Fever In Endemic Areas Research Articles

Evaluation of a Rapid Diagnostic Test (TUBEX-TF) for Diagnosis of Enteric Fever

Abstract Background and Aim: Enteric fever is a systemic febrile disease caused by Salmonella enterica serovars Typhi and Paratyphi. Culture provides a conclusive diagnosis of enteric fever. The main difficulties are a longer turnaround time and practicality in a developing nation with a huge population. The two RDTs that are now most often used are TUBEX-TF and Enterocheck-WB, where TUBEX-TF can identify IgM antibodies against S. Typhi and S. Paratyphi which are anti-O9 and anti-O2. The aim of this study was to evaluate the performance of the TUBEX-TF test in a typhoid fever endemic area of North India. Materials and Methods: In this cross-sectional study, we have performed TUBEX-TF, Enterocheck-WB /Immuno-chromatographic card test, Enzyme linked immunosorbent assay (ELISA), and Widal tests on the sera of 94 clinically suspected cases of enteric fever It was a cross-sectional comparative study that was carried out at a tertiary care institute in North India. In the present study, the ELISA test was taken as a comparative reference test. Results: ELISA, TUBEX-TF, Widal, and Immunochromatographic card test were performed on serum samples collected from 94 clinically suspected enteric fever cases, in which 50(53.19%) were positive by ELISA, 45 (47.87%) were positive by TUBEX- TF, 40 (42.5%) were positive by Typhidot and 19 (20.2%) were positive by Widal. For evaluation of TUBEX-TF, sensitivity specificity, diagnostic accuracy, positive predictive and negative predictive values, a comparison with IgM Anti-LPS ELISA test results was performed & it was found 75%,79.55%,80%,74.47%, and 77.17% respectively. Conclusion: We conclude that the TUBEX-TF test has a greater sensitivity and specificity than other rapid tests currently on the market. It is a simple, rapid test to diagnose enteric fever. The necessity for large-scale research to evaluate TUBEX-TF is necessary due to interviewer variances so that it can become a novel RDT test for the diagnosis of enteric fever.

Tissue distribution of Coxiella burnetii and antibody responses in macropods co-grazing with livestock in Queensland, Australia.

Coxiella burnetii, the causative agent of Q fever, is a zoonotic bacteria of global public health significance. The organism has a complex, diverse, and relatively poorly understood animal reservoir but there is increasing evidence that macropods play some part in the epidemiology of Q fever in Australia. The aim of this cross-sectional survey was to estimate the animal- and tissue-level prevalence of coxiellosis amongst eastern grey (Macropus giganteus) and red (Osphranter rufus) kangaroos co-grazing with domestic cattle in a Q fever endemic area in Queensland. Serum, faeces and tissue samples from a range of organs were collected from 50 kangaroos. A total of 537 tissue samples were tested by real-time PCR, of which 99 specimens from 42 kangaroos (84% of animals, 95% confidence interval [CI], 71% to 93%) were positive for the C. burnetii IS1111 gene when tested in duplicate. Twenty of these specimens from 16 kangaroos (32%, 95% CI 20% to 47%) were also positive for the com1 or htpAB genes. Serum antibodies were present in 24 (57%, 95% CI 41% to 72%) of the PCR positive animals. There was no statistically significant difference in PCR positivity between organs and no single sample type consistently identified C. burnetii positive kangaroos. The results from this study identify a high apparent prevalence of C. burnetii amongst macropods in the study area, albeit seemingly with an inconsistent distribution within tissues and in relatively small quantities, often verging on the limits of detection. We recommend Q fever surveillance in macropods should involve a combination of serosurveys and molecular testing to increase chances of detection in a population, noting that a range of tissues would likely need to be sampled to confirm the diagnosis in a suspect positive animal.

Survey of Rickettsia species in hematophagous arthropods from endemic areas for Japanese spotted fever in China.

