Approach to acute febrile illness during the COVID-19 pandemic

Bhatt, Manasvini; Soneja, Manish; Gupta, Nitin

doi:10.5582/ddt.2020.03083

Cited by 12 publications

(16 citation statements)

References 34 publications

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“…The diagnosis, epidemiology, clinical manifestation, laboratory performance and treatment of acute febrile diseases (AFI) including dengue fever, leptospirosis, typhoid fever, malaria, scrub typhus are similar to COVID-19, which may be misdiagnosed or only found one of the two (such as ignoring AFI due to the pandemic of COVID—19 now), resulting in delays in diagnosis and treatment, expanded spread, rise of its incidence and an extended interval between cases detected (this is the same as our observations), because there are similarities, which can be in control of the COVID-19 and relieve the symptoms of AFI, that reminds us to be vigilant with the diseases of overlapping symptoms[ 26 ]. Current measures to control COVID-19 include isolation of suspected cases, isolation of infected patients, contact tracing and other strategies.…”

Section: Discussionsupporting

confidence: 59%

Comparison of 19 major infectious diseases during COVID-19 epidemic and previous years in Zhejiang, implications for prevention measures

Zhang

et al. 2022

BMC Infect Dis

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Background The global pandemic of coronavirus disease 2019 (COVID-19) has attracted great public health efforts across the world. Few studies, however, have described the potential impact of these measures on other important infectious diseases. Methods The incidence of 19 major infectious diseases in Zhejiang Province was collected from the National Notifiable Infectious Disease Surveillance System from January 2017 to October 2020. The entire epidemic control phase was divided into three stages. The government deployed the first level response from 24 January to 2 March (the most rigorous measures). When the outbreak of COVID-19 was under control, the response level changed to the second level from 3 to 23 March, and then the third level response was implemented after 24 March. We compared the epidemiological characteristics of 19 major infectious diseases during different periods of the COVID-19 epidemic and previous years. Results A total of 1,814,881 cases of 19 infectious diseases were reported in Zhejiang from January 2017 to October 2020, resulting in an incidence rate of 8088.30 cases per 1,000,000 person-years. After the non-pharmaceutical intervention, the incidence of 19 infectious diseases dropped by 70.84%, from 9436.32 cases per 1,000,000 person-years to 2751.51 cases per 1,000,000 person-years, with the large decrease in the first response period of influenza. However, we observed that the daily incidence of severe fever with thrombocytopenia syndrome (SFTS) and leptospirosis increased slightly (from 1.11 cases per 1,000,000 person-years to 1.82 cases per 1,000,000 person-years for SFTS and 0.30 cases per 1,000,000 person-years to 1.24 cases per 1,000,000 person-years for leptospirosis). There was no significant difference in the distribution of epidemiological characteristic of most infectious diseases before and during the implementation of COVID-19 control measures. Conclusion Our study summarizes the epidemiological characteristics of 19 infectious diseases and indicates that the rigorous control measures for COVID-19 are also effective for majority of infectious diseases.

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Section: Discussionsupporting

confidence: 59%

Comparison of 19 major infectious diseases during COVID-19 epidemic and previous years in Zhejiang, implications for prevention measures

Zhang

et al. 2022

BMC Infect Dis

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“…There is an increased "out of pocket expenditure" for the patient as well [18]. With the increase in the COVID-19 cases, AFIs have increased the burden on already overburdened hospitals [19]. In a study from Brazil, most leptospirosis clusters occurred after a natural disaster preceded by heavy rainfall in that area [20].…”

Section: N Resultsmentioning

confidence: 99%

Clinical profile, management and outcome of patients with leptospirosis during the times of COVID-19 pandemic: A prospective study from a tertiary care centre in South India

et al. 2021

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Leptospirosis is a rodent-borne acute febrile illness, classically seen after heavy rainfall and floods. This study aimed to describe the clinical profile, management strategies and outcome of patients with leptospirosis amidst the Coronavirus disease-2019 outbreak. A prospective study of adult patients with undifferentiated fever (5-15 days) was conducted in South India between October 2020 and February 2021. The demographic, clinical details, laboratory details, treatment and outcome of leptospirosis positive (based on serology) and negative patients were compared. A chisquare test was used for qualitative variables, while an independent t-test or Mann Whitney U test was used for continuous variables. Of the 206 patients with suspected acute febrile illness, a total of 63 patients were diagnosed with leptospirosis based on serology results. The median sequential SUMMARY organ failure assessment score was higher in those with leptospirosis (p<0.001). Myalgia, abdominal pain, jaundice, decreased urine output, myocarditis, and dialysis requirement were more common in patients with leptospirosis. Leucocytosis and raised procalcitonin/ C-reactive protein were more common in patients with leptospirosis. The duration of stay and antibiotic consumption was higher in patients with leptospirosis. Acute febrile illness such as leptospirosis should be suspected in tropical areas with significant risk factors. The presence of conjunctival suffusion, hepatic and renal dysfunction should warrant a serology test for leptospirosis.

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“…In conclusion, NMFIs are quite common in fever patients in Africa. With the current COVID-19 pandemic, control of NMFIs has been impeded because (I) clinical presentations tend to overlap, (II) access to healthcare services is restricted as a result of physical distancing measures and the extra demand for personal protective equipment, and (III) the capacity of strained health systems is insufficient [ 176 ]. In addition, the prioritisation of COVID-19 by public health authorities could cause diagnostic and therapeutic delays for NMFIs leading to a higher disease burden.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of the aetiological agents of non-malarial febrile illnesses in Africa

et al. 2022

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Background The awareness of non-malarial febrile illnesses (NMFIs) has been on the rise over the last decades. Therefore, we undertook a systematic literature review and meta-analysis of causative agents of non-malarial fevers on the African continent. Methodology We searched for literature in African Journals Online, EMBASE, PubMed, Scopus, and Web of Science databases to identify aetiologic agents that had been reported and to determine summary estimates of the proportional morbidity rates (PMr) associated with these pathogens among fever patients. Findings A total of 133 studies comprising 391,835 patients from 25 of the 54 African countries were eligible. A wide array of aetiologic agents were described with considerable regional differences among the leading agents. Overall, bacterial pathogens tested from blood samples accounted for the largest proportion. The summary estimates from the meta-analysis were low for most of the agents. This may have resulted from a true low prevalence of the agents, the failure to test for many agents or the low sensitivity of the diagnostic methods applied. Our meta-regression analysis of study and population variables showed that diagnostic methods determined the PMr estimates of typhoidal Salmonella and Dengue virus. An increase in the PMr of Klebsiella spp. infections was observed over time. Furthermore, the status of patients as either inpatient or outpatient predicted the PMr of Haemophilus spp. infections. Conclusion The small number of epidemiological studies and the variety of NMFI agents on the African continent emphasizes the need for harmonized studies with larger sample sizes. In particular, diagnostic procedures for NMFIs should be standardized to facilitate comparability of study results and to improve future meta-analyses. Reliable NMFI burden estimates will inform regional public health strategies.

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Approach to acute febrile illness during the COVID-19 pandemic

Cited by 12 publications

References 34 publications

Comparison of 19 major infectious diseases during COVID-19 epidemic and previous years in Zhejiang, implications for prevention measures

Comparison of 19 major infectious diseases during COVID-19 epidemic and previous years in Zhejiang, implications for prevention measures

Clinical profile, management and outcome of patients with leptospirosis during the times of COVID-19 pandemic: A prospective study from a tertiary care centre in South India

A systematic review and meta-analysis of the aetiological agents of non-malarial febrile illnesses in Africa

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