Coinfections as an aetiology of acute undifferentiated febrile illness among adult patients in the sub-Himalayan region of north India

Raina, Sujeet; Raina, Rashmi Kaul; Agarwala, Niraj; Raina, Sunil Kumar; Sharma, Rajesh

doi:10.4103/0972-9062.242560

Cited by 20 publications

(27 citation statements)

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“…Similarly, the temperature threshold used to define fever varied from 37.5–38.5°Celsius. Sixteen studies included adult (> 16 years) patients [1, 12, 21, 22, 32, 36–38, 40, 45, 47, 49–52, 55], eight studies included children (< 16 years) [7, 11, 25, 27, 39, 41, 42, 54] and 19 studies included patients of all ages [2, 20, 23, 24, 26, 28–31, 33–35, 43, 44, 46, 48, 53, 56, 57]. The number of patients involved in each study varied from 50 to 38,635.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-five studies included patients admitted to hospital [1, 7, 12, 21–23, 27, 32–35, 37, 38, 40–45, 47, 48, 50, 52, 55, 57] making up 18.7% (14420) of the total study sample (80554). Six studies included patients attending outpatients department corresponding to 18.7% (15075) of study sample [2, 11, 20, 24, 28, 39].…”

Section: Resultsmentioning

confidence: 99%

“…Molecular testing (using polymerase chain reaction [PCR] was carried out in 16 studies [24–27, 29, 30, 35, 38–40, 42, 49, 50, 54–56]. Serological diagnoses were confirmed by blood cultures in 16 studies out of 43 [2, 20–22, 24, 26, 32, 37, 40, 42, 43, 45, 47, 48, 50, 51]. Microscopy was used for the diagnosis in 15 studies [20–22, 24, 26, 32, 37, 43, 44, 46, 47, 49–51, 55] .…”

Section: Resultsmentioning

confidence: 99%

“…Serological diagnoses were confirmed by blood cultures in 16 studies out of 43 [2, 20–22, 24, 26, 32, 37, 40, 42, 43, 45, 47, 48, 50, 51]. Microscopy was used for the diagnosis in 15 studies [20–22, 24, 26, 32, 37, 43, 44, 46, 47, 49–51, 55] . Nucleotide sequencing was done in two studies [29, 35] (Fig.…”

Section: Resultsmentioning

confidence: 99%

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Diversity of infectious aetiologies of acute undifferentiated febrile illnesses in south and Southeast Asia: a systematic review

et al. 2019

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Background: Acute undifferentiated febrile illness (AUFI) is caused by a multitude of diverse pathogens, with significant morbidity and mortality in the developing world. The objective of this review was to characterise the diversity and relative importance of common infectious aetiologies of AUFI in South and Southeast Asia. Methods: We conducted a comprehensive literature review to identify common aetiologies of AUFI in Asian countries. Four medical and life sciences databases including PubMed, Medline, Embase and Cochrane Central, and Google Scholar were searched for articles published from January 1998 to March 2019. Results: Forty-three studies met the inclusion criteria. Among AUFI cases, viral aetiologies at 18.5% (14888) were more common than bacterial aetiologies (12.9% [10384]). From 80,554 cases, dengue fever was the most common aetiology (11.8%, 9511), followed by leptospirosis (4.4%, 3549), typhoid (4.0%, 3258), scrub typhus (4.0%, 3243) and influenza other than H1N1 (3.1%, 2514). In both adults and children: dengue fever was the leading cause of AUFI with 16.6% (1928) and 18.7% (1281) of the total cases. In admitted patients, dengue fever was the main cause of AUFI at 16.4% (2377), however leptospirosis at 13.9% (2090) was the main cause of AUFI for outpatients. In South Asia, dengue fever was the main cause of AUFI, causing 12.0% (6821) of cases, whereas in Southeast Asia, leptospirosis was the main diagnosis, causing 12.1% (2861) of cases. Conclusions: In this study the most common causes of AUFI were viral, followed by bacterial and protozoal (malaria) infections. Dengue was the commonest virus that caused AUFI while leptospirosis and typhoid were important bacterial infectious causes. Therefore, it is imperative to maintain a sound epidemiological knowledge of AUFI so that evidence-based diagnostic criteria and treatment guidelines can be developed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Diversity of infectious aetiologies of acute undifferentiated febrile illnesses in south and Southeast Asia: a systematic review

et al. 2019

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“…Thus, high prevalence of infective vectors, increased human vector contact, temperature, humidity, prolonged rains, stagnant water, floods, abundant growth of vegetation, sleeping habits of humans, density, and biting patterns of vectors turn the milieu favorable for disease transmission [2]. Seasonal trend analysis of fever cases seeking health-care services have revealed an increasing trend of acute undifferentiated fever (AUF) illness during and after the monsoon period in the sub-Himalayan state of Himachal Pradesh [3]. Scrub typhus is the leading cause of acute febrile illness in Himachal Pradesh [4].…”

Section: Introductionmentioning

confidence: 99%

Concurrent Coinfections in Tropics: A Hospital-Based Observational Study from Himachal Pradesh, India

Malakar¹,

Negi²,

Dutt³

et al. 2019

Recent Advances in Biology and Medicine

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India is the epicenter of tropical fever diseases. Large numbers of cases are diagnosed with scrub typhus, leptospirosis, malaria, dengue, chikungunya, and enteric fever. Coinfections as an etiology of acute undifferentiated fever (AUF) have been recently recognized. The objective of this study was to assess the prevalence of coinfections in patients admitted with AUF in a tertiary-care hospital in the rural setting of Himachal Pradesh, India. Patients with coinfections as an etiology of AUF were the subjects of the study. The clinical records of patients diagnosed with confections between July 2018 and October 2018 were analyzed retrospectively in this hospital-based cross-sectional study. Standard protocol and guidelines were followed for the case definitions. Among total patients of 1005 with AUF, 14 (1.39%) patients were found to have coinfections. The most common coinfection was scrub typhus with leptospirosis and was diagnosed in seven (50%) patients. Other coinfections were scrub typhus with dengue in four (29%) and one patient each with scrub typhus and tubercular meningitis, scrub and influenza A (H1N1/2009) infection, and scrub and malaria (P. falciparum). Scrub typhus was the most common etiological diagnosis for the AUF and was observed in 159 (15.8%) patients. All the patients with coinfections had scrub typhus as the common infection. The prevalence of coinfections among scrub typhus patients constituted 8%. In tropical regions, coinfections are not very rare. High clinical suspicion for coinfections is required. Syndromic approach in the management is justified.

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Global prevalence of dengue and chikungunya coinfection: A systematic review and meta-analysis of 43,341 participants

et al. 2022

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Coinfections as an aetiology of acute undifferentiated febrile illness among adult patients in the sub-Himalayan region of north India

Cited by 20 publications

References 0 publications

Diversity of infectious aetiologies of acute undifferentiated febrile illnesses in south and Southeast Asia: a systematic review

Diversity of infectious aetiologies of acute undifferentiated febrile illnesses in south and Southeast Asia: a systematic review

Concurrent Coinfections in Tropics: A Hospital-Based Observational Study from Himachal Pradesh, India

Global prevalence of dengue and chikungunya coinfection: A systematic review and meta-analysis of 43,341 participants

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