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Renee Galloway
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Michael Friedman
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Adam L. Cohen
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
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Comparative evaluation of serological tests used for the diagnosis of rickettsial diseases prevalent in the temperate region of North India. Indian J Med Microbiol 2021; 40:294-298. [PMID: 34980488 DOI: 10.1016/j.ijmmb.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/17/2021] [Accepted: 12/11/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE The clinical manifestations of rickettsial diseases mimic other endemic infections with similar presentations thus posing a serious challenge to clinicians for their diagnosis. For the diagnosis of rickettsial disease serological tests like Weil Felix, ELISA and IFA are used. There are limited studies that have evaluated different serological tests for the diagnosis of rickettsial diseases. Therefore, the present study was undertaken to evaluate the ELISA and Weil Felix test for the diagnosis of rickettsial diseases prevalent in this region. METHODS Samples from 281 patients clinically suspected of rickettsial diseases were tested for spotted fever group (SFG), typhus group (TG) and scrub typhus group (STG) by Weil Felix, ELISA and IFA was taken as the gold standard. Baseline titers and cut-off ODs were calculated by taking samples from healthy blood donors. RESULTS The sensitivity, specificity, positive and negative predictive value of Weil Felix test ranged from 30% to 44%, 83.46%-97.86%, 9%-77%, 92-96% respectively. The sensitivity and specificity, positive and negative predictive value of ELISA ranged from 80.77% to 96.15%, 96.33%-98.43%, 70.21%-88.64%, 92.89%-99.60% respectively. Maximum cross-reactions were observed between SFG and STG by the Weil Felix test and between STG and TG by ELISA. CONCLUSIONS ELISA was found to be sensitive and specific for the diagnosis of rickettsial diseases. It is easy to perform, does not require a technical expert for result interpretation and a large number of samples can be processed at a time.
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Mansoor T, Fomda BA, Koul AN, Bhat MA, Abdullah N, Bhattacharya S, Saleem SM. Rickettsial Infections among the Undifferentiated Febrile Patients Attending a Tertiary Care Teaching Hospital of Northern India: A Longitudinal Study. Infect Chemother 2021; 53:96-106. [PMID: 34409783 PMCID: PMC8032907 DOI: 10.3947/ic.2020.0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/05/2021] [Indexed: 11/24/2022] Open
Abstract
Background Acute undifferentiated febrile illness (AUFI) is one of the most daunting challenges a physician faces in such settings. Among AUFI, rickettsial infections are most common and related infections (such as anaplasmosis, ehrlichiosis, and Q fever) which are caused by an unusual type of bacteria that can live only inside the cells of another organism. The present study was therefore planned with an objective to estimate the prevalence of rickettsial infection among patients of undifferentiated fever and to determine any association of socio-demographic characteristics with rickettsial disease. Materials and Methods Patients presenting with febrile illness and admitted or attending out-patient department of Sher-i-Kashmir Institute of Medical Sciences, Srinagar was approached and recruited in the study. Weil Felix Assay, enzyme-linked immunosorbent assay and indirect immunofluorescence assay were done to detect the anti-rickettsial antibodies. Serological evidence of a fourfold increase in IgG-specific antibody titer reactive with spotted fever group rickettsial antigen by indirect immunofluorescence antibody assays between paired serum specimens was considered a confirmatory diagnosis for the rickettsial disease. Results Most of the patients were males 61.6%, and most 46.2% were in the age group of 20 -39 years. Most of the patients, 80.8% belonged to rural areas, and 48% belonged to the upper middle (II) class of the socio-economic class according to modified Kuppuswamy scale. Of the studied participants, a majority, 47.0%, were determined undiagnosed, while 15.4% studied participants were diagnosed to have a rickettsial disease. In patients positive for typhus group, 67.8% were IgM positive, 28.5% were IgG positive, and only 3% were positive for IgM and IgG. In patients positive for Scrub Typhus Group, 32.7% were positive for IgM, and 62.0% were positive for IgG, and only 5.0% were positive for both IgM and IgG. In patients positive for spotted fever group, 36.1% were positive for IgM, and 58.5% were positive for IgG, and only 5.5% were positive for both IgM and IgG. The prevalence of rickettsial disease was found to be 11.3%. Conclusion Rickettsial diseases, typhoid and brucellosis, were the most prevalent diseased diagnosed among patients reporting to hospitals with undifferentiated febrile illness. Clinicians must consider rickettsial diseases as one of the differential diagnosis while treating patients with fever.