Japanese spotted fever (JSF) is caused by Rickettsia japonica, mainly vectored by hard ticks. However, whether R. japonica can be transmitted by other arthropods remains unknown. Moreover, it is of interest to investigate whether other Rickettsia species cause spotted fever in endemic areas. In this study, a survey of Rickettsia species was performed in hematophagous arthropods (mosquitoes, tabanids, and ticks) from endemic areas for JSF in Hubei Province, central China. The results showed that the diversity and prevalence of Rickettsia species in mosquitoes are low, suggesting that mosquitoes may not be the vector of zoonotic Rickettsia species. A novel Rickettsia species showed a high prevalence (16.31%, 23/141) in tabanids and was named "Candidatus Rickettsia tabanidii." It is closely related to Rickettsia from fleas and mosquitoes; however, its pathogenicity in humans needs further investigation. Five Rickettsia species were identified in ticks. Rickettsia japonica, the agent of JSF, was detected only in Haemaphysalis longicornis and Haemaphysalis hystricis, suggesting that they may be the major vectors of R. japonica. Notably, two novel species were identified in H. hystricis ticks, one belonging to the spotted fever group and the other potentially belonging to the ancestral group. The latter one named "Candidatus Rickettsia hubeiensis" may provide valuable insight into the evolutionary history of Rickettsia.

Novel Oliveros-like Clade C Mammarenaviruses from Rodents in Argentina, 1990-2020.

Following an Argentine Hemorrhagic Fever (AHF) outbreak in the early 1990s, a rodent survey for Junín virus, a New World Clade B arenavirus, in endemic areas of Argentina was conducted. Since 1990, INEVH has been developing eco-epidemiological surveillance of rodents, inside and outside the Argentine Hemorrhagic Fever endemic area. Samples from rodents captured between 1993 and 2019 that were positive for Arenavirus infection underwent Sanger and unbiased, Illumina-based high-throughput sequencing, which yielded 5 complete and 88 partial Mammarenaviruses genomes. Previously, 11 genomes representing four species of New World arenavirus Clade C existed in public records. This work has generated 13 novel genomes, expanding the New World arenavirus Clade C to 24 total genomes. Additionally, two genomes exhibit sufficient genetic diversity to be considered a new species, as per ICTV guidelines (proposed name Mammarenavirus vellosense). The 13 novel genomes exhibited reassortment between the small and large segments in New World Mammarenaviruses. This work demonstrates that Clade C Mammarenavirus infections circulate broadly among Necromys species in the Argentine Hemorrhagic Fever endemic area; however, the risk for Clade C Mammarenavirus human infection is currently unknown.

Seroprevalence and clinical manifestations of Chikungunya infection in Makassar city, Indonesia

Background: Chikungunya is a vector-borne disease with a high morbidity rate, spread in dengue hemorrhagic fever endemic areas because the vector carrying the virus is transmitted by the same mosquitoes, namely Aedes Aegypti and Aedes Albopictus. The number of mosquito breeding sites is often associated with an increased incidence of chikungunya disease. The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya. Data related to chikungunya is still lacking in Makassar. This study aims to understand the prevalence of CHIKV infection through serodiagnosis by measuring CHIKV IgG antibodies and looking at the history of clinical symptoms associated with CHIKV infection in Makassar to reduce widespread transmission.

Factors associated with the confirmation and death for Brazilian spotted fever in an important endemic area of the State of São Paulo, 2007-2021.

We evaluated the predictive factors for case confirmation and death from Brazilian spotted fever in an endemic area of Southeastern Brazil. A cross-sectional study was conducted. All suspected cases reported between 2007 and 2021 were analyzed using two logistic regression models. 60 cases were confirmed. Male sex, age group of 40-59 years, tick parasitism, presence of capybaras or horses, exanthema and hospitalization were positively associated with confirmation. Death was associated with a longer period between first symptom-hospitalization and shorter treatment. Complete clinical evaluation and information on risk exposure are key to early suspicion, diagnosis, treatment and prevention of deaths.

