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-
1
Phuong HL, de Vries PJ, Nagelkerke N, Giao PT, Hung le Q, Binh TQ, Nga TT, Nam NV, Kager PA, 2006. Acute undifferentiated fever in Binh Thuan province, Vietnam: imprecise clinical diagnosis and irrational pharmacotherapy. Trop Med Int Health 11 :869–879.
-
2
Vinetz JM, 2003. Detection of leptospirosis in India. Arch Dis Child 88 :1033.
-
3
Phuong HL, de Vries PJ, Nga TT, Giao PT, Hung le Q, Binh TQ, Nam NV, Nagelkerke N, Kager PA, 2006. Dengue as a cause of acute undifferentiated fever in Vietnam. BMC Infect Dis 6 :123.
-
4
Siddiqui FJ, Rabbani F, Hasan R, Nizami SQ, Bhutta ZA, 2006. Typhoid fever in children: some epidemiological considerations from Karachi, Pakistan. Int J Infect Dis 10 :215–222.
-
5
Suttinont C, Losuwanaluk K, Niwatayakul K, Hoontrakul S, Intaranongpai W, Silpasakorn S, Suwancharoen D, Panlar P, Saisongkorh W, Rolain JM, Raoult D, Suputtamongkol Y, 2006. Causes of acute, undifferentiated, febrile illness in rural Thailand: results of a prospective observational study. Ann Trop Med Parasitol 100 :363–370.
-
6
Watt G, Jongsakul K, 2003. Acute undifferentiated fever caused by infection with Japanese encephalitis virus. Am J Trop Med Hyg 68 :704–706.
-
7
World Health Organization, 2005. World Malaria Report 2005. Geneva: WHO and UNICEF.
-
8
World Health Organization, 2007. Global RBM Online Database. Geneva: WHO. Available at: http://www.rbm.who.int/wmr2005/htm/1-1.htm.
-
9
Njama-Meya D, Clark TD, Nzarubara B, Staedke S, Kamya MR, Dorsey G, 2007. Treatment of malaria restricted to laboratory confirmed cases: a prospective cohort study in Ugandan children. Malar J 6 :7.
-
10
Zurovac D, Midia B, Ochola SA, English M, Snow RW, 2006. Microscopy and outpatient malaria case management among older children and adults in Kenya. Trop Med Int Health 11 :1–9.
-
11
Ochola L, Vounatsou P, Smith T, Mabaso M, Newton C, 2006. The reliability of diagnostic techniques in the diagnosis and management of malaria in the absence of a gold standard. Lancet Infect Dis 6 :582–588.
-
12
Amexo M, Tolhurst R, Barnish G, Bates I, 2004. Malaria misdiagnosis: effects on the poor and vulnerable. Lancet 364 :1896–1898.
-
13
Reyburn H, Mbatia R, Drakeley C, Carneiro I, Mwakasungula E, Mwerinde O, Saganda K, Shao J, Kitua A, Olomi R, Greenwood BM, Whitty CJ, 2004. Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: a prospective study. BMJ 329 :1212.
-
14
Sur D, von Seidlein L, Manna B, Dutta S, Deb AK, Sarkar BL, Kanungo S, Deen JL, Ali M, Kim DR, Gupta VK, Ochiai RL, Tsuzuki A, Acosta CJ, Clemens JD, Bhattacharya SK, 2006. The malaria and typhoid fever burden in the slums of Kolkata, India: data from a prospective community-based study. Trans R Soc Trop Med Hyg 100 :725–733.
-
15
Hamer DH, Ndhlovu M, Zurovac D, Fox M, Yeboah-Antwi K, Chanda P, Sipilinyambe N, Simon JL, Snow RW, 2007. Improved diagnostic testing and malaria treatment practices in Zambia. JAMA 297 :2227–2231.
