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A pilot study investigating severe community-acquired febrile illness through implementation of an innovative microbiological and nucleic acid amplification testing strategy in Timor-Leste (ISIN-MANAS-TL).
Ximenes, Deolindo; de Jesus, Gustodio; de Sousa, Antonio Scfc; Soares, Caetano; Amaral, Luciana C; Oakley, Tessa; Alves, Lucsendar; Amaral, Salvador; Sarmento, Nevio; Guterres, Helio; Cabral, José António de Deus; Boavida, Flavio; Yan, Jennifer; Francis, Joshua R; Martins, Nelson; Arkell, Paul.
Afiliación
  • Ximenes D; Global and Tropical Health Division, Menzies School of Health Research Timor-Leste Office, Charles Darwin University, Dili, Timor-Leste.
  • de Jesus G; Emergency Department, Hospital Nacional Guido Valadares, Dili, Timor-Leste.
  • de Sousa AS; Global and Tropical Health Division, Menzies School of Health Research Timor-Leste Office, Charles Darwin University, Dili, Timor-Leste.
  • Soares C; Molecular and Serology Department, Laboratorio Nacional da Saúde, Dili, Timor-Leste.
  • Amaral LC; Emergency Department, Hospital Nacional Guido Valadares, Dili, Timor-Leste.
  • Oakley T; Emergency Department, Hospital Nacional Guido Valadares, Dili, Timor-Leste.
  • Alves L; Global and Tropical Health Division, Menzies School of Health Research Timor-Leste Office, Charles Darwin University, Dili, Timor-Leste.
  • Amaral S; Global and Tropical Health Division, Menzies School of Health Research Timor-Leste Office, Charles Darwin University, Dili, Timor-Leste.
  • Sarmento N; Global and Tropical Health Division, Menzies School of Health Research Timor-Leste Office, Charles Darwin University, Dili, Timor-Leste.
  • Guterres H; Global and Tropical Health Division, Menzies School of Health Research Timor-Leste Office, Charles Darwin University, Dili, Timor-Leste.
  • Cabral JAD; Internal Medicine Department, Hospital Nacional Guido Valadares, Dili, Timor-Leste.
  • Boavida F; Paediatrics Department, Hospital Nacional Guido Valadares, Dili, Timor-Leste.
  • Yan J; Emergency Department, Hospital Nacional Guido Valadares, Dili, Timor-Leste.
  • Francis JR; Global and Tropical Health Division, Menzies School of Health Research Timor-Leste Office, Charles Darwin University, Dili, Timor-Leste.
  • Martins N; Global and Tropical Health Division, Menzies School of Health Research Timor-Leste Office, Charles Darwin University, Dili, Timor-Leste.
  • Arkell P; Global and Tropical Health Division, Menzies School of Health Research Timor-Leste Office, Charles Darwin University, Dili, Timor-Leste.
IJID Reg ; 11: 100345, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38596819
ABSTRACT

Objectives:

Acute febrile illness (AFI) causes significant health-seeking, morbidity, and mortality in Southeast Asia. This pilot study aimed to describe presentation, etiology, treatment, and outcomes of patients with AFI at one hospital in Timor-Leste and assessing the feasibility of conducting larger studies in this setting.

Methods:

Patients attending Hospital Nacional Guido Valadares with tympanic or axillary temperature ≥37.5°C in whom a blood culture was taken as part of routine clinical care were eligible. Participants were followed up daily for 10 days and again after 30 days. Whole blood was analyzed using a real-time quantitative polymerase chain reaction assay detecting dengue virus serotypes 1-4 and other arthropod-borne infections.

Results:

A total of 82 participants were recruited. Polymerase chain reaction testing was positive for dengue in 14 of 82 (17.1%) participants and blood culture identified a bacterial pathogen in three of 82 (3.7%) participants. Follow-up was completed by 75 of 82 (91.5%) participants. High rates of hospital admission (58 of 82, 70.7%), broad-spectrum antimicrobial treatment (34 of 82, 41.5%), and mortality (9 of 82, 11.0%) were observed.

Conclusions:

Patients with AFI experience poor clinical outcomes. Prospective observational and interventional studies assessing interventions, such as enhanced diagnostic testing, clinical decision support tools, or antimicrobial stewardship interventions, are required and would be feasible to conduct in this setting.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: IJID Reg Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: IJID Reg Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido