Undifferentiated Febrile Illness in Kathmandu, Nepal
نویسندگان
چکیده
Undifferentiated febrile illnesses (UFIs) are common in low- and middle-income countries. We prospectively investigated the causes of UFIs in 627 patients presenting to a tertiary referral hospital in Kathmandu, Nepal. Patients with microbiologically confirmed enteric fever (218 of 627; 34.8%) randomized to gatifloxacin or ofloxacin treatment were previously reported. We randomly selected 125 of 627 (20%) of these UFI patients, consisting of 96 of 409 (23%) cases with sterile blood cultures and 29 of 218 (13%) cases with enteric fever, for additional diagnostic investigations. We found serological evidence of acute murine typhus in 21 of 125 (17%) patients, with 12 of 21 (57%) patients polymerase chain reaction (PCR)-positive for Rickettsia typhi. Three UFI cases were quantitative PCR-positive for Rickettsia spp., two UFI cases were seropositive for Hantavirus, and one UFI case was seropositive for Q fever. Fever clearance time (FCT) for rickettsial infection was 44.5 hours (interquartile range = 26-66 hours), and there was no difference in FCT between ofloxacin or gatifloxacin. Murine typhus represents an important cause of predominantly urban UFIs in Nepal, and fluoroquinolones seem to be an effective empirical treatment.
منابع مشابه
Evidence of West Nile virus infection in Nepal
BACKGROUND Acute febrile illness is common among those seeking medical care and is frequently treated empirically with the underlying illness remaining undiagnosed in resource-poor countries. A febrile illness study was conducted 2009-2010 to identify known and unknown pathogens circulating in Nepal. METHOD Study methods included diagnostic testing and preliminary ELISA screening of acute and...
متن کاملMurine Typhus and Febrile Illness, Nepal
Murine typhus was diagnosed by PCR in 50 (7%) of 756 adults with febrile illness seeking treatment at Patan Hospital in Kathmandu, Nepal. Of patients with murine typhus, 64% were women, 86% were residents of Kathmandu, and 90% were unwell during the winter. No characteristics clearly distinguished typhus patients from those with blood culture-positive enteric fever.
متن کاملFactors Associated with Enrolment of Households in Nepal’s National Health Insurance Program
Background Nepal has made remarkable efforts towards social health protection over the past several years. In 2016, the Government of Nepal introduced a National Health Insurance Program (NHIP) with an aim to ensure equitable and universal access to healthcare by all Nepalese citizens. Following the first year of operation, the scheme has covered 5 percent of its target population. There ...
متن کاملInvasion of Parthenium hysterophorus L. across land use types in Kirtipur Municipality
Parthenium hysterophorus, an invasive alien weed, is spreading rapidly across various land uses in Nepal. To understand how Parthenium is spreading across land uses at local scale, occurrence of this weed was recorded and its’ coverage in percent estimated along trails and road network at every 100 meter distance in Kirtipur Municipality of Kathmandu valley. In addition, vegetation sampling was...
متن کاملBerberis Aristata: A Highly Efficient and Thermally Stable Green Corrosion Inhibitor for Mild Steel in Acidic Medium
Plant extracts are extensively researched as a source of green corrosion inhibitors. Herein, we report on a highly efficient and thermally stable corrosion inhibitor from the stem extract of high-altitude shrub Berberis aristata. The corrosion inhibition efficiency (IE) of the extract was tested in 1.0 M H2SO4 for the corrosion protection of mild steel (MS) by using gravimetric and electrochemi...
متن کامل