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Dengue, chikungunya, and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, India.
BMC Infect Dis 2019; 19(1):572BI

Abstract

BACKGROUND

We conducted a diagnostic surveillance study to identify Plasmodium, dengue virus, chikungunya virus, and Orientia tsutsugamushi infections among febrile patients who underwent triage for malaria in the outpatient department at Ispat General Hospital, Rourkela, Odisha, India.

METHODS

Febrile patients were enrolled from January 2016-January 2017. Blood smears and small volumes or vacutainers of blood were collected from study participants to carry out diagnostic assays. Malaria was diagnosed using rapid diagnostic tests (RDT), microscopy, and PCR. Dengue, chikungunya, and scrub typhus infections were identified using rapid diagnostic test kits and ELISA.

RESULTS

Nine hundred and fifty-four patients were prospectively enrolled in our study. The majority of patients were male (58.4%) and more than 15 years of age (66.4%). All 954 enrollees underwent additional testing for malaria; a subset of enrollees (293/954) that had larger volumes of plasma available was also tested for dengue, chikungunya and scrub typhus by either RDT or ELISA or both tests. Fifty-four of 954 patients (5.7%) were positive for malaria by RDT, or microscopy, or PCR. Seventy-four of 293 patients (25.3%) tested positive for dengue by either RDT or ELISA, and 17 of 293 patients (5.8%) tested positive for chikungunya-specific IgM by either ELISA or RDT. Ten of 287 patients tested (3.5%) were positive for scrub typhus by ELISA specific for scrub typhus IgM. Seventeen patients among 290 (5.9%) with results for ≥3 infections tested positive for more than one infection. Patients with scrub typhus and chikungunya had high rates of co-infection: of the 10 patients positive for scrub typhus, six were positive for dengue (p = 0.009), and five of 17 patients positive for chikungunya (by RDT or ELISA) were also diagnosed with malaria (p < 0.001).

CONCLUSIONS

Dengue, chikungunya and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, and comorbidity should be considered. Routine febrile illness surveillance is required to accurately establish the prevalence of these infections in this region, to offer timely treatment, and to implement appropriate methods of control.

Authors+Show Affiliations

Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA. , Present Address: Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, USA.Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA.Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.Center for the Study of Complex Malaria in India, Ispat General Hospital, Rourkela, Odisha, India.Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, USA. jane.carlton@nyu.edu.Department of Pathology, Ispat General Hospital Rourkela, Rourkela, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31269906

Citation

Rao, Pavitra N., et al. "Dengue, Chikungunya, and Scrub Typhus Are Important Etiologies of Non-malarial Febrile Illness in Rourkela, Odisha, India." BMC Infectious Diseases, vol. 19, no. 1, 2019, p. 572.
Rao PN, van Eijk AM, Choubey S, et al. Dengue, chikungunya, and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, India. BMC Infect Dis. 2019;19(1):572.
Rao, P. N., van Eijk, A. M., Choubey, S., Ali, S. Z., Dash, A., Barla, P., ... Satpathi, S. (2019). Dengue, chikungunya, and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, India. BMC Infectious Diseases, 19(1), p. 572. doi:10.1186/s12879-019-4161-6.
Rao PN, et al. Dengue, Chikungunya, and Scrub Typhus Are Important Etiologies of Non-malarial Febrile Illness in Rourkela, Odisha, India. BMC Infect Dis. 2019 Jul 3;19(1):572. PubMed PMID: 31269906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dengue, chikungunya, and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, India. AU - Rao,Pavitra N, AU - van Eijk,Anna Maria, AU - Choubey,Sandhya, AU - Ali,Syed Zeeshan, AU - Dash,Aditee, AU - Barla,Punam, AU - Oraon,Rajshri Rani, AU - Patel,Gautam, AU - Nandini,P, AU - Acharya,Subrata, AU - Mohanty,Sanjib, AU - Carlton,Jane M, AU - Satpathi,Sanghamitra, Y1 - 2019/07/03/ PY - 2018/06/28/received PY - 2019/06/04/accepted PY - 2019/7/5/entrez PY - 2019/7/5/pubmed PY - 2019/9/19/medline KW - Chikungunya KW - Dengue KW - Febrile illness KW - India KW - Malaria KW - Scrub typhus KW - Surveillance SP - 572 EP - 572 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 19 IS - 1 N2 - BACKGROUND: We conducted a diagnostic surveillance study to identify Plasmodium, dengue virus, chikungunya virus, and Orientia tsutsugamushi infections among febrile patients who underwent triage for malaria in the outpatient department at Ispat General Hospital, Rourkela, Odisha, India. METHODS: Febrile patients were enrolled from January 2016-January 2017. Blood smears and small volumes or vacutainers of blood were collected from study participants to carry out diagnostic assays. Malaria was diagnosed using rapid diagnostic tests (RDT), microscopy, and PCR. Dengue, chikungunya, and scrub typhus infections were identified using rapid diagnostic test kits and ELISA. RESULTS: Nine hundred and fifty-four patients were prospectively enrolled in our study. The majority of patients were male (58.4%) and more than 15 years of age (66.4%). All 954 enrollees underwent additional testing for malaria; a subset of enrollees (293/954) that had larger volumes of plasma available was also tested for dengue, chikungunya and scrub typhus by either RDT or ELISA or both tests. Fifty-four of 954 patients (5.7%) were positive for malaria by RDT, or microscopy, or PCR. Seventy-four of 293 patients (25.3%) tested positive for dengue by either RDT or ELISA, and 17 of 293 patients (5.8%) tested positive for chikungunya-specific IgM by either ELISA or RDT. Ten of 287 patients tested (3.5%) were positive for scrub typhus by ELISA specific for scrub typhus IgM. Seventeen patients among 290 (5.9%) with results for ≥3 infections tested positive for more than one infection. Patients with scrub typhus and chikungunya had high rates of co-infection: of the 10 patients positive for scrub typhus, six were positive for dengue (p = 0.009), and five of 17 patients positive for chikungunya (by RDT or ELISA) were also diagnosed with malaria (p < 0.001). CONCLUSIONS: Dengue, chikungunya and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, and comorbidity should be considered. Routine febrile illness surveillance is required to accurately establish the prevalence of these infections in this region, to offer timely treatment, and to implement appropriate methods of control. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/31269906/Dengue_chikungunya_and_scrub_typhus_are_important_etiologies_of_non_malarial_febrile_illness_in_Rourkela_Odisha_India_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4161-6 DB - PRIME DP - Unbound Medicine ER -