Febrile Illnesses Resulting in Hospital Admission: A Bacteriological and Serological Study in Jakarta, Indonesia *

Anderson, Karl E.; Peenen, P. F. D. Van; Butler, Sunoto Thomas; Nasution, Remy; Joseph, Sam W.; Watten, Raymond H.; Saroso, J. Sulianti; Irving, G. S.

doi:10.4269/ajtmh.1976.25.116

Cited by 24 publications

(13 citation statements)

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“…Only four studies were excluded due to location outside of sSSA, highlighting the dearth of data from other regions. Three of these studies reported predominantly data from adults [9-11]. A study of 340 children with severe malaria in Papua New Guinea recorded two cases of malaria with concomitant infection (invasive candida and Klebsiella Pneumoniae ); however, not all children had blood cultures taken [12].…”

Section: Resultsmentioning

confidence: 99%

Invasive bacterial co-infection in African children with Plasmodium falciparum malaria: a systematic review

Church

Maitland

2014

BMC Med

164

150

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BackgroundSevere malaria remains a major cause of pediatric hospital admission across Africa. Invasive bacterial infection (IBI) is a recognized complication of Plasmodium falciparum malaria, resulting in a substantially worse outcome. Whether a biological relationship exists between malaria infection and IBI susceptibility remains unclear. We, therefore, examined the extent, nature and evidence of this association.MethodsWe conducted a systematic search in August 2012 of three major scientific databases, PubMed, Embase and Africa Wide Information, for articles describing bacterial infection among children with P. falciparum malaria using the search string ‘(malaria OR plasmodium) AND (bacteria OR bacterial OR bacteremia OR bacteraemia OR sepsis OR septicaemia OR septicemia).’ Eligiblity criteria also included studies of children hospitalized with malaria or outpatient attendances in sub-Saharan Africa.ResultsA total of 25 studies across 11 African countries fulfilled our criteria. They comprised twenty cohort analyses, two randomized controlled trials and three prospective epidemiological studies. In the meta-analysis of 7,208 children with severe malaria the mean prevalence of IBI was 6.4% (95% confidence interval (CI) 5.81 to 6.98%). In a further meta-analysis of 20,889 children hospitalised with all-severity malaria and 27,641 children with non-malarial febrile illness the mean prevalence of IBI was 5.58 (95% CI 5.5 to 5.66%) in children with malaria and 7.77% (95% CI 7.72 to 7.83%) in non-malaria illness. Ten studies reported mortality stratified by IBI. Case fatality was higher at 81 of 336, 24.1% (95% CI 18.9 to 29.4) in children with malaria/IBI co-infection compared to 585 of 5,760, 10.2% (95% CI 9.3 to 10.98) with malaria alone. Enteric gram-negative organisms were over-represented in malaria cases, non-typhoidal Salmonellae being the most commonest isolate. There was weak evidence indicating IBI was more common in the severe anemia manifestation of severe malaria.ConclusionsThe accumulated evidence suggests that children with recent or acute malaria are at risk of bacterial infection, which results in an increased risk of mortality. Characterising the exact nature of this association is challenging due to the paucity of appropriate severity-matched controls and the heterogeneous data. Further research to define those at greatest risk is necessary to target antimicrobial treatment.

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Section: Resultsmentioning

confidence: 99%

Invasive bacterial co-infection in African children with Plasmodium falciparum malaria: a systematic review

Church

Maitland

2014

BMC Med

164

150

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“…Some of these hospital-based cohort studies have focused on bacterial infections, and others have included serologic testing as well as bacterial cultures. [4][5][6][7][8][9][10] Results from these studies have been used to improve local empirical treatment decisions and to enhance the appropriate use of resources and to improve quality of diagnostic services. 2 Three reports of studies of febrile illness in Thailand have been published: of bacterial infections in adults in Bangkok; of causes of fever in children during flooding in a provincial hospital; and of etiologies of acute pyrexia of unknown origin in children and adults at 10 community hospitals.…”

Section: Introductionmentioning

confidence: 99%

Causes of Fever in Adults on the Thai-Myanmar Border

Ellis¹,

Fukuda²,

McDaniel³

et al. 2006

The American Journal of Tropical Medicine and Hygiene

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A hospital-based study was conducted along the Thai-Myanmar border to provide greater knowledge of the causes of febrile illness and to determine what zoonotic and vector-borne emerging infectious diseases might be present. A total of 613 adults were enrolled from June 1999 to March 2002. Cases were classified based on clinical findings and laboratory results. An etiologic diagnosis was made for 48% of subjects. Malaria was the most common diagnosis, accounting for 25% of subjects, with two-thirds Plasmodium falciparum. Serologic evidence for leptospirosis was found in 17% of subjects. Other etiologic diagnoses included rickettsial infections, dengue fever, and typhoid. The most frequent clinical diagnoses were nonspecific febrile illness, respiratory infections, and gastroenteritis. Clinical associations were generally not predictive of etiologic diagnosis. Apparent dual diagnoses were common, particularly for malaria and leptospirosis. Findings have been used to modify treatment of unspecified febrile illness in the area.

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“…Following the WHO recommendations of that time [27], a study that involved <1100 children found that a mother's report of fever in her child was 93% sensitive and 21% specific for the detection of malaria parasitemia on a blood smear [59]. However, in general, clinical algorithms have poor precision and cannot sufficiently discriminate among the etiologies of fever [60][61][62][63]. Culture-Based Methods.…”

Section: Diagnostic Challengesmentioning

confidence: 99%

Challenges in the Etiology and Diagnosis of Acute Febrile Illness in Children in Low- and Middle-Income Countries

2016

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Acute febrile illness is a common cause of hospital admission, and its associated infectious causes contribute to substantial morbidity and death among children worldwide, especially in low- and middle-income countries. Declining transmission of malaria in many regions, combined with the increasing use of rapid diagnostic tests for malaria, has led to the increasing recognition of leptospirosis, rickettsioses, respiratory viruses, and arboviruses as etiologic agents of fevers. However, clinical discrimination between these etiologies can be difficult. Overtreatment with antimalarial drugs is common, even in the setting of a negative test result, as is overtreatment with empiric antibacterial drugs. Viral etiologies remain underrecognized and poorly investigated. More-sensitive diagnostics have led to additional dilemmas in discriminating whether a positive test result reflects a causative pathogen. Here, we review and summarize the current epidemiology and focus particularly on children and the challenges for future research.

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Febrile Illnesses Resulting in Hospital Admission: A Bacteriological and Serological Study in Jakarta, Indonesia *

Cited by 24 publications

References 0 publications

Invasive bacterial co-infection in African children with Plasmodium falciparum malaria: a systematic review

Invasive bacterial co-infection in African children with Plasmodium falciparum malaria: a systematic review

Causes of Fever in Adults on the Thai-Myanmar Border

Challenges in the Etiology and Diagnosis of Acute Febrile Illness in Children in Low- and Middle-Income Countries

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