Analysis of entomological indicators and distribution of <i>Aedes aegypti</i> larvae in dengue endemic areas

Background. The cause of dengue fevers endemicity is vector larvae density, with Aedes aegypti as the prime vector. Bandung municipality is a high dengue fever endemic area. Hence, studying the habitat characteristics of the Aedes mosquito is essential to controlling the populations of mosquitos.
 Purpose. This study aimed to identify the aedes larvae breeding sites and the relationship between the breeding risk index, hygiene risk index, maya index, and the existence of larvae with the incidence of dengue fever.
 Method. The design used in this research was a cross-sectional survey. The sampling technique used simple random sampling. The quantity of the sample was 544 directly observed houses.
 Results. The entomological parameters obtained were house index (23.89%), container index (7.81%), Breteau index (50.73%), and larva free number (76.10%). The breeding risk index, hygiene risk index, and maya index are in the low category. The chi-square test conveyed that the breeding risk index, maya index, and the existence of larvae were significantly associated with the incidence of dengue fever.
 Conclusion. The entomological index may influence the high incidence of dengue fever. These findings and results may help the authorities to improve mosquito nest eradication in attempts to prevent dengue transmission.

Seroprevalence and Evaluation of IgM and NS1 Ag Detection for Early Diagnosis of Dengue Cases in a Tertiary Care Hospital

Introduction: Dengue fever, a mosquito borne illness, have grown to pose a serious danger to public health systems in developing nations. The Dengue virus (DENV), a member of the Flavivirus genus has four serotypes that cause the disease which range in severity from subclinical infections to severe disease with high morbidity & mortality. This study aims to assess the seroprevalence of dengue fever cases in a tertiary care hospital from East- Delhi region.
 Material & Methods: This study was a retrospective observational study conducted in the Department of Microbiology at UCMS & GTBH. The data was collected from laboratory records from a period of Jan 2019 to December 2019.
 Results: A total of 1449 clinically suspected cases of dengue were tested for the presence of NS1 antigen and IgM antibodies by capture ELISA. This study showed 32.22% (467/1449) seropositivity of dengue infection. Out of 1272, a total of 456 samples were positive for NS1 Ag ELISA. Whereas, out of 177, a total 11 samples were positive for IgM ELISA.
 Observation: The study highlights the importance of early diagnosis and prompt management of dengue cases to prevent severe disease and reduce morbidity and mortality. This underscores the need for increased awareness, early detection, and appropriate management of dengue fever in endemic areas. especially during the peak months of October and November.

Identification of seropositive wild boars in Eurasia as a sign of possible formation of African swine fever-endemic areas (review)

The continued spread of African swine fever (ASF) in Eurasia remains a global problem for the world pig industry. The disease is characterized by high mortality (up to 100 %) and acute course - domestic and wild animals die within the first two weeks after infection. However, active surveillance on ASF in Eastern Europe had been showing regular detection of seropositive susceptible animals, especially among wild boar populations which may indicate chronic, asymptomatic infection and even the survival of individual animals. At the same time, the persistence of the virus in the wild boar population creates constant risks of sporadic outbreaks of ASF in infected areas, and the infection can become endemic. The aim of the study was a systematic review of the available data on seroprevalence among wild boars in relation to the possible establishment of ASF endemicity in Eurasia. In these animals, there was a change in the dynamics of the disease, which is manifested by self-sustaining cycles of infection. Seropositive wild boars are being found in the Baltic countries, Hungary, Poland, Romania, Slovakia, and Russia. Seroprevalence rates among wild boars hunted in ASF-infected areas of European countries range from 0.3 to 3.8 %. In the Baltic countries, the number of seropositive samples from wild boars exceeds the number of samples positive for ASF virus in polymer chain reaction (PCR). A similar trend persists in those regions where the ASF virus has been present for a long time (Poland, Lithuania, Latvia, Estonia), which may indicate the endemic nature of ASF. In the Russian Federation, ASF-endemic territories in the wild have not yet been registered, although isolated cases of seropositive wild boars have been detected in some regions since 2013. In the future, in order to understand the dynamics of the disease in the wild, it is necessary to conduct a comprehensive diagnosis of the ASF virus genome and antibodies in wild boar samples, which eventually will allow choosing the right strategy to combat ASF.

