Reducing Uncertainty for Acute Febrile Illness in Resource-Limited Settings: The Current Diagnostic Landscape

Abstract

Diagnosing the cause of acute febrile illness in resource-limited settings is important-to give the correct antimicrobials to patients who need them, to prevent unnecessary antimicrobial use, to detect emerging infectious diseases early, and to guide vaccine deployment. A variety of approaches are yielding more rapid and accurate tests that can detect more pathogens in a wider variety of settings. After decades of slow progress in diagnostics for acute febrile illness in resource-limited settings, a wave of converging advancements will enable clinicians in resource-limited settings to reduce uncertainty for the diagnosis of acute febrile illness.

Isolation of Oropouche Virus from Febrile Patient, Ecuador

“…OROV might spread unnoticed across a wide geographic area, as suggested by this unexpected detection. Several studies have successfully documented the use of metagenomic sequencing for virus identification in febrile patients ( 10 ); this approach is becoming more practicable as costs decrease, the major benefit being the ability to detect unexpected or novel viral sequences, as evidenced by this detection of OROV. …”

Unidentified dengue serotypes in DENV positive samples and detection of other pathogens responsible for an acute febrile illness outbreak 2016 in Cajamarca, Peru

“…In recent years, important advances have been made that reduce, but not eliminate, uncertainty in diagnosing the cause of acute febrile illness in the context of medical practice with limited resources [1]. This fact has allowed to detect some emerging infectious diseases early and identify pathogens that were believed to be eradicated in other contexts.…”

“…Fever is one of the most common symptoms reported by patients seeking medical attention in resource-limited settings [1]. Acute febrile illness (AFI) is a clinical syndrome that emcompasses a wide variety of differential diagnosis, which is caused by several infectious diseases that contribute to the global burden of morbidity and mortality [1,2]. AFI can be caused by emerging and reemerging infectious diseases, such as viral and bacterial pathogens with high epidemic potential [3].…”

Oropouche infection a neglected arbovirus in patients with acute febrile illness from the Peruvian coast

“…These factors affect the spatial and temporal distribution, as well as the abundance of the arthropods, the characteristics of the life cycles and the transmission efficiency [4]. Additionally, the implementation of new molecular techniques has also contributed to a more accurate etiological diagnosis in undifferentiated acute febrile illnesses (AFI) [5,6].…”