-
16
Reyburn H, Mbakilwa H, Mwangi R, Mwerinde O, Olomi R, Drakeley C, 2007. Rapid diagnostic tests compared with malaria microscopy for guiding outpatient treatment of febrile illness in Tanzania: randomised trial. BMJ 334 :403.
-
17
Zurovac D, Larson BA, Akhwale W, Snow RW, 2006. The financial and clinical implications of adult malaria diagnosis using microscopy in Kenya. Trop Med Int Health 11 :1185–1194.
-
18
Ambrose OT, Bloland P, D’Alessandro U, 2004. History, dynamics, and public health importance of malaria parasite resistance. Clin Microbiol Rev 17 :235–254.
-
19
D’Alessandro U, Buttiens H, 2001. History and importance of antimalarial drug resistance. Trop Med Int Health 6 :845–848.
-
20
Peters CJ, 2005. Infections caused by arthropod and rodent-borne viruses. Kasper DL, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL, eds. Harrison’s Principles of Internal Medicine. New York: McGraw Hill, 1161.
-
21
Pan American Health Organization, 2000. Third Meeting of the Surveillance Networks for Emerging Infectious Diseases in the Amazon and South Cone Regions. Atlanta, GA: PAHO.
-
22
World Health Organization, 2002. Operations Manual for the Integrated Disease Surveillance Program: India. New Delhi: WHO.
-
23
Lombardo J, Burkom H, Elbert E, Magruder S, Lewis SH, Loschen W, Sari J, Sniegoski C, Wojcik R, Pavlin J, 2003. A systems overview of the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE II). J Urban Health 80 (2 Suppl 1):i32–i42.
-
24
Sosin DM, 2003. Syndromic surveillance: the case for skillful investment. Biosecur Bioterror 1 :247–253.
-
25
Lathia TB, Joshi R, 2004. Can hematological parameters discriminate malaria from non-malarious acute febrile illness in the tropics? Indian J Med Sci 58 :1–7.
-
26
Kalantri SP, Joshi R, Riley LW, 2006. Chikungunya epidemic: an Indian perspective. Nat Med J India 19 :315–322.
-
27
Chadwick D, Arch B, Wilder-Smith A, Paton N, 2006. Distinguishing dengue fever from other infections on the basis of simple clinical and laboratory features: application of logistic regression analysis. J Clin Virol 35 :147–153.
-
28
Ali N, Nadeem A, Anwar M, Tariq WU, Chotani RA, 2006. Dengue fever in malaria endemic areas. J Coll Physicians Surg Pak 16 :340–342.
-
29
Yacoub S, Mohammed MJ, Ramsan M, Albonico M, 2005. Clinical predictors of malaria and other febrile illnesses in children under five on Pemba Island, Tanzania. Trop Doct 35 :78–81.
-
30
Ellis RD, Fukuda MM, McDaniel P, Welch K, Nisalak A, Murray CK, Gray MR, Uthaimongkol N, Buathong N, Sriwichai S, Phasuk R, Yingyuen K, Mathavarat C, Miller RS, 2006. Causes of fever in adults on the Thai–Myanmar border. Am J Trop Med Hyg 74 :108–113.
-
31
Long SS, 2005. Distinguishing among prolonged, recurrent, and periodic fever syndromes: approach of a pediatric infectious diseases subspecialist. Pediatr Clin North Am 52 :811–835.
-
32
Singh M, Pai M, Kalantri SP, 2003. Accuracy of perception of touch for detecting fevers in adults: a hospital based study from rural tertiary care hospital in rural India. Trop Med Int Health 8 :408–414.
-
33
Gomes M, Espino FE, Abaquin J, Realon C, Salazar NP, 1994. Symptomatic identification of malaria in the home and in the primary health care clinic. Bull World Health Organ 72 :383–390.
-
34
Osterholt DM, Rowe AK, Hamel MJ, Flanders WD, Mkandala C, Marum LH, Kaimila N, 2006. Predictors of treatment error for children with uncomplicated malaria seen as outpatients in Blantyre district, Malawi. Trop Med Int Health 11 :1147–1156.
-
35
Sachs J, Malaney P, 2002. The economic and social burden of malaria. Nature 415 :680–685.
-
36
D’Acremont V, Lengeler C, Genton B, 2007. Stop ambiguous messages on malaria diagnosis. BMJ 334 :489 [letter].
-
37
Mboera LE, Fanello CI, Malima RC, Talbert A, Fogliati P, Bobbio F, Molteni F, 2006. Comparison of the Paracheck-Pf test with microscopy, for the confirmation of Plasmodium falciparum malaria in Tanzania. Ann Trop Med Parasitol 100 :115–122.
-
38
Falsey AR, Murata Y, Walsh EE, 2007. Impact of rapid diagnosis on management of adults hospitalized with Influenza. Arch Intern Med 167 :354–360.
-
39
Hashizume M, Kondo H, Murakami T, Kodama M, Nakahara S, Lucas ME, Wakai S, 2006. Use of rapid diagnostic tests for malaria in an emergency situation after the flood disaster in Mozambique. Public Health 120 :444–447.
-
40
Samuel PP, Thenmozhi V, Tyagi BK, 2007. A focal outbreak of dengue fever in a rural area of Tamil Nadu. Indian J Med Res 125 :179–181.
-
41
Thomas EA, John M, Bhatia A, 2007. Cutaneous manifestations of dengue viral infection in Punjab (north India). Int J Dermatol 46 :715–719.
-
42
Lal M, Aggarwal A, Oberoi A, 2007. Seroprevalence of leptospirosis in patients of PUO in Ludhiana. Indian J Pathol Microbiol 50 :462–463.
-
43
Bhattacharya SS, Dash U, 2007. A sudden rise in occurrence of Salmonella paratyphi a infection in Rourkela, Orissa. Indian J Med Microbiol 25 :78–79.
-
44
Bachani D, 2006. Integration of disease surveillance in India: current scenario and future perspective. Indian J Public Health 50 :7–10.
-
45
Watt G, Jongsakul K, Ruangvirayuth R, Kantipong P, Silpapojakul K, 2005. Short report: prospective evaluation of a multi-test strip for the diagnoses of scrub and murine typhus, leptospirosis, dengue fever, and Salmonella typhi infection. Am J Trop Med Hyg 72 :10–12.
-
46
Palacios G, Quan PL, Jabado OJ, Conlan S, Hirschberg DL, Liu Y, Zhai J, Renwick N, Hui J, Hegyi H, Grolla A, Strong JE, Towner JS, Geisbert TW, Jahrling PB, Büchen-Osmond C, Ellerbrok H, Sanchez-Seco MP, Lussier Y, Formenty P, Nichol MS, Feldmann H, Briese T, Lipkin WI, 2007. Panmicrobial oligonucleotide array for diagnosis of infectious diseases. Emerg Infect Dis 13 :73–81.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 37 | 37 | 11 |
| Full Text Views | 357 | 111 | 0 |
| PDF Downloads | 141 | 38 | 0 |
Nonmalarial Acute Undifferentiated Fever in a Rural Hospital in Central India: Diagnostic Uncertainty and Overtreatment with Antimalarial Agents
Rajnish Joshi
Rajnish Joshi
Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
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John M. Colford Jr.
John M. Colford Jr.
Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
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Arthur L. Reingold
Arthur L. Reingold
Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
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Shriprakash Kalantri
Shriprakash Kalantri
Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
Search for other papers by Shriprakash Kalantri in
Current site
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PubMed
Search for other papers by Shriprakash Kalantri in
Current site
Google Scholar
PubMed
Nonmalarial acute undifferentiated fever (NMAUF) refers to a febrile illness with no indication of an organ-specific disease after diagnosis of malaria has been excluded. In developing countries, the empirical treatment of NMAUFs with antimalarial drugs continues even in the era of highly specific rapid diagnostic tests (RDTs) for malaria. We carried out a retrospective review of patients with fever admitted to a rural teaching hospital in central India. We categorized patients with NMAUF into different clinical syndromes and determined their demographic profile, inhospital course, and the pattern of antimalarial use. The study sample included 1,197 adult patients who were investigated for malaria; 1,053 (88%) of them had NMAUF, and use of further diagnostics in this group was limited. Despite one or more negative tests for malaria, many patients (39.9%, 95% CI 37.0–43.3) received antimalarial drugs. These results suggest a need for guidelines and training to improve empirical treatment of NMAUF.
Author Notes
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Reference Manager
BibTeX
Zotero
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-
1
Phuong HL, de Vries PJ, Nagelkerke N, Giao PT, Hung le Q, Binh TQ, Nga TT, Nam NV, Kager PA, 2006. Acute undifferentiated fever in Binh Thuan province, Vietnam: imprecise clinical diagnosis and irrational pharmacotherapy. Trop Med Int Health 11 :869–879.
-
2
Vinetz JM, 2003. Detection of leptospirosis in India. Arch Dis Child 88 :1033.
-
3
Phuong HL, de Vries PJ, Nga TT, Giao PT, Hung le Q, Binh TQ, Nam NV, Nagelkerke N, Kager PA, 2006. Dengue as a cause of acute undifferentiated fever in Vietnam. BMC Infect Dis 6 :123.
-
4
Siddiqui FJ, Rabbani F, Hasan R, Nizami SQ, Bhutta ZA, 2006. Typhoid fever in children: some epidemiological considerations from Karachi, Pakistan. Int J Infect Dis 10 :215–222.
-
5
Suttinont C, Losuwanaluk K, Niwatayakul K, Hoontrakul S, Intaranongpai W, Silpasakorn S, Suwancharoen D, Panlar P, Saisongkorh W, Rolain JM, Raoult D, Suputtamongkol Y, 2006. Causes of acute, undifferentiated, febrile illness in rural Thailand: results of a prospective observational study. Ann Trop Med Parasitol 100 :363–370.
-
6
Watt G, Jongsakul K, 2003. Acute undifferentiated fever caused by infection with Japanese encephalitis virus. Am J Trop Med Hyg 68 :704–706.
-
7
World Health Organization, 2005. World Malaria Report 2005. Geneva: WHO and UNICEF.
-
8
World Health Organization, 2007. Global RBM Online Database. Geneva: WHO. Available at: http://www.rbm.who.int/wmr2005/htm/1-1.htm.
-
9
Njama-Meya D, Clark TD, Nzarubara B, Staedke S, Kamya MR, Dorsey G, 2007. Treatment of malaria restricted to laboratory confirmed cases: a prospective cohort study in Ugandan children. Malar J 6 :7.
-
10
Zurovac D, Midia B, Ochola SA, English M, Snow RW, 2006. Microscopy and outpatient malaria case management among older children and adults in Kenya. Trop Med Int Health 11 :1–9.
-
11
Ochola L, Vounatsou P, Smith T, Mabaso M, Newton C, 2006. The reliability of diagnostic techniques in the diagnosis and management of malaria in the absence of a gold standard. Lancet Infect Dis 6 :582–588.
-
12
Amexo M, Tolhurst R, Barnish G, Bates I, 2004. Malaria misdiagnosis: effects on the poor and vulnerable. Lancet 364 :1896–1898.
-
13
Reyburn H, Mbatia R, Drakeley C, Carneiro I, Mwakasungula E, Mwerinde O, Saganda K, Shao J, Kitua A, Olomi R, Greenwood BM, Whitty CJ, 2004. Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: a prospective study. BMJ 329 :1212.
