Clinical profile and role of serology in pediatric acute febrile illness: Experience from a tertiary care hospital in South India

Kavirayani, Vaishnavi; Madiyal, Mridula; Aroor, Shrikiran; Chhabra, S.

doi:10.1016/j.cegh.2021.100898

Cited by 4 publications

(5 citation statements)

References 15 publications

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“…typhi, and Rickettsia infection by confirmatory tests. The sero-prevalence of S. typhi infection in this study was slightly higher than the previous reports in Ethiopia ( 15 , 16 ), and India ( 17 ), but lower than other findings in Ethiopia ( 18 , 19 ) and Sudan ( 20 ). The sero-prevalence of Rickettsia infection was in line with other reported findings in different developing countries ( 21 – 25 ), but it is lower than a finding in Ethiopia ( 15 , 18 ), Malaysia ( 26 ), and India ( 27 ).…”

Section: Discussioncontrasting

confidence: 90%

Health facility-based prevalence of typhoid fever, typhus and malaria among individuals suspected of acute febrile illnesses in Southwest Region, Ethiopia

Abayneh,

Aberad,

Habtemariam

et al. 2024

Front. Epidemiol.

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BackgroundAcute febrile illnesses such as typhoid fever, typhus, and malaria are still major causes of hospital admission in many parts of Ethiopia. However, there are substantial gaps in the monitoring systems, which result in a lack of knowledge about the geographic distribution and role of common pathogens, particularly in rural areas. Thus, this study was aimed at assessing the seroprevalence of typhoid fever, typhus, and malaria among suspected acute febrile patients at the MTU Teaching Hospital and Mizan-Aman Health Center, Southwest region of Ethiopia.MethodA health facility-based cross-sectional study was carried out from July to October 2022. Blood samples were collected from a total of 384 individuals. Widal and Weilfelix direct card agglutination and tube agglutination test methods were used for the Salmonella enterica serotype Typhi (S. typhi) and Rickettsia infections. The diagnosis of malaria was made using thick and thin blood smears. Questionnaires given by interviewers were used to gather information on risk factors and other sociodemographic factors. The data was analyzed using STATA/SE 14.0.ResultA total of 371 patients were tested for S. Typhi and Rickettsia infections using direct card agglutination and tube agglutination methods. Using the screening test, 20.5% (76/371) patients were reactive either for O or H antigens or both, of which 55.3% (42/76) were reactive by the titration test at the cutoff value ≥ 1:80. About 17.5% (65/371) were reactive to OX19 antigen by card agglutination test, and of which 58.5% (38/65) were reactive by the titration test at the cutoff value ≥ 1:80. The overall seroprevalence of S. Typhi and Rickettsia infections using combined direct card and tube agglutination techniques was 11.3% (42/371) and 10.2% (38/371), respectively. Out of 384 suspected malaria patients, 43 (11.2%) were found positive either for P. falciparum, 27 (7.03%), or P. vivax, 16 (4.2%).ConclusionIn this study, typhoid fever, typhus, and malaria were found among symptomatic acute febrile patients. To increase disease awareness, it is necessary to provide sustainable health education about risk factor behaviors, disease transmission, and prevention strategies. In addition, improving laboratory diagnosis services and early treatment may also lower the likelihood of potentially fatal consequences.

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Section: Discussioncontrasting

confidence: 90%

Health facility-based prevalence of typhoid fever, typhus and malaria among individuals suspected of acute febrile illnesses in Southwest Region, Ethiopia

Abayneh,

Aberad,

Habtemariam

et al. 2024

Front. Epidemiol.

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“…Most of these studies discussed the low sensitivity of the test is based on cases of scrub typhus rather than cases of spotted fever or typhus fever. [ 7 , 8 , 22 , 28 ]. Among the non-scrub typhus rickettsial infections, R. conorii was the most prevalent rickettsia pathogen, followed by R. typhi .…”

Section: Discussionmentioning

confidence: 99%

“…Most studies which documented non-ST RDs are based on serological investigations such as the Weil–Felix test (WFT), enzyme-linked immunosorbent assay (ELISA) for IgM and IgG antibodies against Rickettsia species such as Rickettsia conorii and Rickettsia typhi , and indirect immunofluorescent assay (IFA) [ 6 , 7 , 8 , 9 , 10 , 11 ]. Molecular assay-based studies for non-ST RDs are limited in the Indian scenario.…”