Integration of climate, transmission, and spread of dengue hemorrhagic fever in endemic areas

Introduction. Dengue Hemorrhagic Fever (DHF) is still a public health problem even in the era of the COVID-19 pandemic in 2020, including in Indonesia. This study aimed to analyze the incidence of DHF based on the integration of climatic factors, including rainfall, humidity, air temperature, and duration of sunlight and their distribution. Materials and Methods. This was an ecological time series study with secondary data from the Surabaya City Health Office covering the incidence of DHF and larva-free rate and climate data on rainfall, humidity, air temperature, and duration of sunlight obtained from the Meteorology and Geophysics Agency (BMKG). Silver station in Surabaya, the distribution of dengue incidence during 2018-2020. Results and Discussion. The results showed that humidity was correlated with the larvae-free rate. Meanwhile, the larva-free rate did not correlate with the number of DHF cases. DHF control is estimated due to the correlation of climatic factors and the incidence of DHF, control of vectors and disease agents, control of transmission media, and exposure to the community. Conclusions. The integration of DHF control can be used for early precautions in the era of the COVID-19 pandemic by controlling DHF early in the period from January to June in Surabaya. It is concluded that humidity can affect the dengue outbreak and it can be used as an early warning system and travel warning regarding the relative risk of DHF outbreak.

Immune response to co-administration of measles, mumps, and rubella (MMR), and yellow fever vaccines: a randomized non-inferiority trial among one-year-old children in Argentina

BackgroundIn yellow fever (YF) endemic areas, measles, mumps, and rubella (MMR), and YF vaccines are often co-administered in childhood vaccination schedules. Because these are live vaccines, we assessed potential immune interference that could result from co-administration.MethodsWe conducted an open-label, randomized non-inferiority trial among healthy 1-year-olds in Misiones Province, Argentina. Children were randomized to one of three groups (1:1:1): Co-administration of MMR and YF vaccines (MMR1YF1), MMR followed by YF vaccine four weeks later (MMR1YF2), or YF followed by MMR vaccine four weeks later (YF1MMR2). Blood samples obtained pre-vaccination and 28 days post-vaccination were tested for immunoglobulin G antibodies against measles, mumps, and rubella, and for YF virus-specific neutralizing antibodies. Non-inferiority in seroconversion was assessed using a -5% non-inferiority margin. Antibody concentrations were compared with Kruskal-Wallis tests.ResultsOf 851 randomized children, 738 were correctly vaccinated, had ≥ 1 follow-up sample, and were included in the intention-to-treat population. Non-inferior seroconversion was observed for all antigens (measles seroconversion: 97.9% in the MMR1YF1 group versus 96.3% in the MMR1YF2 group, a difference of 1.6% [90% CI -1.5, 4.7]; rubella: 97.9% MMR1YF1 versus 94.7% MMR1YF2, a difference of 3.3% [-0.1, 6.7]; mumps: 96.7% MMR1YF1 versus 97.9% MMR1YF2, a difference of -1.3% [-4.1, 1.5]; and YF: 96.3% MMR1YF1 versus 97.5% YF1MMR2, a difference of -1.2% [-4.2, 1.7]). Rubella antibody concentrations and YF titers were significantly lower following co-administration; measles and mumps concentrations were not impacted.ConclusionEffective seroconversion was achieved and was not impacted by the co-administration, although antibody levels for two antigens were lower. The impact of lower antibody levels needs to be weighed against missed opportunities for vaccination to determine optimal timing for MMR and YF vaccine administration.Trial RegistrationThe study was retrospectively registered in ClinicalTrials.gov (NCT03368495) on 11/12/2017.

Effectiveness of the Combination of Lethal Ovitrap Attractant of Local Organic Materials and Natural Larvicides in Dengue Hemorrhagic Fever Endemic Areas

