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Malaria, Dengue Fever, and Leptospirosis in the Urabá Antioqueño Region, Colombia: Etiological and Molecular Characterization among Patients with Acute Undifferentiated Febrile Illness
Nicaela Restrepo-López
Nicaela Restrepo-López
Grupo de Investigación en Ciencias Veterinarias Centauro, Universidad de Antioquia, Medellín, Colombia;
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Carlos Ramiro Silva-Ramos
cramiro-silva@javeriana.edu.co
Carlos Ramiro Silva-Ramos
Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia;
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Juan David Rodas
jdavid.rodas@udea.edu.co
Juan David Rodas
Grupo de Investigación en Ciencias Veterinarias Centauro, Universidad de Antioquia, Medellín, Colombia;
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Margarita Arboleda
Margarita Arboleda
Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín, Colombia;
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Diana Fernández
Diana Fernández
Grupo de Investigación en Ciencias Veterinarias Centauro, Universidad de Antioquia, Medellín, Colombia;
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Pablo Uribe-Restrepo
Pablo Uribe-Restrepo
Grupo de Investigación en Ciencias de la Vida y de la Salud, Escuela de Graduados, Universidad CES, Medellín, Colombia;
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Piedad Agudelo-Flórez
Piedad Agudelo-Flórez
Grupo de Investigación en Ciencias de la Vida y de la Salud, Escuela de Graduados, Universidad CES, Medellín, Colombia;
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Alberto Tobón-Castaño
Alberto Tobón-Castaño
Grupo de Malaria, Universidad de Antioquia, Medellín, Colombia;
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Marylin Hidalgo
Marylin Hidalgo
Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia;
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Peter C. Melby
Peter C. Melby
Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas;
Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas;
Department of Pathology, University of Texas Medical Branch, Galveston, Texas;
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Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas;
Department of Pathology, University of Texas Medical Branch, Galveston, Texas;
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Patricia V. Aguilar
Patricia V. Aguilar
Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas;
Department of Pathology, University of Texas Medical Branch, Galveston, Texas;
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Department of Pathology, University of Texas Medical Branch, Galveston, Texas;
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Miguel M. Cabada
Miguel M. Cabada
Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas;
Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas;
Sede Cusco—Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru;
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Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas;
Sede Cusco—Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru;
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Francisco J. Díaz
Francisco J. Díaz
Grupo de Inmunovirología, Universidad de Antioquia, Medellín, Colombia
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Special Recognition of the Members of the Global Infectious Diseases Research Network (GIDRN)
Special Recognition of the Members of the Global Infectious Diseases Research Network (GIDRN)
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ABSTRACT.
Acute undifferentiated febrile illness (AUFI) is the main cause of medical attention in the tropics worldwide. Malaria, arboviral diseases, and leptospirosis are the most important etiologies. These are highly endemic in the Urabá antioqueño, Colombia, being the main causes of fever in several municipalities in this region. However, up-to-date data regarding the infecting species and serotypes are lacking. Thus, we characterized the etiology of AUFI, focusing on malaria, arboviruses, and leptospirosis in this region and the circulating infecting species. An active surveillance was conducted between January and April 2022, and July and October 2023 in two local hospitals in the Urabá antioqueño. Febrile patients were enrolled voluntarily. Malaria, arboviral diseases, and leptospirosis were screened through direct, serological, molecular, and rapid diagnostic methods. Amplicons obtained for dengue virus (DENV) and Leptospira spp. were analyzed through phylogenetic analysis. A total of 184 febrile patients were enrolled. A confirmed etiology was detected in 43.4% of patients from Apartadó and 61.2% from Turbo. Malaria was the most frequent cause in both municipalities, which was caused mainly by Plasmodium falciparum in Apartadó and Plasmodium vivax in Turbo. Dengue virus serotype 1 genotype V, DENV genotype Asian-American, and DENV genotype Cosmopolitan were identified, as well as pathogenic Leptospira species closely related to Leptospira santarosai and Leptospira noguchii. The present study confirms the importance of malaria, dengue fever, and leptospirosis in the Urabá antioqueño. Plasmodium falciparum and P. vivax were identified, as well as two DENV serotypes and three DENV genotypes and two different Leptospira species.
Author Notes
Financial support: This study was supported as part of the
Disclosures: The study protocol and the written informed consent and assent were approved by the Bioethics Committee of the Medical School at the Universidad de Antioquia. All recruited adult patients voluntarily signed the written informed consent before any study procedure was performed. For children less than 6 years old and those in critical condition, signed informed consent was obtained from the parents or legal guardians. In the case of children 6–18 years old, an informed assent was voluntarily signed, and the parents or legal guardians provided a signed written informed consent. All signed informed consents were kept locked and available only to the principal investigators. The personal information obtained from each patient was anonymized by assigning a numeric code. The study procedures, management, conservation of biological specimens, and technical-administrative procedures adhered to health research regulations as stated in Resolution 8430 of the Ministry of Health of Colombia from 1993 and to the Declaration of Helsinki for ethical and medical research in human subjects.
Data availability: The data generated and analyzed during the current study are not publicly available, but they can be shared by request to the corresponding author.
Current contact information: Nicaela Restrepo-López, Juan David Rodas, Diana Fernández, Alberto Tobón-Castaño, and Francisco J. Díaz, Universidad de Antioquia, Medellín, Colombia, E-mails: nicaela.restrepo@udea.edu.co, jdavid.rodas@udea.edu.co, diana.fernandez@udea.edu.co, alberto.tobon1@udea.edu.co, and francisco.diaz@udea.edu.co. Carlos Ramiro Silva-Ramos and Marylin Hidalgo, Pontificia Universidad Javeriana, Bogotá, Colombia, E-mails: cramiro-silva@javeriana.edu.co and hidalgo.m@javeriana.edu.co. Margarita Arboleda, Pablo Uribe-Restrepo, and Piedad Agudelo-Flórez, Universidad CES, Medellín, Colombia, E-mails: marboleda@ces.edu.co, uribe.pablo@uces.edu.co, and pagudelo@ces.edu.co. Peter C. Melby, Patricia V. Aguilar, and Miguel M. Cabada, University of Texas Medical Branch, Galveston, Texas, E-mails: pcmelby@utmb.edu, pvaguila@utmb.edu, and micabada@utmb.edu.
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3.
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