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Affiliation(s)
- Tabeen Mansoor
- Department of Microbiology, Government Medical College, Srinagar, India.
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6
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Turebekov N, Abdiyeva K, Yegemberdiyeva R, Kuznetsov A, Dmitrovskiy A, Yeraliyeva L, Shapiyeva Z, Batyrbayeva D, Tukhanova N, Shin A, Musralina L, Hoelscher M, Froeschl G, Dobler G, Freimueller K, Wagner E, Frey S, Essbauer S. Occurrence of Anti-Rickettsia spp. Antibodies in Hospitalized Patients with Undifferentiated Febrile Illness in the Southern Region of Kazakhstan. Am J Trop Med Hyg 2021; 104:2000-2008. [PMID: 33901004 DOI: 10.4269/ajtmh.20-0388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 02/09/2021] [Indexed: 12/16/2022] Open
Abstract
Undifferentiated febrile illness still represents a demanding medical problem all over the world, but primarily in low- and middle-income countries. Scientific and clinical investigations related to undifferentiated febrile illness and rickettsial diseases in Kazakhstan are lacking. This study reflects the investigation of antibodies against spotted fever group (SFG) and typhus group (TG) rickettsiae in patients with undifferentiated febrile illness in the southern region of Kazakhstan (Almaty and Kyzylorda oblasts). Paired serum samples were gathered from 13 hospitals in these two oblasts and explored for the presence of IgM and IgG antibodies against typhus group and IgG antibodies against spotted fever group rickettsiae using ELISA. Patient's questionnaires were statistically analyzed. In total, 802 inpatients from Almaty (N = 9) and Kyzylorda (N = 4) hospitals were included in this research. Based on ELISA results, 250 patients out of 802 (31.2%) from both oblasts had IgG antibodies against SFG rickettsiae. Results from 11 (1.4%) patients indicated acute infection with tick-borne rickettsiosis. Regarding TG rickettsiae (R. typhi), a past infection was detected in 248 (30.9%) febrile patients and acute infection in 22 (2.7%) patients in the two selected oblasts. The data indicated that SFG and TG rickettsioses are present in Kazakhstan. Kazakh physicians should be aware of these emerging diseases in both investigated oblasts because the occurrence of these diseases is not suspected during day-to-day clinical practice. The identification of rickettsial pathogens and implementation of modern laboratory methods for the diagnostics of rickettsioses are in need throughout Kazakhstan.
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Affiliation(s)
- Nurkeldi Turebekov
- 1Central Reference Laboratory, National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan
| | - Karlygash Abdiyeva
- 1Central Reference Laboratory, National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan
| | - Ravilya Yegemberdiyeva
- 2Department of Infectious and Tropical Diseases, Kazakh National Medical University, Almaty, Kazakhstan
| | - Andrey Kuznetsov
- 3National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan
| | - Andrey Dmitrovskiy
- 3National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan
| | - Lyazzat Yeraliyeva
- 4Department of Children's Infectious Diseases, Kazakh National Medical University, Almaty, Kazakhstan
| | - Zhanna Shapiyeva
- 5Scientific Practical Center of Sanitary Epidemiological Expertise and Monitoring, Almaty, Kazakhstan
| | - Dinara Batyrbayeva
- 6Scientific Clinical Diagnostic Laboratory, Kazakh National Medical University, Almaty, Kazakhstan
| | - Nur Tukhanova
- 7Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
| | - Anna Shin
- 7Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
| | - Lyazzat Musralina
