Dengue, chikungunya, and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, India.


Journal

BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551

Informations de publication

Date de publication:
03 Jul 2019
Historique:
received: 28 06 2018
accepted: 04 06 2019
entrez: 5 7 2019
pubmed: 5 7 2019
medline: 19 9 2019
Statut: epublish

Résumé

We conducted a diagnostic surveillance study to identify Plasmodium, dengue virus, chikungunya virus, and Orientia tsutsugamushi infections among febrile patients who underwent triage for malaria in the outpatient department at Ispat General Hospital, Rourkela, Odisha, India. Febrile patients were enrolled from January 2016-January 2017. Blood smears and small volumes or vacutainers of blood were collected from study participants to carry out diagnostic assays. Malaria was diagnosed using rapid diagnostic tests (RDT), microscopy, and PCR. Dengue, chikungunya, and scrub typhus infections were identified using rapid diagnostic test kits and ELISA. Nine hundred and fifty-four patients were prospectively enrolled in our study. The majority of patients were male (58.4%) and more than 15 years of age (66.4%). All 954 enrollees underwent additional testing for malaria; a subset of enrollees (293/954) that had larger volumes of plasma available was also tested for dengue, chikungunya and scrub typhus by either RDT or ELISA or both tests. Fifty-four of 954 patients (5.7%) were positive for malaria by RDT, or microscopy, or PCR. Seventy-four of 293 patients (25.3%) tested positive for dengue by either RDT or ELISA, and 17 of 293 patients (5.8%) tested positive for chikungunya-specific IgM by either ELISA or RDT. Ten of 287 patients tested (3.5%) were positive for scrub typhus by ELISA specific for scrub typhus IgM. Seventeen patients among 290 (5.9%) with results for ≥3 infections tested positive for more than one infection. Patients with scrub typhus and chikungunya had high rates of co-infection: of the 10 patients positive for scrub typhus, six were positive for dengue (p = 0.009), and five of 17 patients positive for chikungunya (by RDT or ELISA) were also diagnosed with malaria (p < 0.001). Dengue, chikungunya and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, and comorbidity should be considered. Routine febrile illness surveillance is required to accurately establish the prevalence of these infections in this region, to offer timely treatment, and to implement appropriate methods of control.

Sections du résumé

BACKGROUND BACKGROUND
We conducted a diagnostic surveillance study to identify Plasmodium, dengue virus, chikungunya virus, and Orientia tsutsugamushi infections among febrile patients who underwent triage for malaria in the outpatient department at Ispat General Hospital, Rourkela, Odisha, India.
METHODS METHODS
Febrile patients were enrolled from January 2016-January 2017. Blood smears and small volumes or vacutainers of blood were collected from study participants to carry out diagnostic assays. Malaria was diagnosed using rapid diagnostic tests (RDT), microscopy, and PCR. Dengue, chikungunya, and scrub typhus infections were identified using rapid diagnostic test kits and ELISA.
RESULTS RESULTS
Nine hundred and fifty-four patients were prospectively enrolled in our study. The majority of patients were male (58.4%) and more than 15 years of age (66.4%). All 954 enrollees underwent additional testing for malaria; a subset of enrollees (293/954) that had larger volumes of plasma available was also tested for dengue, chikungunya and scrub typhus by either RDT or ELISA or both tests. Fifty-four of 954 patients (5.7%) were positive for malaria by RDT, or microscopy, or PCR. Seventy-four of 293 patients (25.3%) tested positive for dengue by either RDT or ELISA, and 17 of 293 patients (5.8%) tested positive for chikungunya-specific IgM by either ELISA or RDT. Ten of 287 patients tested (3.5%) were positive for scrub typhus by ELISA specific for scrub typhus IgM. Seventeen patients among 290 (5.9%) with results for ≥3 infections tested positive for more than one infection. Patients with scrub typhus and chikungunya had high rates of co-infection: of the 10 patients positive for scrub typhus, six were positive for dengue (p = 0.009), and five of 17 patients positive for chikungunya (by RDT or ELISA) were also diagnosed with malaria (p < 0.001).
CONCLUSIONS CONCLUSIONS
Dengue, chikungunya and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, and comorbidity should be considered. Routine febrile illness surveillance is required to accurately establish the prevalence of these infections in this region, to offer timely treatment, and to implement appropriate methods of control.

Identifiants

pubmed: 31269906
doi: 10.1186/s12879-019-4161-6
pii: 10.1186/s12879-019-4161-6
pmc: PMC6607595
doi:

Substances chimiques

Reagent Kits, Diagnostic 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

572

Subventions

Organisme : NIAID NIH HHS
ID : U19 AI089676
Pays : United States
Organisme : National Institute of Allergy and Infectious Diseases
ID : U19AI089676

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Auteurs

Pavitra N Rao (PN)

Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA.
, Present Address: Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, USA.

Anna Maria van Eijk (AM)

Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA.

Sandhya Choubey (S)

Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.

Syed Zeeshan Ali (SZ)

Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.

Aditee Dash (A)

Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.

Punam Barla (P)

Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.

Rajshri Rani Oraon (RR)

Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.

Gautam Patel (G)

Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.

P Nandini (P)

Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.

Subrata Acharya (S)

Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.

Sanjib Mohanty (S)

Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.

Jane M Carlton (JM)

Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA. jane.carlton@nyu.edu.

Sanghamitra Satpathi (S)

Department of Pathology, Ispat General Hospital Rourkela, Rourkela, India.

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