Tags

Type your tag names separated by a space and hit enter

Coinfections as an aetiology of acute undifferentiated febrile illness among adult patients in the sub-Himalayan region of north India.
J Vector Borne Dis 2018 Apr-Jun; 55(2):130-136JV

Abstract

Background & objectives

In India, certain geographic regions witness simultaneous outbreaks of two or more diseases like scrub typhus, dengue fever, malaria, leptospirosis and chikungunya during monsoon and post-monsoon period, sharing common indication of acute febrile illness. The objective of the present study was to assess the prevalence of coinfections among patients with acute undifferentiated fevers (AUF) admitted in a tertiary care hospital in the northern hilly state of Himachal Pradesh, India.

Methods

This was a hospital based open cohort study conducted over a period of two months (September and October) in 2016. All the patients above the age of 18 yr admitted in medical wards and fulfilling the definition of AUF were included. The patients diagnosed with dual infections were the subjects of the study. Standard guidelines were used for case definitions of scrub typhus, dengue, chikungunya, malaria and leptospirosis.

Results

Dual infections were noted in 16 patients admitted with AUF. The most common coinfection was scrub typhus and dengue, reported in 10 patients. Scrub typhus and leptospirosis coinfection was observed in three patients. Dengue and chikungunya was observed in one patient. Scrub typhus, dengue and vivax malaria was detected in one patient. Scrub typhus and vivax malaria was detected in one patient. Out of the 10 cases positive for both scrub and dengue, four had no history of travel outside Himachal Pradesh. All three cases positive for both scrub and leptospirosis were indigenous without any history of travel outside Kangra, Himachal Pradesh. The outcome of all the patients was with full recovery.

Interpretation & conclusion

The study established the presence of coinfections (mainly dengue fever and leptospirosis) as a cause of AUF in the study area, which is a nonendemic region. The role of easily available and widely performed serological tests in the aetiological diagnosis of AUF is significant. Studies are required to determine the normal titres in the local population before using the imported commercially available serological tests in the diagnosis of AUF.

Authors+Show Affiliations

Department of Medicine, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.Department of Pathology, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.Department of Medicine, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.Department of Community Medicine, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.Department of Medicine, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30280711

Citation

Raina, Sujeet, et al. "Coinfections as an Aetiology of Acute Undifferentiated Febrile Illness Among Adult Patients in the sub-Himalayan Region of North India." Journal of Vector Borne Diseases, vol. 55, no. 2, 2018, pp. 130-136.
Raina S, Raina RK, Agarwala N, et al. Coinfections as an aetiology of acute undifferentiated febrile illness among adult patients in the sub-Himalayan region of north India. J Vector Borne Dis. 2018;55(2):130-136.
Raina, S., Raina, R. K., Agarwala, N., Raina, S. K., & Sharma, R. (2018). Coinfections as an aetiology of acute undifferentiated febrile illness among adult patients in the sub-Himalayan region of north India. Journal of Vector Borne Diseases, 55(2), pp. 130-136. doi:10.4103/0972-9062.242560.
Raina S, et al. Coinfections as an Aetiology of Acute Undifferentiated Febrile Illness Among Adult Patients in the sub-Himalayan Region of North India. J Vector Borne Dis. 2018;55(2):130-136. PubMed PMID: 30280711.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coinfections as an aetiology of acute undifferentiated febrile illness among adult patients in the sub-Himalayan region of north India. AU - Raina,Sujeet, AU - Raina,Rashmi Kaul, AU - Agarwala,Niraj, AU - Raina,Sunil Kumar, AU - Sharma,Rajesh, PY - 2018/10/4/entrez PY - 2018/10/4/pubmed PY - 2018/12/15/medline KW - Coinfections KW - Himachal Pradesh KW - cross reactivity KW - seasonal fever KW - tropical fever SP - 130 EP - 136 JF - Journal of vector borne diseases JO - J Vector Borne Dis VL - 55 IS - 2 N2 - Background & objectives: In India, certain geographic regions witness simultaneous outbreaks of two or more diseases like scrub typhus, dengue fever, malaria, leptospirosis and chikungunya during monsoon and post-monsoon period, sharing common indication of acute febrile illness. The objective of the present study was to assess the prevalence of coinfections among patients with acute undifferentiated fevers (AUF) admitted in a tertiary care hospital in the northern hilly state of Himachal Pradesh, India. Methods: This was a hospital based open cohort study conducted over a period of two months (September and October) in 2016. All the patients above the age of 18 yr admitted in medical wards and fulfilling the definition of AUF were included. The patients diagnosed with dual infections were the subjects of the study. Standard guidelines were used for case definitions of scrub typhus, dengue, chikungunya, malaria and leptospirosis. Results: Dual infections were noted in 16 patients admitted with AUF. The most common coinfection was scrub typhus and dengue, reported in 10 patients. Scrub typhus and leptospirosis coinfection was observed in three patients. Dengue and chikungunya was observed in one patient. Scrub typhus, dengue and vivax malaria was detected in one patient. Scrub typhus and vivax malaria was detected in one patient. Out of the 10 cases positive for both scrub and dengue, four had no history of travel outside Himachal Pradesh. All three cases positive for both scrub and leptospirosis were indigenous without any history of travel outside Kangra, Himachal Pradesh. The outcome of all the patients was with full recovery. Interpretation & conclusion: The study established the presence of coinfections (mainly dengue fever and leptospirosis) as a cause of AUF in the study area, which is a nonendemic region. The role of easily available and widely performed serological tests in the aetiological diagnosis of AUF is significant. Studies are required to determine the normal titres in the local population before using the imported commercially available serological tests in the diagnosis of AUF. SN - 0972-9062 UR - https://www.unboundmedicine.com/medline/citation/30280711/Coinfections_as_an_aetiology_of_acute_undifferentiated_febrile_illness_among_adult_patients_in_the_sub_Himalayan_region_of_north_India_ L2 - http://www.jvbd.org/article.asp?issn=0972-9062;year=2018;volume=55;issue=2;spage=130;epage=136;aulast=Raina DB - PRIME DP - Unbound Medicine ER -