1921
Volume 86, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

We conducted a prospective, inpatient fever study in malaria-endemic Papua, Indonesia to determine non-malaria fever etiologies. Investigations included malaria blood films, blood culture, paired serologic samples analysis for dengue, Japanese encephalitis, leptospirosis, scrub typhus, murine typhus, and spotted fever group rickettsia. During 1997–2000, 226 patients (127 males and 99 females) 1–80 years of age (median age = 25 years) were enrolled. Positive blood cultures (n = 34, 15%) were obtained for Typhi (n = 13), (n = 8), (n = 6), (n = 5), (n = 1), and (n = 1). Twenty (8.8%) patients were positive for leptospirosis by polymerase chain reaction. Eighty (35.4%) of 226 patients had ≥ 1 positive serology, diagnostic for 15 rickettsial and 9 dengue cases. Acid-fast bacilli–positive sputum was obtained from three patients. Most common confirmed (81 of 226, 35.8%)/suspected diagnoses were typhoid fever (n = 41), pneumonia (n = 29), leptospirosis (n = 28), urinary tract infections (n = 20), rickettsioses (n = 19), dengue (n = 17), and meningitis/encephalitis (n = 15). There were 17 deaths, 7 (46.7%) were caused by meningitis/encephalitis. Multiple positive serologic results and few confirmed diagnoses indicate the need for improved diagnostics.

[open-access] Freely available online through the Open Access option.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.2012.10-0497
2012-01-01
2019-05-23
Loading full text...

Full text loading...

/deliver/fulltext/14761645/86/1/046.html?itemId=/content/journals/10.4269/ajtmh.2012.10-0497&mimeType=html&fmt=ahah

