Tags

Type your tag names separated by a space and hit enter

Non-Respiratory and Non-Diarrheal Causes of Acute Febrile Illnesses in Children Requiring Hospitalization in a Tertiary Care Hospital in North India: A Prospective Study.
Am J Trop Med Hyg 2018; 99(3):783-788AJ

Abstract

Acute febrile illnesses (AFIs) in children from the developing world can have varying etiologies. Awareness of local epidemiology helps in prioritizing investigations and empiric treatment. This prospective study was carried out in a tertiary care center in North India, aiming to determine the burden, etiology, and outcome of AFI other than pneumonia and diarrhea in hospitalized children. A total of 613 consecutive children aged 3 months to 12 years with febrile illness of < 7 days during four selected months of 2014 representing different seasons were screened for eligibility. Those with acute respiratory diseases (N = 175, 28.5%) and diarrheal illness (N = 46, 7.5%) were excluded and 217 children were enrolled. Mean (standard deviation) age was 4.8 (3.4) years. Nearly half (N = 91, 41.9%) presented in post-monsoon season. Diagnosis could be established in 187 (86.2%) children. Acute central nervous system infections were the most common (N = 54, 24.8%). Among specific infections, scrub typhus was the most frequent (N = 23, 10.5%) followed by malaria (N = 14, 6.4%), typhoid (N = 14, 6.5%), and viral hepatitis (N = 13, 6.0%). Blood culture had a low (6.5%) yield; Salmonella typhi (N = 6) and Staphylococcus aureus (N = 5) were the common isolates. Serological tests were helpful in 50 (23%) cases. In multivariate analysis, hepatomegaly and/or splenomegaly independently predicted scrub typhus. Mortality rate was 10.1%. We conclude that AFI other than pneumonia and diarrhea are a significant burden and follow a seasonal trend. Scrub typhus has emerged as an important etiology of childhood AFIs in northern India. Periodic review of regional epidemiology will help in understanding the changing pattern of infectious diseases.

Authors+Show Affiliations

Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.Department of Pediatrics, Maulana Azad Medical College, New Delhi, India.Department of Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Pub Type(s)

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

Language

eng

PubMed ID

29988003

Citation

Rauf, Abdul, et al. "Non-Respiratory and Non-Diarrheal Causes of Acute Febrile Illnesses in Children Requiring Hospitalization in a Tertiary Care Hospital in North India: a Prospective Study." The American Journal of Tropical Medicine and Hygiene, vol. 99, no. 3, 2018, pp. 783-788.
Rauf A, Singhi S, Nallasamy K, et al. Non-Respiratory and Non-Diarrheal Causes of Acute Febrile Illnesses in Children Requiring Hospitalization in a Tertiary Care Hospital in North India: A Prospective Study. Am J Trop Med Hyg. 2018;99(3):783-788.
Rauf, A., Singhi, S., Nallasamy, K., Walia, M., & Ray, P. (2018). Non-Respiratory and Non-Diarrheal Causes of Acute Febrile Illnesses in Children Requiring Hospitalization in a Tertiary Care Hospital in North India: A Prospective Study. The American Journal of Tropical Medicine and Hygiene, 99(3), pp. 783-788. doi:10.4269/ajtmh.18-0056.
Rauf A, et al. Non-Respiratory and Non-Diarrheal Causes of Acute Febrile Illnesses in Children Requiring Hospitalization in a Tertiary Care Hospital in North India: a Prospective Study. Am J Trop Med Hyg. 2018;99(3):783-788. PubMed PMID: 29988003.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-Respiratory and Non-Diarrheal Causes of Acute Febrile Illnesses in Children Requiring Hospitalization in a Tertiary Care Hospital in North India: A Prospective Study. AU - Rauf,Abdul, AU - Singhi,Sunit, AU - Nallasamy,Karthi, AU - Walia,Mandeep, AU - Ray,Pallab, Y1 - 2018/07/05/ PY - 2018/7/11/pubmed PY - 2019/9/4/medline PY - 2018/7/11/entrez SP - 783 EP - 788 JF - The American journal of tropical medicine and hygiene JO - Am. J. Trop. Med. Hyg. VL - 99 IS - 3 N2 - Acute febrile illnesses (AFIs) in children from the developing world can have varying etiologies. Awareness of local epidemiology helps in prioritizing investigations and empiric treatment. This prospective study was carried out in a tertiary care center in North India, aiming to determine the burden, etiology, and outcome of AFI other than pneumonia and diarrhea in hospitalized children. A total of 613 consecutive children aged 3 months to 12 years with febrile illness of < 7 days during four selected months of 2014 representing different seasons were screened for eligibility. Those with acute respiratory diseases (N = 175, 28.5%) and diarrheal illness (N = 46, 7.5%) were excluded and 217 children were enrolled. Mean (standard deviation) age was 4.8 (3.4) years. Nearly half (N = 91, 41.9%) presented in post-monsoon season. Diagnosis could be established in 187 (86.2%) children. Acute central nervous system infections were the most common (N = 54, 24.8%). Among specific infections, scrub typhus was the most frequent (N = 23, 10.5%) followed by malaria (N = 14, 6.4%), typhoid (N = 14, 6.5%), and viral hepatitis (N = 13, 6.0%). Blood culture had a low (6.5%) yield; Salmonella typhi (N = 6) and Staphylococcus aureus (N = 5) were the common isolates. Serological tests were helpful in 50 (23%) cases. In multivariate analysis, hepatomegaly and/or splenomegaly independently predicted scrub typhus. Mortality rate was 10.1%. We conclude that AFI other than pneumonia and diarrhea are a significant burden and follow a seasonal trend. Scrub typhus has emerged as an important etiology of childhood AFIs in northern India. Periodic review of regional epidemiology will help in understanding the changing pattern of infectious diseases. SN - 1476-1645 UR - https://www.unboundmedicine.com/medline/citation/29988003/Non_Respiratory_and_Non_Diarrheal_Causes_of_Acute_Febrile_Illnesses_in_Children_Requiring_Hospitalization_in_a_Tertiary_Care_Hospital_in_North_India:_A_Prospective_Study_ L2 - http://www.ajtmh.org/content/journals/10.4269/ajtmh.18-0056?crawler=true&amp;mimetype=application/pdf DB - PRIME DP - Unbound Medicine ER -