Dengue fever is a viral infection that is transmitted to humans through the bite of an infected mosquito. Dengue prevention and control depends on effective vector control measures, including lethalovitrap.The purpose of this study was to determine the effectiveness of mango leaf infusions (Mangifera indica), rambutan leaves (Nephelium lappaceum) and cashew leaf (Anacardium ocidentale) in lethal ovitrap a combination of ethanol extract of rambutan leaves (Nephelium lappaceum), srikaya seed water extract (Annona squomosa) and Baccilus thuringiensis var israelensis (Bti) in the endemic area of ​​Mataram City Dengue Fever, This study was an experimental study that tested and analyzed the effectiveness of nine lethal ovitrap atractant combination. The population and sample of this study were Aedes aegypti mosquitoes female from colonization from endemic areas of DHF in Mataram City. The laboratory test results from nine effective lethal ovitrap combination attractants were Cashew leaf infusion and Rambutan leaf ethanol extract with trapped eggs of Aedes aegypti mosquitoes averaging 133 grains and no eggs hatching into larvae. Statistical analysis with ANOVA followed by the Tukey HSD post-Hoc test with a significant difference of <0.05 the effectiveness of the combination of lethal ovitrap attractants, especially Cashew leaf infusion and ethanol extract from rambutan leaves and Rambutan leaf infusion and rambutan leaf ethanol extract. The results of the field test were the percentage of the number of eggs trapped in combination of Cashew leaf infusion (41.6%) and Rambutan leaf infusion with ethanol extract of Rambutan leaves (58.4%).

Aedes aegypti anti-salivary proteins IgG levels in a cohort of DENV-like symptoms subjects from a dengue-endemic region in Colombia.

Dengue fever, caused by the dengue virus (DENV), is currently a threat to about half of the world's population. DENV is mainly transmitted to the vertebrate host through the bite of a female Aedes mosquito while taking a blood meal. During this process, salivary proteins are introduced into the host skin and blood to facilitate blood acquisition. These salivary proteins modulate both local (skin) and systemic immune responses. Several salivary proteins have been identified as immunogenic inducing the production of antibodies with some of those proteins also displaying immunomodulatory properties enhancing arboviral infections. IgG antibody responses against salivary gland extracts of a diverse number of mosquitoes, as well as antibody responses against the Ae. aegypti peptide, Nterm-34 kDa, have been suggested as biomarkers of human exposure to mosquito bites while antibodies against AgBR1 and NeSt1 proteins have been investigated for their potential protective effect against Zika virus (ZIKV) and West Nile virus infections. Thus, we were interested in evaluating whether IgG antibodies against AgBR1, NeSt1, Nterm-34 kDa peptide, and SGE were associated with DENV infections and clinical characteristics. For this, we tested samples from volunteers living in a dengue fever endemic area in Colombia in 2019 for the presence of IgG antibodies against those salivary proteins and peptides using an ELISA test. Results from this pilot study suggest an involvement of antibody responses against salivary proteins in dengue disease progression.

Seropositivity of Leptospira spp. Antibodies among Febrile Patients Attending Outpatient Clinics in Mwanza, Tanzania: Should It Be Included in Routine Diagnosis?

Leptospirosis is a zoonotic neglected tropical disease with a worldwide distribution caused by the pathogenic spirochetes of the genus Leptospira. Despite being a widespread disease in tropical regions, it has never been considered in the routine diagnostic panel for febrile patients. This study determined seropositivity and factors associated with Leptospira antibodies among febrile adult patients in Mwanza, Tanzania. The cross-sectional study involving 296 febrile patients attending different outpatient clinics in Mwanza region was conducted between May and July 2019. Detection of Leptospira serovars antibodies was done using a microscopic agglutination test (MAT). Descriptive analysis was done using STATA version 13. The median age of the febrile patients was 32 (IQR: 24–45 years). Out of 296 patients, 36 (12.16%, 95%CI: 8–15) were seropositive for Leptospira antibodies. Common circulating serovars were Sokoine 28 (9.45%), followed by Lora 12 (4.05%) and Grippotyphosa 2 (0.67%). In the multivariable logistic regression analysis, the odds of being Leptospira seropositive were significantly higher with increased age (aOR: 1.03, 95%CI 1.00–1.07, p = 0.03). About one tenth of febrile patients in Mwanza were seropositive for Leptospira antibodies and this was significantly associated with age. With the decline of malaria fever in endemic areas, other causes of febrile illness like Leptospiral spp. should be considered in the routine diagnostic panel for febrile patients.