- 8Al-Farabi Kazakh National University, Almaty, Kazakhstan.,9Institute of General Genetics and Cytology, Almaty, Kazakhstan
| | - Michael Hoelscher
- 10Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität, German Center for Infection Research, Munich Partner site, Munich, Germany
| | - Guenter Froeschl
- 7Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany.,10Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität, German Center for Infection Research, Munich Partner site, Munich, Germany
| | - Gerhard Dobler
- 11Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, German Center for Infection Research, Munich Partner site, Munich, Germany
| | - Klaus Freimueller
- 11Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, German Center for Infection Research, Munich Partner site, Munich, Germany
| | - Edith Wagner
- 11Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, German Center for Infection Research, Munich Partner site, Munich, Germany
| | - Stefan Frey
- 11Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, German Center for Infection Research, Munich Partner site, Munich, Germany.,12Bundeswehr Research Institute for Protective Technologies and CBRN Protection, Munster, Germany
| | - Sandra Essbauer
- 11Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, German Center for Infection Research, Munich Partner site, Munich, Germany
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Chowdhury S, Aleem MA, Khan MSI, Hossain ME, Ghosh S, Rahman MZ. Major zoonotic diseases of public health importance in Bangladesh. Vet Med Sci 2021; 7:1199-1210. [PMID: 33650812 PMCID: PMC8013274 DOI: 10.1002/vms3.465] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 01/01/2021] [Accepted: 02/16/2021] [Indexed: 12/19/2022] Open
Abstract
Zoonotic diseases cause repeated outbreaks in humans globally. The majority of emerging infections in humans are zoonotic. COVID‐19 is an ideal example of a recently identified emerging zoonotic disease, causing a global pandemic. Anthropogenic factors such as modernisation of agriculture and livestock farming, wildlife hunting, the destruction of wild animal habitats, mixing wild and domestic animals, wildlife trading, changing food habits and urbanisation could drive the emergence of zoonotic diseases in humans. Since 2001, Bangladesh has been reporting many emerging zoonotic disease outbreaks such as nipah, highly pathogenic avian influenza, pandemic H1N1, and COVID‐19. There are many other potential zoonotic pathogens such as Ebola, Middle East respiratory syndrome coronavirus, Kyasanur forest disease virus and Crimean–Congo haemorrhagic fever that may emerge in the future. However, we have a limited understanding of zoonotic diseases’ overall risk in humans and associated factors that drive the emergence of zoonotic pathogens. This narrative review summarised the major emerging, re‐emerging, neglected and other potential zoonotic diseases in Bangladesh and their associated risk factors. Nipah virus and Bacillus anthracis caused repeated outbreaks in humans. More than 300 human cases with Nipah virus infection were reported since the first outbreak in 2001. The highly pathogenic avian influenza virus (H5N1) caused more than 550 outbreaks in poultry, and eight human cases were reported so far since 2007. People of Bangladesh are frequently exposed to zoonotic pathogens due to close interaction with domestic and peri‐domestic animals. The rapidly changing intensified animal–human–ecosystem interfaces and risky practices increase the risk of zoonotic disease transmission. The narrative review's findings are useful to draw attention to the risk and emergence of zoonotic diseases to public health policymakers in Bangladesh and the application of one‐health approach to address this public health threat.
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Affiliation(s)
- Sukanta Chowdhury
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad A Aleem
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.,University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Md Shafiqul I Khan
- Department of Food Microbiology, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Mohammad Enayet Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sumon Ghosh
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammed Z Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Srinivas S, Vijayasuriar S, Chandrasekaran P, Lakshmikantha K. Chikungunya rickettsial coinfection with fatal outcome: A diagnostic dilemma. INDIAN JOURNAL OF PAEDIATRIC DERMATOLOGY 2021. [DOI: 10.4103/ijpd.ijpd_143_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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9
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Rahman MM, Been Sayed SJ, Moniruzzaman M, Kabir AKMH, Mallik MU, Hasan MR, Siddique AB, Hossain MA, Uddin N, Hassan MM, Chowdhury FR. Clinical and Laboratory Characteristics of an Acute Chikungunya Outbreak in Bangladesh in 2017. Am J Trop Med Hyg 2019; 100:405-410. [PMID: 30526743 PMCID: PMC6367608 DOI: 10.4269/ajtmh.18-0636] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
From April to September 2017, Bangladesh experienced a huge outbreak of acute Chikungunya virus infection in Dhaka. This series describes the clinical and laboratory features of a large number of cases (690; 399 confirmed and 291 probable) suffered during that period. This observational study was carried out at Dhaka Medical College Hospital, Bangladesh. The median age of the patients at presentation was 38 years (IQR 30–50) with a male (57.3%) predominance. Hypertension and diabetes were the most common comorbidities. The mean (±SD) duration of fever was 3.7 (±1.4) days. Other common manifestations were arthralgia (99.2%), maculopapular rash (50.2%), morning stiffness (49.7%), joint swelling (48.5%), and headache (37.6%). Cases were confirmed by anti-chikungunya IgG (173; 43.3%), IgM (165; 42.3%), and reverse transcription polymerase chain reaction (44; 11.0%). Important laboratory findings include high erythrocyte sedimentation rate (156; 22.6%), raised serum glutamic pyruvic transaminase (73; 10.5%), random blood sugar (54; 7.8%), leukopenia (72; 10.4%), thrombocytopenia (41; 5.9%), and others. The oligo-articular (453; 66.1%) variety of joint involvement was significantly more common compared with the poly-articular (237; 34.5%) variety. Commonly involved joints were the wrist (371; 54.1%), small joints of the hand (321; 46.8%), ankle (251; 36.6%), knee (240; 35.0%), and elbow (228; 33.2%). Eleven cases were found to be complicated with neurological involvement and two of them died. Another patient died due to myocarditis. Public health experts, clinicians, and policymakers could use the results of this study to construct the future strategy tackling chikungunya in Bangladesh and other epidemic countries.
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Affiliation(s)
| | | | | | | | - Md Uzzwal Mallik
- Director General of Health Services, Dhaka, Bangladesh.,Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Md Rockyb Hasan
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | | | - Md Arman Hossain
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Nazim Uddin
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Md Mehedi Hassan
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Fazle Rabbi Chowdhury
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.,Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
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10
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Satjanadumrong J, Robinson MT, Hughes T, Blacksell SD. Distribution and Ecological Drivers of Spotted Fever Group Rickettsia in Asia. ECOHEALTH 2019; 16:611-626. [PMID: 30993545 PMCID: PMC6910891 DOI: 10.1007/s10393-019-01409-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 05/30/2023]
Abstract
Spotted fever group and related rickettsia (SFGR) are a neglected group of pathogens that belong to the genus Rickettsia. SFGR are zoonotic and are transmitted by arthropod vectors, primarily ticks, fleas and mites to accidental hosts. These emerging and re-emerging infections are widely distributed throughout the world. Land-use change and increasing human-wildlife conflict compound the risk of SFGR infection to local people in endemic areas and travelers to these regions. In this article, we discuss the rickettsial organisms causing spotted fever and related diseases, their arthropod vectors in Asia and the impact of land-use change on their spread.
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Affiliation(s)
- Jaruwan Satjanadumrong
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Bangkok, 10400, Thailand
| | - Matthew T Robinson
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, OX3 7FZ, UK
| | - Tom Hughes
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Bangkok, 10400, Thailand
- EcoHealth Alliance, 460 West 34th Street, 17th Floor, New York, NY, USA
| | - Stuart D Blacksell
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Bangkok, 10400, Thailand.
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People's Democratic Republic.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, OX3 7FZ, UK.
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11
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Abstract
Spotted fever group rickettsiae (SFG) are a neglected group of bacteria, belonging to the genus Rickettsia, that represent a large number of new and emerging infectious diseases with a worldwide distribution. The diseases are zoonotic and are transmitted by arthropod vectors, mainly ticks, fleas and mites, to hosts such as wild animals. Domesticated animals and humans are accidental hosts. In Asia, local people in endemic areas as well as travellers to these regions are at high risk of infection. In this review we compare SFG molecular and serological diagnostic methods and discuss their limitations. While there is a large range of molecular diagnostics and serological assays, both approaches have limitations and a positive result is dependent on the timing of sample collection. There is an increasing need for less expensive and easy-to-use diagnostic tests. However, despite many tests being available, their lack of suitability for use in resource-limited regions is of concern, as many require technical expertise, expensive equipment and reagents. In addition, many existing diagnostic tests still require rigorous validation in the regions and populations where these tests may be used, in particular to establish coherent and worthwhile cut-offs. It is likely that the best strategy is to use a real-time quantitative polymerase chain reaction (qPCR) and immunofluorescence assay in tandem. If the specimen is collected early enough in the infection there will be no antibodies but there will be a greater chance of a PCR positive result. Conversely, when there are detectable antibodies it is less likely that there will be a positive PCR result. It is therefore extremely important that a complete medical history is provided especially the number of days of fever prior to sample collection. More effort is required to develop and validate SFG diagnostics and those of other rickettsial infections.
