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Comparison of clinical characteristics and laboratory findings of malaria, dengue, and enteric fever in returning travelers: 8-year experience at a referral center in Tokyo, Japan.
J Infect Chemother. 2015 Apr; 21(4):272-6.JI

Abstract

BACKGROUND

Without specific symptoms, diagnosis of febrile illness in returning travelers is challenging. Dengue, malaria, and enteric fever are common causes of fever in returning travelers and timely and appropriate treatment is important. However, differentiation is difficult without specific diagnostic tests.

METHODS

A retrospective study was conducted at the National Centre for Global Health and Medicine (NCGM) from April 2005 to March 2013. Febrile travelers returning from overseas who were diagnosed with dengue, malaria, or enteric fever were included in this study. Clinical characteristics and laboratory findings were compared for each diagnosis.

RESULTS

During the study period, 86 malaria, 85 dengue, and 31 enteric fever cases were identified. The mean age of the study cohort was 33.1 ± 12 years and 134 (66.3%) study participants were male. Asia was the most common area visited by returning travelers with fevers (89% of dengue, 18.6% of malaria, and 100% of enteric fever cases), followed by Africa (1.2% of dengue and 70.9% of malaria cases). Clinical characteristics and laboratory findings were significantly different among each group with each diagnosis. Decision tree models revealed that returning from Africa and CRP levels <10 mg/L were factors specific for diagnosis of malaria and dengue fever, respectively.

CONCLUSION

Clinical manifestations, simple laboratory test results, and regions of travel are helpful to distinguish between dengue, malaria, and enteric fever in febrile returning travelers with non-specific symptoms.

Authors+Show Affiliations

National Centre for Global Health and Medicine, Disease Control and Prevention Center, Japan. Electronic address: sonare.since1192@gmail.com.National Centre for Global Health and Medicine, Disease Control and Prevention Center, Japan.National Centre for Global Health and Medicine, Disease Control and Prevention Center, Japan.National Centre for Global Health and Medicine, Disease Control and Prevention Center, Japan.National Centre for Global Health and Medicine, Disease Control and Prevention Center, Japan.National Centre for Global Health and Medicine, Disease Control and Prevention Center, Japan.National Centre for Global Health and Medicine, Disease Control and Prevention Center, Japan.National Centre for Global Health and Medicine, Disease Control and Prevention Center, Japan.

Pub Type(s)

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

Language

eng

PubMed ID

25592811

Citation

Kutsuna, Satoshi, et al. "Comparison of Clinical Characteristics and Laboratory Findings of Malaria, Dengue, and Enteric Fever in Returning Travelers: 8-year Experience at a Referral Center in Tokyo, Japan." Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy, vol. 21, no. 4, 2015, pp. 272-6.
Kutsuna S, Hayakawa K, Kato Y, et al. Comparison of clinical characteristics and laboratory findings of malaria, dengue, and enteric fever in returning travelers: 8-year experience at a referral center in Tokyo, Japan. J Infect Chemother. 2015;21(4):272-6.
Kutsuna, S., Hayakawa, K., Kato, Y., Fujiya, Y., Mawatari, M., Takeshita, N., Kanagawa, S., & Ohmagari, N. (2015). Comparison of clinical characteristics and laboratory findings of malaria, dengue, and enteric fever in returning travelers: 8-year experience at a referral center in Tokyo, Japan. Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy, 21(4), 272-6. https://doi.org/10.1016/j.jiac.2014.12.004
Kutsuna S, et al. Comparison of Clinical Characteristics and Laboratory Findings of Malaria, Dengue, and Enteric Fever in Returning Travelers: 8-year Experience at a Referral Center in Tokyo, Japan. J Infect Chemother. 2015;21(4):272-6. PubMed PMID: 25592811.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of clinical characteristics and laboratory findings of malaria, dengue, and enteric fever in returning travelers: 8-year experience at a referral center in Tokyo, Japan. AU - Kutsuna,Satoshi, AU - Hayakawa,Kayoko, AU - Kato,Yasuyuki, AU - Fujiya,Yoshihiro, AU - Mawatari,Momoko, AU - Takeshita,Nozomi, AU - Kanagawa,Shuzo, AU - Ohmagari,Norio, Y1 - 2014/12/18/ PY - 2014/06/02/received PY - 2014/11/28/revised PY - 2014/12/09/accepted PY - 2015/1/17/entrez PY - 2015/1/17/pubmed PY - 2016/1/6/medline KW - C-reactive protein KW - Dengue fever KW - Enteric fever KW - Malaria KW - Typhoid fever SP - 272 EP - 6 JF - Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy JO - J. Infect. Chemother. VL - 21 IS - 4 N2 - BACKGROUND: Without specific symptoms, diagnosis of febrile illness in returning travelers is challenging. Dengue, malaria, and enteric fever are common causes of fever in returning travelers and timely and appropriate treatment is important. However, differentiation is difficult without specific diagnostic tests. METHODS: A retrospective study was conducted at the National Centre for Global Health and Medicine (NCGM) from April 2005 to March 2013. Febrile travelers returning from overseas who were diagnosed with dengue, malaria, or enteric fever were included in this study. Clinical characteristics and laboratory findings were compared for each diagnosis. RESULTS: During the study period, 86 malaria, 85 dengue, and 31 enteric fever cases were identified. The mean age of the study cohort was 33.1 ± 12 years and 134 (66.3%) study participants were male. Asia was the most common area visited by returning travelers with fevers (89% of dengue, 18.6% of malaria, and 100% of enteric fever cases), followed by Africa (1.2% of dengue and 70.9% of malaria cases). Clinical characteristics and laboratory findings were significantly different among each group with each diagnosis. Decision tree models revealed that returning from Africa and CRP levels <10 mg/L were factors specific for diagnosis of malaria and dengue fever, respectively. CONCLUSION: Clinical manifestations, simple laboratory test results, and regions of travel are helpful to distinguish between dengue, malaria, and enteric fever in febrile returning travelers with non-specific symptoms. SN - 1437-7780 UR - https://www.unboundmedicine.com/medline/citation/25592811/Comparison_of_clinical_characteristics_and_laboratory_findings_of_malaria_dengue_and_enteric_fever_in_returning_travelers:_8_year_experience_at_a_referral_center_in_Tokyo_Japan_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1341-321X(14)00418-8 DB - PRIME DP - Unbound Medicine ER -