Estimating the risk of environmental contamination by forest users in African Swine Fever endemic areas

BackgroundAfrican Swine Fever (ASF) is a highly lethal viral disease caused by the African Swine Fever Virus (ASFV), the only virus of the Asfaviridae family, which affects different species of wild and domestic suids, and for which no vaccination or effective medical treatment is currently available. The virus can survive for long periods in the environment, and humans can unintentionally act as vectors through infected fomites, a risk that is linked to the ASF introduction into pig farms. We ran a simulation study, in which we reconstructed the probability process leading to the different forms of human-mediated ASF contamination in ASF endemic areas. We compared the infection risks related to different types of human forest activities and produced estimates of the minimum expected number of human-induced contamination events occurring annually at the scale of some European countries.ResultsWhen analysed on a short temporal scale and in a relatively small spatial context, ASF environmental contamination appeared as a rather unlikely event for most of the simulated forest uses, with contamination probabilities often lower than 0.1%. When scaling up the contamination process to a whole year and to large geographic areas, though, the accumulation of the same forest activities, repeated several times per month within the same patch of forest, produced the expectation that thousands of contamination events would occur each year, with potentially relevant epidemiological consequences. Wild boar supplemental feeding and forest logging emerged as the riskiest activities in terms of contamination probabilities, but risk was highly influenced by the frequency and intensity of the different types of forest use.ConclusionsThe risk of human-mediated ASF environmental contamination should not be disregarded when planning management actions to reduce ASF circulation and prevent its breach into the pig farming system. Supplemental feeding should be strongly reduced or avoided in ASF affected areas. Wild boar hunting, which is often employed as an active management tool in ASF affected areas, should be seen as both a tool for controlling wild boar density and as a potential risk for further contamination. It is essential to implement and enforce strict biosecurity measures for all forest-based human activities in ASF endemic areas.

Detection of Salmonella Typhi in Bile by Quantitative Real-Time PCR.

ABSTRACTIn countries where the incidence of typhoid fever is high, fecal material from short-term carriers of Salmonella Typhi contaminates inadequately treated water supplies. As treated water supplies and improved sanitation become available, chronic (mainly gallbladder) carriers of S. Typhi become important. The objective of this study was to develop a method for detection of S. Typhi in bile by quantitative real-time PCR (qPCR) in patients undergoing cholecystectomy. We evaluated sensitivity and specificity of probesets that target oriC, viaB, fliC-d, STY0201, and stoD. We optimized DNA extraction from bile and compared the sensitivity of culture and our qPCR method to detect S. Typhi in bile samples containing various cephalosporins. With the use of an optimized DNA extraction technique, our limit of detection of S. Typhi in spiked human bile samples was 7.4 × 102 CFU/mL. We observed that S. Typhi could be detected by qPCR in samples containing cefazolin, cefotaxime, or ceftriaxone whereas culture could only detect Typhi in samples containing cefazolin but not cefotaxime or ceftriaxone. Our qPCR detection method for S. Typhi in bile should be preferred in areas where antibiotic usage is common.IMPORTANCE New Salmonella Typhi conjugate vaccines have been deployed, which will potentially lead to a fall in incidence rates of typhoid fever in endemic areas. Identification of chronic carriers of S. Typhi will be important as these individuals can be a potential source of transmission to susceptible persons. To address this public health concern, we have developed a novel method to detect S. Typhi in bile using real-time PCR. Our method can be used to identify carriers of S. Typhi among patients undergoing cholecystectomy (gallbladder removal surgery). The sensitivity of our molecular-based assay was superior to culture when performed in the presence of antibiotics commonly used during surgery. Our methodology will complement efforts to eliminate typhoid disease.

Is dengue and COVID-19 coinfection or misdiagnosis possible? A review on reported cases

Novel coronavirus has continued to spread throughout the world where there are other endemic diseases that have been a burden to public health for many years. As any infection, it was expected there could be coinfection between these. Tropical and subtropical countries are currently managing with dengue as peaks increase with shorter periods of time. To summarize the evidence that exists in the co-infection related to SARS-CoV-2 and the dengue virus. We conducted a narrative review in data bases about reports of coinfection and misdiagnosis of SARS-CoV-2 and dengue virus given the fact that rainy season every year increase the prevalence of viral infections in endemic countries. Recent reports have even described positive cases in one of these infections that later resulted in false positive. A positive test for COVID-19 or dengue fever in endemic areas should not exclude the other infection. From now on, these two should be considered as a differential diagnosis and this should raise public health concern for COVID-19 and dengue coinfection in endemic countries to reinforce promotion and prevention to communities to prevent these diseases.

Persistence of anti-Salmonella O9 IgM as measured by Tubex® TF may contribute to the over-diagnosis of typhoid fever in endemic areas

Background: Diagnosing typhoid fever definitively, using bone-marrow, blood or feces culture is either invasive, time-consuming, expensive, or complicated. Hence, clinicians often use clinical presentations and/or rapid diagnostic methods to examine the indirect evidence of Salmonella typhi infections. This study describes the proportion of typhoid fever, challenges of diagnosing typhoid fever, and the kinetics of anti-Salmonella O9 IgM. Methods: During a prospective dengue study in Bandung, Indonesia, 1,431 febrile occurrences were observed among 2,978 adult volunteers over a four-year period. As typhoid fever is endemic and represents a major cause of febrile illness in this study area, acute- and convalescent-phase sera from 964 subjects that had been excluded for dengue and chikungunya infections, were tested with Tubex® TF. To observe the kinetics of anti-Salmonella O9 IgM, we tested sequential sera up to 260 days post-illness from 3 subjects. Results: Based on Tubex® TF, 71 of 964 (7.4%) subjects had anti-Salmonella O9 IgM (score≥4) in their convalescent sera. Anti-Salmonella O9 IgM scores in convalescent sera increased compared to the acute sera in 36 subjects, indicating probable acute typhoid fever. The convalescent scores decreased/remained the same as acute sera in the other 35 subjects, which more likely indicating previous S. typhi infections. Using serially collected sera, it was determined that anti-Salmonella O9 IgM could be detected for a long period after illness. Conclusion: Tubex® TF test should be conducted using paired acute- and convalescent-phase sera to reduce the chance of false positive result that may due to long-lasting anti-Salmonella O9 IgM.

Dengue Fever: Clinical, Laboratory Profile and Outcome in Pediatric Patient

Introduction: Infection with any of the 4 dengue virus serotypes results in a diverse range of symptoms, from mild undifferentiated fever to life-threatening hemorrhagic fever and shock. Given that dengue virus infection elicits such a broad range of clinical symptoms, early and accurate laboratory diagnosis is essential for appropriate patient management. So a study was carried out to know its clinical profile, correlation between the laboratory profile and the severity of dengue fever and outcome in dengue patients.
 Aim: To study the clinical profile, correlation between the laboratory profile and the severity of dengue fever and outcome in dengue patients at tertiary care center.
 Method: Retrospective Observational study from 1st May 2019 to 31st April 2021.
 Result: Total 323 patients were studied during 1st May 2019 to 31st April 2021. Most common presentation was fever (100%), most common clinical finding is hepatomegaly (14.2%). All severe dengue infection has platelet count < 50000/cumm. In study of 323 patients 194(60%) of dengue fever,85(26.4%) of DHF GRADE 1,9(2.8%) of DHF GRADE 2 were discharged .13(4%) patients of DSS were expired.22 patients (6.8%) went DAMA.
 Conclusion: Reliable diagnosis of dengue fever in endemic areas can be done by clinical parameters like presence of nausea, vomiting, pain abdomen and hepatomegaly. Monitoring platelet count, hematocrit and WBC count is very useful for management of dengue cases.
 Keywords: dengue fever, platelet count, outcome

In vitro analysis of human immune response (IgG) against salivary gland extract of dengue vector from dengue hemorrhagic fever (DHF) endemic area in Jember, Indonesia

The mosquito species Ae. aegyptiand Ae. albopictusare two potential vectors of dengue fever. The salivary glands of these species contain substances that play a role in the transmission of pathogens. These include vasodilators and immunomodulatory compounds. Immunomodulatory components can modulate the host immune system by producing specific antibodies (IgG). This study aims to investigate the human immune response (IgG) against the salivary gland extract of Ae. aegyptiand Ae. albopictus. Samples were collected from individuals who were Dengue patients, as well as healthy individuals and neonates from the Jember endemic area. Results show that the levels of IgG response vary across the individual. Generally, Dengue patients and healthy people in the DHF-endemic area had higher levels of IgG. The highest immune response was found in DHF patients, followed by healthy persons, and finally the neonate samples, respectively.