-
14
Sur D, von Seidlein L, Manna B, Dutta S, Deb AK, Sarkar BL, Kanungo S, Deen JL, Ali M, Kim DR, Gupta VK, Ochiai RL, Tsuzuki A, Acosta CJ, Clemens JD, Bhattacharya SK, 2006. The malaria and typhoid fever burden in the slums of Kolkata, India: data from a prospective community-based study. Trans R Soc Trop Med Hyg 100 :725–733.
-
15
Hamer DH, Ndhlovu M, Zurovac D, Fox M, Yeboah-Antwi K, Chanda P, Sipilinyambe N, Simon JL, Snow RW, 2007. Improved diagnostic testing and malaria treatment practices in Zambia. JAMA 297 :2227–2231.
-
16
Reyburn H, Mbakilwa H, Mwangi R, Mwerinde O, Olomi R, Drakeley C, 2007. Rapid diagnostic tests compared with malaria microscopy for guiding outpatient treatment of febrile illness in Tanzania: randomised trial. BMJ 334 :403.
-
17
Zurovac D, Larson BA, Akhwale W, Snow RW, 2006. The financial and clinical implications of adult malaria diagnosis using microscopy in Kenya. Trop Med Int Health 11 :1185–1194.
-
18
Ambrose OT, Bloland P, D’Alessandro U, 2004. History, dynamics, and public health importance of malaria parasite resistance. Clin Microbiol Rev 17 :235–254.
-
19
D’Alessandro U, Buttiens H, 2001. History and importance of antimalarial drug resistance. Trop Med Int Health 6 :845–848.
-
20
Peters CJ, 2005. Infections caused by arthropod and rodent-borne viruses. Kasper DL, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL, eds. Harrison’s Principles of Internal Medicine. New York: McGraw Hill, 1161.
-
21
Pan American Health Organization, 2000. Third Meeting of the Surveillance Networks for Emerging Infectious Diseases in the Amazon and South Cone Regions. Atlanta, GA: PAHO.
-
22
World Health Organization, 2002. Operations Manual for the Integrated Disease Surveillance Program: India. New Delhi: WHO.
-
23
Lombardo J, Burkom H, Elbert E, Magruder S, Lewis SH, Loschen W, Sari J, Sniegoski C, Wojcik R, Pavlin J, 2003. A systems overview of the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE II). J Urban Health 80 (2 Suppl 1):i32–i42.
-
24
Sosin DM, 2003. Syndromic surveillance: the case for skillful investment. Biosecur Bioterror 1 :247–253.
-
25
Lathia TB, Joshi R, 2004. Can hematological parameters discriminate malaria from non-malarious acute febrile illness in the tropics? Indian J Med Sci 58 :1–7.
-
26
Kalantri SP, Joshi R, Riley LW, 2006. Chikungunya epidemic: an Indian perspective. Nat Med J India 19 :315–322.
-
27
Chadwick D, Arch B, Wilder-Smith A, Paton N, 2006. Distinguishing dengue fever from other infections on the basis of simple clinical and laboratory features: application of logistic regression analysis. J Clin Virol 35 :147–153.
-
28
Ali N, Nadeem A, Anwar M, Tariq WU, Chotani RA, 2006. Dengue fever in malaria endemic areas. J Coll Physicians Surg Pak 16 :340–342.
-
29
Yacoub S, Mohammed MJ, Ramsan M, Albonico M, 2005. Clinical predictors of malaria and other febrile illnesses in children under five on Pemba Island, Tanzania. Trop Doct 35 :78–81.
-
30
Ellis RD, Fukuda MM, McDaniel P, Welch K, Nisalak A, Murray CK, Gray MR, Uthaimongkol N, Buathong N, Sriwichai S, Phasuk R, Yingyuen K, Mathavarat C, Miller RS, 2006. Causes of fever in adults on the Thai–Myanmar border. Am J Trop Med Hyg 74 :108–113.