Section: Introductionmentioning

confidence: 99%

A Review of Rickettsial Diseases Other Than Scrub Typhus in India

et al. 2023

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Rickettsial diseases (RD) are widely reported all over the world. Scrub typhus (ST) is a major tropical infection which is well documented all over India. Therefore, the index of suspicion of scrub typhus is high among physicians with regard to patients presenting with acute febrile illness (AFI) and acute undifferentiated febrile illness (AUFI) in India. Rickettsial diseases other than ST (non-ST RDs), which include spotted fever group (SFG) rickettsioses and typhus group (TG) rickettsioses are not uncommon in India, but the index of suspicion is not as high as ST unless there is a history of the presence of fever with rashes and/or recent arthropod bites. This review aims to look into the Indian scenario on the epidemiology of non-ST RDs, especially the SFG and TG rickettsioses based on various investigations, spectrum of clinical presentation, challenges and gaps in knowledge to suspect and diagnose these infections.

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“…This challenging issue requires accurate and affordable diagnostic testing for tropical low-to-middle income countries. The serology for COVID-19 detection was applied in patient triage in some settings [ 31 , 32 ] and the serology is the main diagnostic method in tropical diseases [ 23 ]; therefore, cross-reactivity is a matter of concern that needs to be explored for patient triage policy making.…”

Section: Discussionmentioning

confidence: 99%

“…The common tropical diseases causing acute undifferentiated febrile illness (AUFI) in urban settings in Thailand were dengue (39.6%), follow by murine typhus (5%), leptospirosis (3.5%), and influenza (1.5%) [ 22 ]. Inevitably, serology remains an important diagnostic testing tool of tropical diseases [ 23 ]. It is currently unclear whether common tropical diseases such as dengue, rickettsiosis, influenza, and leptospirosis provide false positives in ELISA based on spike and nucleocapsid proteins of SARS-CoV-2 [ 15 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

False Positivity of Anti-SARS-CoV-2 Antibodies in Patients with Acute Tropical Diseases in Thailand

et al. 2022

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Serology remains a useful indirect method of diagnosing tropical diseases, especially in dengue infection. However, the current literature regarding cross-reactivity between SARS-CoV-2 and dengue serology is limited and revealed conflicting results. As a means to uncover relevant serological insight involving antibody classes against SARS-CoV-2 and cross-reactivity, anti-SARS-CoV-2 IgA, IgM, and IgG ELISA, based on spike and nucleocapsid proteins, were selected for a fever-presenting tropical disease patient investigation. The study was conducted at the Faculty of Tropical Medicine during March to December 2021. The study data source comprised (i) 170 non-COVID-19 sera from 140 adults and children presenting with acute undifferentiated febrile illness and 30 healthy volunteers, and (ii) 31 COVID-19 sera from 17 RT-PCR-confirmed COVID-19 patients. Among 170 non-COVID-19 samples, 27 were false positives (15.9%), of which IgA, IgM, and IgG cross-reactive antibody classes were detected in 18 (10.6%), 9 (5.3%), and 3 (1.8%) cases, respectively. Interestingly, one case exhibited both IgA and IgM false positivity, while two cases exhibited both IgA and IgG false positivity. The false positivity rate in anti-SARS-CoV-2 IgA and IgM was reported in adults with dengue infection (11.3% and 5%) and adults with other tropical diseases (16.7% and 13.3%). The urea dissociation method applied to mitigate false positivity resulted in significantly decreased ELISA-based false and true positives. In conclusion, the analysis of antibody against SARS-CoV-2 in sera of patients with different tropical diseases showed that high IgA and IgM false positivity thus potentially limits serological assay utility in fever-presenting patients in tropical areas.

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Clinical profile and role of serology in pediatric acute febrile illness: Experience from a tertiary care hospital in South India

Cited by 4 publications

References 15 publications

Health facility-based prevalence of typhoid fever, typhus and malaria among individuals suspected of acute febrile illnesses in Southwest Region, Ethiopia

Health facility-based prevalence of typhoid fever, typhus and malaria among individuals suspected of acute febrile illnesses in Southwest Region, Ethiopia

A Review of Rickettsial Diseases Other Than Scrub Typhus in India

False Positivity of Anti-SARS-CoV-2 Antibodies in Patients with Acute Tropical Diseases in Thailand

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