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A study of'febrile illnesses on the Thai-Myanmar border: predictive factors of rickettsioses.
Southeast Asian J Trop Med Public Health. 2004 Sep; 35(3):657-63.SA

Abstract

We have performed a case-control analysis to determine the significance of clinical, laboratory and epidemiological features as predictive factors of rickettsioses among patients in Sangkhla Buri, Thailand (Thai-Myanmar border). Fifteen serologically-confirmed rickettsiosis patients including Spotted Fever Group (SFG) rickettsioses, scrub typhus, and murine typhus were classified as 'cases'; one hundred and sixty-three acutely febrile patients presenting to the same hospital during the same time period, who had no serological evidence of acute rickettsiosis, were classified as 'controls'. Patients' report of rash/arthropod bite [Odds ratio (OR) 22.90, 95% CI (confidence interval) 6.23, 84.13] and history of jungle trips (OR 5.30, 95% CI 1.69-16.62) were significant risk factors. Elevated ALT (OR 3.04, 95% CI 1.04, 8.88) and depressed platelet count (OR 3.38, 95% CI 1.13, 10.10) were also useful differentiating markers of rickettsioses in this population. Definitive diagnosis of rickettsioses is difficult without specialized diagnostic capabilities that are rarely available in remote areas such as Sangkhla Buri, where other acute febrile illnesses with similar presentation are commonly found. The relative importance of predictive factors presented here may provide clinicians with some useful guidance in distinguishing rickettsioses from other acute febrile illnesses. Timely administration of empiric treatment in highly suspicious cases can deter potential morbidity from these arthropod-borne infections.

Authors+Show Affiliations

Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

15689083

Citation

PicKard, Amy L., et al. "A Study Of'febrile Illnesses On the Thai-Myanmar Border: Predictive Factors of Rickettsioses." The Southeast Asian Journal of Tropical Medicine and Public Health, vol. 35, no. 3, 2004, pp. 657-63.
PicKard AL, McDaniel P, Miller RS, et al. A study of'febrile illnesses on the Thai-Myanmar border: predictive factors of rickettsioses. Southeast Asian J Trop Med Public Health. 2004;35(3):657-63.
PicKard, A. L., McDaniel, P., Miller, R. S., Uthaimongkol, N., Buathong, N., Murray, C. K., Telford, S. R., Parola, P., & Wongsrichanalai, C. (2004). A study of'febrile illnesses on the Thai-Myanmar border: predictive factors of rickettsioses. The Southeast Asian Journal of Tropical Medicine and Public Health, 35(3), 657-63.
PicKard AL, et al. A Study Of'febrile Illnesses On the Thai-Myanmar Border: Predictive Factors of Rickettsioses. Southeast Asian J Trop Med Public Health. 2004;35(3):657-63. PubMed PMID: 15689083.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A study of'febrile illnesses on the Thai-Myanmar border: predictive factors of rickettsioses. AU - PicKard,Amy L, AU - McDaniel,Philip, AU - Miller,R Scott, AU - Uthaimongkol,Nichapat, AU - Buathong,Nillawan, AU - Murray,Clinton K, AU - Telford,Sam R,3rd AU - Parola,Philippe, AU - Wongsrichanalai,Chansuda, PY - 2005/2/4/pubmed PY - 2005/6/1/medline PY - 2005/2/4/entrez SP - 657 EP - 63 JF - The Southeast Asian journal of tropical medicine and public health JO - Southeast Asian J Trop Med Public Health VL - 35 IS - 3 N2 - We have performed a case-control analysis to determine the significance of clinical, laboratory and epidemiological features as predictive factors of rickettsioses among patients in Sangkhla Buri, Thailand (Thai-Myanmar border). Fifteen serologically-confirmed rickettsiosis patients including Spotted Fever Group (SFG) rickettsioses, scrub typhus, and murine typhus were classified as 'cases'; one hundred and sixty-three acutely febrile patients presenting to the same hospital during the same time period, who had no serological evidence of acute rickettsiosis, were classified as 'controls'. Patients' report of rash/arthropod bite [Odds ratio (OR) 22.90, 95% CI (confidence interval) 6.23, 84.13] and history of jungle trips (OR 5.30, 95% CI 1.69-16.62) were significant risk factors. Elevated ALT (OR 3.04, 95% CI 1.04, 8.88) and depressed platelet count (OR 3.38, 95% CI 1.13, 10.10) were also useful differentiating markers of rickettsioses in this population. Definitive diagnosis of rickettsioses is difficult without specialized diagnostic capabilities that are rarely available in remote areas such as Sangkhla Buri, where other acute febrile illnesses with similar presentation are commonly found. The relative importance of predictive factors presented here may provide clinicians with some useful guidance in distinguishing rickettsioses from other acute febrile illnesses. Timely administration of empiric treatment in highly suspicious cases can deter potential morbidity from these arthropod-borne infections. SN - 0125-1562 UR - https://www.unboundmedicine.com/medline/citation/15689083/A_study_of'febrile_illnesses_on_the_Thai_Myanmar_border:_predictive_factors_of_rickettsioses_ L2 - https://ClinicalTrials.gov/search/term=15689083 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -