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Rickettsial illnesses as important causes of febrile illness in Chittagong, Bangladesh

Kingston, Hugh W. and Hossain, Mosharraf and Leopold, Stije and Anantatat, Tippawan and Tanganuchitcharnchai, Ampai and Sinha, Ipsita and Plewes, Katherine and Maude, Richard J. and Chowdhury, M. A. Hassan and Paul, Sujat and Uddin, Rabiul Alam Mohammed Erfan and Siddiqui, Mohammed Abu Naser and Zahed, Abu Shahed and Abu Sayeed, Abdullah and Rahman, Mohammed Habibur and Barua, Anupam and Uddin, Mohammed Jasim and Sattar, Mohammed Abdus and Dondorp, Arjen M. and Blacksell, Stuart D. and Day, Nicholas P. J. and Ghose, Aniruddha and Hossain, Amir and Paris, Daniel H.. (2018) Rickettsial illnesses as important causes of febrile illness in Chittagong, Bangladesh. Emerging Infectious Diseases, 24 (4). pp. 638-645.

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Abstract

We conducted a yearlong prospective study of febrile patients admitted to a tertiary referral hospital in Chittagong, Bangladesh, to assess the proportion of patients with rickettsial illnesses and identify the causative pathogens, strain genotypes, and associated seasonality patterns. We diagnosed scrub typhus in 16.8% (70/416) and murine typhus in 5.8% (24/416) of patients; 2 patients had infections attributable to undifferentiated Rickettsia spp. and 2 had DNA sequence-confirmed R. felis infection. Orientia tsutsugamushi genotypes included Karp, Gilliam, Kato, and TA763-like strains, with a prominence of Karp-like strains. Scrub typhus admissions peaked in a biphasic pattern before and after the rainy season, whereas murine typhus more frequently occurred before the rainy season. Death occurred in 4% (18/416) of cases; case-fatality rates were 4% each for scrub typhus (3/70) and murine typhus (1/28). Overall, 23.1% (96/416) of patients had evidence of treatable rickettsial illnesses, providing important evidence toward optimizing empirical treatment strategies.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medicine (MED)
UniBasel Contributors:Paris, Daniel Henry
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:National Center for Infectious Diseases
ISSN:1080-6040
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:10 Aug 2018 11:23
Deposited On:03 Jul 2018 08:14

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