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Stewart AGA, Smith S, Binotto E, McBride WJH, Hanson J. The epidemiology and clinical features of rickettsial diseases in North Queensland, Australia: Implications for patient identification and management. PLoS Negl Trop Dis 2019; 13:e0007583. [PMID: 31318873 PMCID: PMC6667154 DOI: 10.1371/journal.pntd.0007583] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/30/2019] [Accepted: 06/27/2019] [Indexed: 12/12/2022] Open
Abstract
Background Rickettsial infections are a common cause of hospitalization in tropical settings, although early diagnosis is challenging in the rural locations where these infections are usually seen. Methods This retrospective, clinical audit of microbiologically-confirmed cases of scrub typhus or spotted fever group (SFG) rickettsial infection between 1997 and 2016 was performed a tertiary referral hospital in tropical Australia. Clinical, laboratory and radiological findings at presentation were correlated with the patients’ subsequent clinical course. Results There were 135 locally-acquired cases (95 scrub typhus, 37 SFG, 3 undifferentiated). There were nine hospitalizations during the first 5 years of the study period and 81 in the last 5 years (p for trend = 0.003). Eighteen (13%) of the 135 cases required ICU admission, all of whom were adults. A greater proportion of patients with SFG infection required ICU support (8/37 (22%) compared with 10/95 (11%) scrub typhus cases), although this difference did not reach statistical significance (p = 0.10). Three (8%) of the 37 patients with SFG infection had severe disease (1 died, 2 developed permanent disability) versus 0/95 scrub typhus patients (p = 0.02). Adults with a high admission qSOFA score (≥2) had an odds ratio (OR) of 19 (95% CI:4.8–74.5) for subsequent ICU admission (p<0.001); adults with a high NEWS2 score (≥7) had an OR of 14.3 (95% CI:4.5–45.32) for ICU admission (p<0.001). A patient’s respiratory rate at presentation had strong prognostic utility: if an adult had an admission respiratory rate <22 breaths/minute, the negative predictive value for subsequent ICU admission was 95% (95% CI 88–99). Conclusions In the well-resourced Australian health system outcomes are excellent, but the local burden of rickettsial disease appears to be increasing and the clinical phenotype of SFG infections may be more severe than previously believed. Simple, clinical assessment on admission has prognostic utility and may be used to guide management. Rickettsial infections are a common cause of hospitalization in tropical settings, although early, definitive diagnosis is challenging in the rural and remote locations where they are usually seen. It is important to recognise rickettsial infections early in their disease course as they can lead to life-threatening multi-organ failure if specific anti-rickettsial antimicrobial therapy is not prescribed promptly. In tropical Australia, scrub typhus and spotted fever group (SFG) rickettsiae are the dominant rickettsial pathogens and this twenty-year retrospective series examines the clinical and laboratory findings which might facilitate their recognition. The study highlights the infections’ increasing local clinical burden and reports that over 20% of the SFG cases in the series required Intensive Care Unit (ICU) admission, suggesting that severe SFG disease may be more common than previously believed. Simple, clinical prediction scores—calculated at presentation—identified patients who would subsequently require ICU admission. Importantly, they were also able to identify patients at low risk of disease progression. These entirely clinical scores—which can be calculated rapidly at the bedside—have the potential to facilitate the management of patients with scrub typhus and SFG infection, particularly in resource-limited settings which have the greatest burden of disease.