-
31
Long SS, 2005. Distinguishing among prolonged, recurrent, and periodic fever syndromes: approach of a pediatric infectious diseases subspecialist. Pediatr Clin North Am 52 :811–835.
-
32
Singh M, Pai M, Kalantri SP, 2003. Accuracy of perception of touch for detecting fevers in adults: a hospital based study from rural tertiary care hospital in rural India. Trop Med Int Health 8 :408–414.
-
33
Gomes M, Espino FE, Abaquin J, Realon C, Salazar NP, 1994. Symptomatic identification of malaria in the home and in the primary health care clinic. Bull World Health Organ 72 :383–390.
-
34
Osterholt DM, Rowe AK, Hamel MJ, Flanders WD, Mkandala C, Marum LH, Kaimila N, 2006. Predictors of treatment error for children with uncomplicated malaria seen as outpatients in Blantyre district, Malawi. Trop Med Int Health 11 :1147–1156.
-
35
Sachs J, Malaney P, 2002. The economic and social burden of malaria. Nature 415 :680–685.
-
36
D’Acremont V, Lengeler C, Genton B, 2007. Stop ambiguous messages on malaria diagnosis. BMJ 334 :489 [letter].
-
37
Mboera LE, Fanello CI, Malima RC, Talbert A, Fogliati P, Bobbio F, Molteni F, 2006. Comparison of the Paracheck-Pf test with microscopy, for the confirmation of Plasmodium falciparum malaria in Tanzania. Ann Trop Med Parasitol 100 :115–122.
-
38
Falsey AR, Murata Y, Walsh EE, 2007. Impact of rapid diagnosis on management of adults hospitalized with Influenza. Arch Intern Med 167 :354–360.
-
39
Hashizume M, Kondo H, Murakami T, Kodama M, Nakahara S, Lucas ME, Wakai S, 2006. Use of rapid diagnostic tests for malaria in an emergency situation after the flood disaster in Mozambique. Public Health 120 :444–447.
-
40
Samuel PP, Thenmozhi V, Tyagi BK, 2007. A focal outbreak of dengue fever in a rural area of Tamil Nadu. Indian J Med Res 125 :179–181.
-
41
Thomas EA, John M, Bhatia A, 2007. Cutaneous manifestations of dengue viral infection in Punjab (north India). Int J Dermatol 46 :715–719.
-
42
Lal M, Aggarwal A, Oberoi A, 2007. Seroprevalence of leptospirosis in patients of PUO in Ludhiana. Indian J Pathol Microbiol 50 :462–463.
-
43
Bhattacharya SS, Dash U, 2007. A sudden rise in occurrence of Salmonella paratyphi a infection in Rourkela, Orissa. Indian J Med Microbiol 25 :78–79.
-
44
Bachani D, 2006. Integration of disease surveillance in India: current scenario and future perspective. Indian J Public Health 50 :7–10.
-
45
Watt G, Jongsakul K, Ruangvirayuth R, Kantipong P, Silpapojakul K, 2005. Short report: prospective evaluation of a multi-test strip for the diagnoses of scrub and murine typhus, leptospirosis, dengue fever, and Salmonella typhi infection. Am J Trop Med Hyg 72 :10–12.
-
46
Palacios G, Quan PL, Jabado OJ, Conlan S, Hirschberg DL, Liu Y, Zhai J, Renwick N, Hui J, Hegyi H, Grolla A, Strong JE, Towner JS, Geisbert TW, Jahrling PB, Büchen-Osmond C, Ellerbrok H, Sanchez-Seco MP, Lussier Y, Formenty P, Nichol MS, Feldmann H, Briese T, Lipkin WI, 2007. Panmicrobial oligonucleotide array for diagnosis of infectious diseases. Emerg Infect Dis 13 :73–81.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 37 | 37 | 11 |
| Full Text Views | 357 | 111 | 0 |
| PDF Downloads | 141 | 38 | 0 |