Details

Autor(en) / Beteiligte

• Bressan, Clarisse da Silveira
• Teixeira, Maria de Lourdes Benamor
• Gouvêa, Maria Isabel Fragoso da Silveira
• de Pina-Costa, Anielle
• Santos, Heloísa Ferreira Pinto
• Calvet, Guilherme Amaral
• Lupi, Otilia
• Siqueira, Andre Machado
• Valls-de-Souza, Rogério
• Valim, Clarissa
• Brasil, Patrícia
• Babu, Subbaraman

Titel

Challenges of acute febrile illness diagnosis in a national infectious diseases center in Rio de Janeiro: 16-year experience of syndromic surveillance

Ist Teil von

• PLoS neglected tropical diseases, 2023-04, Vol.17 (4), p.e0011232-e0011232

Ort / Verlag

United States: Public Library of Science

Erscheinungsjahr

2023

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Acute febrile illnesses (AFI) are a frequent chief complaint in outpatients. Because the capacity to investigate the causative pathogen of AFIs is limited in low- and middle-income countries, patient management may be suboptimal. Understanding the distribution of causes of AFI can improve patient outcomes. This study aims to describe the most common etiologies diagnosed over a 16-years period in a national reference center for tropical diseases in a large urban center in Rio de Janeiro, Brazil. From August 2004-December 2019, 3591 patients > 12 years old, with AFI and/or rash were eligible. Complementary exams for etiological investigation were requested using syndromic classification as a decision guide. Results. Among the 3591 patients included, endemic arboviruses such as chikungunya (21%), dengue (15%) and zika (6%) were the most common laboratory-confirmed diagnosis, together with travel-related malaria (11%). Clinical presumptive diagnosis lacked sensitivity for emerging diseases such as zika (31%). Rickettsia disease and leptospirosis were rarely investigated and an infrequent finding when based purely on clinical features. Respiratory symptoms increased the odds for the diagnostic remaining inconclusive. Numerous patients did not have a conclusive etiologic diagnosis. Since syndromic classification used for standardization of etiological investigation and presumptive clinical diagnosis had moderate accuracy, it is necessary to incorporate new diagnostic technologies to improve diagnostic accuracy and surveillance capacity.