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Affiliation(s)
| | - Simon Smith
- Department of Medicine, Cairns Hospital, Cairns, Australia
| | - Enzo Binotto
- Department of Medicine, Cairns Hospital, Cairns, Australia
| | | | - Josh Hanson
- Department of Medicine, Cairns Hospital, Cairns, Australia
- Kirby Institute, University of New South Wales, Sydney, Australia
- * E-mail:
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13
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Aziz MA, Aung MS, Paul SK, Ahmed S, Haque N, Roy S, Al Amin M, Paul A, Miah MAH, Alam MK, Islam MS, Hossain MA, Kobayashi N. First molecular identification of two Leptospira species ( Leptospira interrogans and Leptospira wolffii) in Bangladesh. New Microbes New Infect 2019; 31:100570. [PMID: 31297196 PMCID: PMC6597691 DOI: 10.1016/j.nmni.2019.100570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 11/25/2022] Open
Abstract
Leptospiral 16S rRNA genes were detected in 13 blood samples from 74 febrile patients in north-central Bangladesh, and their sequences phylogenetically clustered with those of Leptospira interrogans or Leptospira wolffii. Genetic diversity in O-antigen polymerase (wzy) was found in an L. interrogans sample.
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Affiliation(s)
- M A Aziz
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - M S Aung
- Sapporo Medical University School of Medicine, Sapporo, Japan
| | - S K Paul
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - S Ahmed
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - N Haque
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - S Roy
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - M Al Amin
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - A Paul
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - M A H Miah
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - M K Alam
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - M S Islam
- Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - M A Hossain
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - N Kobayashi
- Sapporo Medical University School of Medicine, Sapporo, Japan
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14
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Kosoy M, Bai Y. Bartonella Bacteria in Urban Rats: A Movement From the Jungles of Southeast Asia to Metropoles Around the Globe. Front Ecol Evol 2019. [DOI: 10.3389/fevo.2019.00088] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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15
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Ricapa-Antay F, Diaz-Melon K, Silva-Caso W, Del Valle LJ, Aguilar-Luis MA, Vasquez-Achaya F, Palomares-Reyes C, Weilg P, Li D, Manrique C, Del Valle-Mendoza J. Molecular detection and clinical characteristics of Bartonella bacilliformis, Leptospira spp., and Rickettsia spp. in the Southeastern Peruvian Amazon basin. BMC Infect Dis 2018; 18:618. [PMID: 30514235 PMCID: PMC6280516 DOI: 10.1186/s12879-018-3541-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 11/22/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Acute febrile illness (AFI) represent a significant health challenge in the Peruvian Amazon basin population due to their diverse etiologies and the unavailability of specific on-site diagnostic methods, resulting in underreporting of cases. In Peru, one of the most endemic regions to dengue and leptospirosis is Madre de Dios, a region also endemic to emergent bacterial etiologic agents of AFI, such as bartonellosis and rickettsiosis, whose prevalence is usually underreported. We aimed to molecularly identify the presence of Leptospira spp., Bartonella bacilliformis, and Rickettsia spp. by Polymerase Chain Reaction in serum samples from patients with AFI from Puerto Maldonado-Madre de Dios in Peru. METHODS Serum samples from patients with acute febrile illness were analyzed by real-time PCR for detecting the presence of Bartonella bacilliformis, Leptospira spp. and Rickettsia spp. RESULTS Bartonella bacilliformis was the most prevalent bacteria identified in 21.6% (30/139) of the samples, followed by Leptospira spp. in 11.5% (16/139) and Rickettsia spp. in 6.5% (9/139) of the samples. No co-infections were observed between these bacteria. The most frequent symptoms associated with fever among all groups, were headaches, myalgias, and arthralgias. We found no statistically significant differences in the clinical presentation between patients infected with each bacterium. CONCLUSIONS In a previous study, we shown the presence of dengue, chikungunya, Zika and oropouche virus. We were able to identify these pathogens in 29.5% of all the samples, with chikungunya and OROV as the most frequently found in 9.4 and 8.6% of all the samples, respectively. In this study we show that B. bacilliformis (21.6%), Leptospira spp. (11.5%) and Rickettsia spp. (6.5%) accounted for the main etiologies of AFI in samples from Puerto Maldonado-Madre de Dios, Perú. Our analysis of their clinical presentation, further shows the importance of implementing more sensitive and specific on-site diagnostic tools in the national surveillance programs.This study confirms that the un-specificity of signs and symptoms is not only associated with arboviral infections, but also with the clinical presentation of endemic bacterial infections.
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Affiliation(s)
- Fiorella Ricapa-Antay
- School of Medicine. Faculty of Health Sciences. Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Katia Diaz-Melon
- School of Medicine. Faculty of Health Sciences. Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Wilmer Silva-Caso
- School of Medicine. Faculty of Health Sciences. Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biología Molecular. Instituto de Investigación Nutricional, Lima, Peru
| | - Luis J Del Valle
- Barcelona Research Center for Multiscale Science and Engineering, Departament d'Enginyeria Química, EEBE, Universidad Politécnica de Catalunya (UPC), Barcelona Tech, Barcelona, Spain
| | - Miguel Angel Aguilar-Luis
- School of Medicine. Faculty of Health Sciences. Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biología Molecular. Instituto de Investigación Nutricional, Lima, Peru.,Instituto de Investigación de Enfermedades Infecciosas, Lima, Peru
| | - Fernando Vasquez-Achaya
- School of Medicine. Faculty of Health Sciences. Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biología Molecular. Instituto de Investigación Nutricional, Lima, Peru
| | - Carlos Palomares-Reyes
- School of Medicine. Faculty of Health Sciences. Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biología Molecular. Instituto de Investigación Nutricional, Lima, Peru
| | - Pablo Weilg
- School of Medicine. Faculty of Health Sciences. Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Dongmei Li
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Carlos Manrique
- Dirección Regional de Salud Madre de Dios (DIRESA-Madre de Dios), Puerto Maldonado, Madre de Dios, Peru
| | - Juana Del Valle-Mendoza
- School of Medicine. Faculty of Health Sciences. Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru. .,Laboratorio de Biología Molecular. Instituto de Investigación Nutricional, Lima, Peru.
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16
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Seroprevalence of spotted fever group and typhus group rickettsiae in individuals with acute febrile illness from Gorakhpur, India. Int J Infect Dis 2018; 79:195-198. [PMID: 30391326 DOI: 10.1016/j.ijid.2018.10.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/08/2018] [Accepted: 10/12/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The aim of this study was to estimate the seroprevalence of spotted fever group (SFG) and typhus group (TG) rickettsiae among individuals with acute febrile illness (AFI) in the scrub typhus endemic district of Gorakhpur in India. This district is one of the worst affected by annual seasonal acute encephalitis syndrome (AES) outbreaks. METHODS Antibodies against SFG and TG rickettsiae and the associated risk factors were determined in 294 individuals presenting with an AFI, encountered during a community-based survey conducted during the AES outbreak period October-November 2016. RESULTS Respective IgM and IgG seropositivity was 13.6% and 36.7% for SFG, and 7.1% and 15.3% for TG. SFG IgM positivity was significantly higher among females, while IgG positivity was significantly higher among individuals ≥45 years of age. IgM and IgG seropositivity for TG rickettsiae were significantly higher in individuals involved in outdoor activities and housewives, but did not differ according to age group, sex, or educational status. CONCLUSION The study results present serological evidence of SFG and TG rickettsiosis, in addition to scrub typhus, among individuals with AFI in Gorakhpur region and indicate the need to explore their roles as potential causes of AES in the region.
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17
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Shrestha P, Roberts T, Homsana A, Myat TO, Crump JA, Lubell Y, Newton PN. Febrile illness in Asia: gaps in epidemiology, diagnosis and management for informing health policy. Clin Microbiol Infect 2018; 24:815-826. [PMID: 29581051 DOI: 10.1016/j.cmi.2018.03.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 03/12/2018] [Accepted: 03/16/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Increasing evidence is becoming available on the aetiology and management of fevers in Asia; the importance of these fevers has increased with the decline in the incidence of malaria. AIMS To conduct a narrative review of the epidemiology and management of fevers in South and South-East Asia and to highlight gaps in our knowledge that impair evidence-based health policy decisions. SOURCES A narrative review of papers published since 2012 on developments in fever epidemiology, diagnosis and treatment in South and South-East Asia. The papers that the authors felt were pivotal, from their personal perspectives, are discussed. CONTENT We identified 100 studies. Among the 30 studies (30%)-including both children and adults-that investigated three or more pathogens, the most frequently reported fever aetiology was dengue (reported by 15, 50%), followed by leptospirosis (eight, 27%), scrub typhus (seven, 23%) and Salmonella serovar Typhi (six, 20%). Among four studies investigating three or more pathogens in children, dengue and Staphylococcus aureus were the most frequent, followed by non-typhoidal Salmonella spp, Streptococcus pneumoniae, Salmonella serovar Typhi, and Orientia tsutsugamushi. Increased awareness is needed that rickettsial pathogens are common but do not respond to cephalosporins, and that alternative therapies, such as tetracyclines, are required. IMPLICATIONS Many key gaps remain, and consensus guidelines for study design are needed to aid comparative understanding of the epidemiology of fevers. More investment in developing accurate and affordable diagnostic tests for rural Asia and independent evaluation of those already on the market are needed. Treatment algorithms, including simple biomarker assays, appropriate for empirical therapy of fevers in different areas of rural Asia should be a major aim of fever research. Enhanced antimicrobial resistance (AMR) surveillance and openly accessible databases of geography-specific AMR data would inform policy on empirical and specific therapy. More investment in innovative strategies facilitating infectious disease surveillance in remote rural communities would be an important component of poverty reduction and improving public health.
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Affiliation(s)
- P Shrestha
- Infectious Diseases Data Observatory, University of Oxford, UK
| | - T Roberts
- Lao-Oxford-Mahosot-Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Madihol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - A Homsana
- Lao-Oxford-Mahosot-Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - T O Myat
- Department of Microbiology, University of Medicine 1, Yangon, Myanmar; Centre for International Health, University of Otago, Dunedin, New Zealand
| | - J A Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Y Lubell
- Madihol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, University of Oxford, UK
| | - P N Newton
- Infectious Diseases Data Observatory, University of Oxford, UK; Lao-Oxford-Mahosot-Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine and Global Health, University of Oxford, UK.
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18
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Chowdhury NF, Paul SK, Aung MS, Hossain MA, Ahamed F, Ahmed S, Haque N, Nasreen SA, Khan SI, Rahman SMM, Rahman ASMM, Ferdouse F, Ahmed R, Sultan SM, Ahmed MU, Urushibara N, Kobayashi N. Nationwide prevalence of Rickettsia felis infections in patients with febrile illness in Bangladesh. New Microbes New Infect 2017; 19:123-125. [PMID: 28831298 PMCID: PMC5552056 DOI: 10.1016/j.nmni.2017.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/03/2017] [Accepted: 07/11/2017] [Indexed: 11/27/2022] Open
Abstract
From July 2015 to December 2016, the presence of rickettsial pathogens was investigated for 414 patients with unknown fever in eight places in all the divisions of Bangladesh. Rickettsia felis was identified in blood samples from all the regions (overall detection rate, 19.6%), suggesting nationwide prevalence of R. felis infections.
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Affiliation(s)
| | - S K Paul
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - M S Aung
- Sapporo Medical University School of Medicine, Sapporo, Japan
| | - M A Hossain
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - F Ahamed
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - S Ahmed
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - N Haque
- Mymensingh Medical College, Mymensingh, Bangladesh
| | - S A Nasreen
- Jamalpur Medical College, Jamalpur, Bangladesh
| | - S I Khan
- Patuakhali Medical College, Patuakhali, Bangladesh
| | | | | | - F Ferdouse
- Shaheed Monsur Ali Medical College, Dhaka, Bangladesh
| | - R Ahmed
- Manikganj Medical College, Manikganj, Bangladesh
| | - S M Sultan
- Uttara Adhunik Medical College, Dhaka, Bangladesh
| | - M U Ahmed
- Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - N Urushibara
- Sapporo Medical University School of Medicine, Sapporo, Japan
| | - N Kobayashi
- Sapporo Medical University School of Medicine, Sapporo, Japan
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