Symptoms and medical conditions in 204 912 patients visiting primary health-care practitioners in India: a 1-day point prevalence study (the POSEIDON study)

Salvi, Sundeep; Apte, Komalkirti; Madas, Sapna; Barne, Monica; Chhowala, Sushmeeta; Sethi, Tavpritesh; Aggarwal, Kunal; Agrawal, Anurag; Gogtay, Jaideep

doi:10.1016/s2214-109x(15)00152-7

Cited by 69 publications

(64 citation statements)

References 10 publications

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“…India has the world's largest absolute burden of infectious diseases, where fever is a commonly reported symptom. 1,2 Acute febrile illness (AFI) is responsible for 1.9 million deaths annually in India. 3 Despite the immense health-care burden AFI poses in India and beyond, the myriad possible etiologies of AFI presents a daunting challenge to clinicians in tropical low-and middle-income countries.…”

Section: Introductionmentioning

confidence: 99%

Vector-Borne Disease is a Common Cause of Hospitalized Febrile Illness in India

Robinson

Kadam

Khadse

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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Acute febrile illness (AFI) is a major cause of morbidity and mortality in India and other resource-limited settings, yet systematic etiologic characterization of AFI has been limited. We prospectively enrolled adults ( = 970) and children (age 6 months to 12 years, = 755) admitted with fever from the community to Sassoon General Hospital in Pune, India, from July 2013 to December 2015. We systematically obtained a standardized clinical history, basic laboratory testing, and microbiologic diagnostics on enrolled participants. Results from additional testing ordered by treating clinicians were also recorded. A microbiological diagnosis was found in 549 (32%) participants; 211 (12%) met standardized case definitions for pneumonia and meningitis without an identified organism; 559 (32%) were assigned a clinical diagnosis in the absence of a confirmed diagnosis; and 406 (24%) had no diagnosis. Vector-borne diseases were the most common cause of AFI in adults including dengue ( = 188, 19%), malaria ( = 74, 8%), chikungunya ( = 15, 2%), and concurrent mosquito-borne infections ( = 23, 2%) occurring most frequently in the 3 months after the monsoon. In children, pneumonia was the most common cause of AFI ( = 214, 28%) and death. Bacteremia was found in 68 (4%) participants. Central nervous system infections occurred in 58 (6%) adults and 64 (8%) children. Etiology of AFI in India is diverse, highly seasonal, and difficult to differentiate on clinical grounds alone. Diagnostic strategies adapted for season and age may reduce diagnostic uncertainty and identify causative organisms in treatable, fatal causes of AFI.

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Section: Introductionmentioning

confidence: 99%

Vector-Borne Disease is a Common Cause of Hospitalized Febrile Illness in India

Robinson

Kadam

Khadse

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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“…Fever is the most common symptom reported by persons seeking medical care in resource-limited settings. 1,2 There is no widely accepted, universal definition for acute febrile illness. 3 Abrupt-onset illnesses, lasting less than 2 weeks, with symptoms that include fever encompass a wide range of diseases including respiratory tract infections, diarrheal disease, malaria, and other vector-borne diseases which combined cause one-third of all morbidity and one-fourth of all mortality in low-income countries.…”

mentioning

confidence: 99%

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

Robinson

Manabe

2017

The American Society of Tropical Medicine and Hygiene

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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.

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“…The results of previous observational and population health studies of noncommunicable, chronic respiratory diseases in adults in the Asia-Pacific region, which have largely focused on asthma and COPD, indicate an increasing prevalence of both asthma and COPD in the region from 1990 to 2015 [6] and suggest an ongoing need to improve asthma and COPD management as well as patient education in most countries [6, 28-37]. The findings of these additional protocol-defined analyses, together with findings reported in prior APBORD study publications [11-16], build on and extend the results of other studies to include the burden and practice patterns for AR and rhinosinusitis, often present concomitantly with asthma and requiring concurrent management [5, 38, 39].…”

Section: Discussionmentioning

confidence: 99%

Practice Patterns for Chronic Respiratory Diseases in the Asia-Pacific Region: A Cross-Sectional Observational Study

Wang

Cho

Lin

et al. 2018

Int Arch Allergy Immunol

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Background: Allergic rhinitis (AR), asthma, chronic obstructive pulmonary disease (COPD), and rhinosinusitis are common and little studied in the Asia-Pacific region. Objectives: We sought to investigate real-world practice patterns for these respiratory diseases in India, Korea, Malaysia, Singapore, Taiwan, and Thailand. Methods: This cross-sectional observational study enrolled adults (age ≥18 years) presenting to general practitioners (GP) or specialists for physician-diagnosed AR, asthma, COPD, or rhinosinusitis. Physicians and patients completed study-specific surveys at one visit, recording patient characteristics, health-related quality of life (QoL), work impairment, and healthcare resource use. Findings by country and physician category (GP or specialist) were summarized. Results: Of the 13,902 patients screened, 7,243 (52%) presented with AR (18%), asthma (18%), COPD (7%), or rhinosinusitis (9%); 5,250 of the 7,243 (72%) patients were eligible for this study. Most eligible patients (70–100%) in India, Korea, Malaysia, and Singapore attended GP, while most (83–85%) in Taiwan and Thailand attended specialists. From 42% (rhinosinusitis) to 67% (AR) of new diagnoses were made by GP. On average, patients with COPD reported the worst health-related QoL, particularly to GP. Median losses of work productivity for each condition and activity impairment, except for asthma, were numerically greater for patients presenting to GP vs. specialists. GP prescribed more antibiotics for AR and asthma, and fewer intranasal corticosteroids for AR, than specialists (p < 0.001 for all comparisons). Conclusions: Our findings, albeit mostly descriptive and influenced by between-country differences, suggest that practice patterns differ between physician types, and the disease burden may be substantial for patients presenting in general practice.

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Symptoms and medical conditions in 204 912 patients visiting primary health-care practitioners in India: a 1-day point prevalence study (the POSEIDON study)

Abstract: Chest Research Foundation, Council of Scientific and Industrial Research-Institute of Genomics and Integrated Biology (CSIR-IGIB), and Cipla Ltd.

Cited by 69 publications

References 10 publications

Vector-Borne Disease is a Common Cause of Hospitalized Febrile Illness in India

Vector-Borne Disease is a Common Cause of Hospitalized Febrile Illness in India

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

Practice Patterns for Chronic Respiratory Diseases in the Asia-Pacific Region: A Cross-Sectional Observational Study

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