References

  1. Lavalin International Inc, PT Hasfarm Dian Konsultan. Government of Indonesia and United Nations Development Programme INS/83/013. Regional Development Planning for Irian Jaya, Health Sector Draft Report, November 1987, 513. [Google Scholar]
  2. Metselaar D, , 1961. Seven years malaria research and residual house spraying in Netherlands New Guinea. Am J Trop Med Hyg 10: 327. [Google Scholar]
  3. Gunawan S, , 1985. A review of the malaria situation in Irian Jaya. Bull Health Stud 13: 113. [Google Scholar]
  4. Gunther CE, , 1940. A survey of endemic typhus in New Guinea. Med J Aust 2: 564573. [Google Scholar]
  5. Griffiths JT, Jr, 1945. A scrub typhus (tsutsugamushi) outbreak in Dutch New Guinea. J Parasitol 31: 341350.[Crossref] [Google Scholar]
  6. Hoogerheide C, Ensink GJ, , 1956. Cases of scrub typhus in Netherlands New Guinea. Ned Milit Geneeskd Tijdschr 9: 99108. [Google Scholar]
  7. van Thiel P, , 1963. Studies on the incidence of leptospirosis in the central mountain region of West New Guinea by means of blood specimens dried on filter cardboard [in Dutch]. Acta Leiden 32: 280285. [Google Scholar]
  8. Vogel LC, Richens J, , 1989. Donovanosis in Dutch South New Guinea: history, evolution of the epidemic and control. P N G Med J 32: 203218. [Google Scholar]
  9. De Moor CE, , 1963. Cholera or paracholera in west New Guinea. Ned Tijdschr Geneeskd 107: 1727. [Google Scholar]
  10. Richards AL, Bagus R, Baso SM, Follows GA, Tan R, Graham RR, Sandjaja B, Corwin AL, Punjabi N, , 1997. The first reported outbreak of dengue hemorrhagic fever in Irian Jaya, Indonesia. Am J Trop Med Hyg 57: 4955. [Google Scholar]
  11. Sukri NC, Laras K, Wandra T, Didi S, Larasati RP, Rachdyatmaka JR, Osok S, Saragih JM, Hartati S, Listyaningsih E, Porter KR, Beckett CG, Prawira IS, Punjabi N, Soeparmanto SA, Beecham HJ, Bangs MJ, Corwin AL, , 2003. Transmission of epidemic dengue hemorrhagic fever in easternmost Indonesia. Am J Trop Med Hyg 68: 529535. [Google Scholar]
  12. Richards AL, Rahardjo E, Rusidi F, Kelly DL, Dasch GA, Church CJ, Bangs MJ, , 2002. Evidence of Rickettsia typhi and the potential for murine typhus in Jayapura, Irian Jaya, Indonesia. Am J Trop Med Hyg 66: 431434. [Google Scholar]
  13. Van Tongeren HA, Wilterdink JB, Timmers WC, , 1960. Neutralizing antibodies to the virus of poliomyelitis, dengue types 1 and 2, Murray Valley and Japanese B encephalitis in Papuan populations of Netherlands New Guinea. Trop Geogr Med 12: 208215. [Google Scholar]
  14. Spicer PE, , 1997. Japanese encephalitis in western Irian Jaya. J Travel Med 4: 4647.[Crossref] [Google Scholar]
  15. Spicer PE, Phillips D, Pike A, Johansen C, Melrose W, Hall RA, , 1999. Antibodies to Japanese encephalitis virus in human sera collected from Irian Jaya. Follow up of a previously reported case of Japanese encephalitis in that region. Trans R Soc Trop Med Hyg 93: 511514.[Crossref] [Google Scholar]
  16. Corwin AL, Simanjuntak CH, Ingkokusumo G, Sukri N, Larasati RP, Subianto B, Muslim HZ, Burni E, Laras K, Putri MP, Hayes C, Cox N, , 1998. Impact of epidemic influenza A-like acute respiratory illness in a remote jungle highland in Irian Jaya, Indonesia. CID 26: 880888.[Crossref] [Google Scholar]
  17. Jones TR, Baird K, Bangs MJ, Annis BA, Purnomo Basri H, Gunawan S, Harjosuwarno S, McElroy RD, Hoffman SL, , 1994. Malaria vaccine study site in Irian Jaya, Indonesia: Plasmodium falciparum incidence measurements and epidemiological considerations in sample size estimation. Am J Trop Med Hyg 50: 210218. [Google Scholar]
  18. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, , eds., 1999. Manual of Clinical Microbiology. 7th edition. Washington, DC: American Society for Microbiology Press, 442458. [Google Scholar]
  19. Bauer AW, Kirby WM, Sherris JC, Hurck M, , 1966. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol 45: 493496. [Google Scholar]
  20. Halle S, Dasch GA, , 1980. Use of a sensitive microplate enzyme-linked immunosorbent assay in a retrospective serological analysis of a laboratory population at risk to infection with typhus group rickettsiae. J Clin Microbiol 12: 343350. [Google Scholar]
  21. Faine S, , 1982. Guidelines for the Control of Leptospirosis. Geneva: World Health Organization, Mimeographed Document no. 67. [Google Scholar]
  22. Innis BL, Nisalak A, Nimmannitya S, Kusalerdchariya S, Chongswasdi V, Suntayakorn S, Puttisri P, Hoke CH, , 1989. An enzyme-linked immunosorbent assay to characterize dengue infections where dengue and Japanese encephalitis co-circulate. Am J Trop Med Hyg 40: 418427. [Google Scholar]
  23. Loehoeri S Prawoto, , 1992. The role of Widal test as a diagnostic tool for typhoid fever. Acta Med Indones 2: 3942. [Google Scholar]
  24. World Health Organization, 1986. Dengue Hemorrhagic Fever: Diagnosis, Treatment, and Control. Geneva: World Health Organization. [Google Scholar]
  25. Phetsouvanh R, Phongmany S, Soukaloun D, Rasachak B, Soukhaseum V, Soukhaseum S, Frichithavong K, Khounnorath S, Pengdee B, Phiasakha K, Chu V, Luangxay K, Rattanavong S, Sisouk K, Keolouangkot V, Mayxay M, Ramsay A, Blacksell SD, Campbell J, Martinez-Aussel B, Heuanvongsy M, Bounxouei B, Thammavong C, Syhavong B, Strobel M, Peacock SJ, White NJ, Newton PN, , 2006. Causes of community-acquired bacteremia and patterns of antimicrobial resistance in Vientiane, Laos. Am J Trop Med Hyg 75: 978985. [Google Scholar]
  26. Blacksell SD, Sharma NP, Phumratanaprapin W, Jenjaroen K, Peacock SJ, White NJ, Pukrittayakamee S, Day NP, , 2007. Serological and blood culture investigations of Nepalese fever patients. Trans R Soc Trop Med Hyg 101: 686690.[Crossref] [Google Scholar]
  27. Blacksell SD, Bryant NJ, Paris DH, Doust JA, Sakoda Y, Day NP, , 2007. Scrub typhus serologic testing with the indirect immunofluorescence method as a diagnostic gold standard: a lack of consensus leads to a lot of confusion. Clin Infect Dis 44: 391401.[Crossref] [Google Scholar]
  28. Wagenaar JF, Falke TH, Nam NV, Binh TQ, Smits HL, Cobelens FG, de Vries PJ, , 2004. Rapid serological assays for leptospirosis are of limited value in southern Vietnam. Ann Trop Med Parasitol 98: 843850.[Crossref] [Google Scholar]
  29. McGready R, Ashley EA, Wuthiekanun V, Tan SO, Pimanpanarak M, Viladpai-Nguen SJ, Jesadapanpong W, Blacksell SD, Peacock SJ, Paris DH, Day NP, Singhasivanon P, White NJ, Nosten F, , 2010. Arthropod borne disease: the leading cause of fever in pregnancy on the Thai-Burmese border. PLoS Negl Trop Dis 4: e888.[Crossref] [Google Scholar]
  30. Tay ST, Ho TM, Rohani MY, Devi S, , 2000. Antibodies to Orientia tsutsugamushi, Rickettsia typhi and spotted fever group rickettsiae among febrile patients in rural areas of Malaysia. Trans R Soc Trop Med Hyg 94: 280284.[Crossref] [Google Scholar]
  31. Blacksell SD, Mammen MP, Jr Thongpaseuth S, Gibbons RV, Jarman RG, Jenjaroen K, Nisalak A, Phetsouvanh R, Newton PN, Day NP, , 2008. Evaluation of the Panbio dengue virus nonstructural 1 antigen detection and immunoglobulin M antibody enzyme-linked immunosorbent assays for the diagnosis of acute dengue infections in Laos. Diagn Microbiol Infect Dis 60: 4349.[Crossref] [Google Scholar]
  32. Blacksell SD, Smythe L, Phetsouvanh R, Dohnt M, Hartskeerl R, Symonds M, Slack A, Vongsouvath M, Davong V, Lattana O, Phongmany S, Keolouangkot V, White NJ, Day NP, Newton PN, , 2006. Limited diagnostic capacities of two commercial assays for the detection of Leptospira immunoglobulin M antibodies in Laos. Clin Vaccine Immunol 13: 11661169.[Crossref] [Google Scholar]
  33. Hoffman SL, Punjabi NH, Kumala S, Moechtar MA, Pulungsih SP, Rivai AR, Rockhill RC, Woodward TE, Loedin AA, , 1984. Reduction of mortality in chloramphenicol-treated severe typhoid fever by high-dose dexamethasone. N Engl J Med 310: 8288.[Crossref] [Google Scholar]
  34. Richens J, , 1995. Typhoid in the highlands of Papua New Guinea 1984–1990: a hospital-based perspective. P N G Med J 38: 305314. [Google Scholar]
  35. Vourli S, Vagiakou H, Ganteris G, Orfanidou M, Polemis M, Vatopoulos A, Malamou-Ladas H, , 2009. High rates of community-acquired, Panton-Valentine leukocidin (PVL)-positive methicillin-resistant S. aureus (MRSA) infections in adult outpatients in Greece. Euro Surveill 14: pii: 19089. [Google Scholar]
  36. Cardozo DM, Nascimento-Carvalho CM, Souza FR, Silva NM, , 2006. Nasopharyngeal colonization and penicillin resistance among pneumococcal strains: a worldwide 2004 update. Braz J Infect Dis 10: 293304.[Crossref] [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2012.10-0497
Loading
/content/journals/10.4269/ajtmh.2012.10-0497
Loading

Data & Media loading...

  • Received : 07 Sep 2010
  • Accepted : 12 Sep 2011
  • Published online : 01 Jan 2012

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error