When fever is not malaria in Latin America: a systematic review

BMC Medicine

Sabine Dittrich¹  Janaina Barros²  Andre M. Siqueira³  Patricia Brasil³  José Moreira³  Oscar Lapouble⁴  Marcus V. G. Lacerda⁵  Ingrid Felger⁶ 

[1] Foundation for Innovative New Diagnostics, Geneva, Switzerland;Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil;Laboratório de Pesquisa Clínica em Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil;Programa de Pós-Graduação em Pesquisa Clínica em Doenças Infecciosas, Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil;Pan-American Health Organization Office in Suriname, Paramaribo, Suriname;Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil;Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil;Instituto de Pesquisa Clínica Carlos Borborema, Fundacao de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil;Instituto Leonidas e Maria Deane, Fundacao Oswaldo Cruz, Manaus, Brazil;Swiss Tropical and Public Health Institute, Basel, Switzerland;

关键词: Non-malaria febrile illness;    Malaria;    Latin America;    Fever;    Public health;   

DOI  :  10.1186/s12916-020-01746-z

来源: Springer

【 摘 要 】

BackgroundIn malaria-endemic countries, febrile episodes caused by diseases other than malaria are a growing concern. However, limited knowledge of the prevalent etiologic agents and their geographic distributions restrict the ability of health services to address non-malarial morbidity and mortality through effective case management. Here, we review the etiology of fever in Latin America (LA) between 1980 and 2015 and map significant pathogens commonly implicated in febrile infectious diseases.MethodsA literature search was conducted, without language restrictions, in three distinct databases in order to identify fever etiology studies that report laboratory-confirmed fever-causing pathogens that were isolated from usually sterile body sites. Data analyses and mapping was conducted with Tableau Desktop (version 2018.2.3).ResultsInclusion criteria were met by 625 publications corresponding to data relative to 34 countries. Studies using serology (n = 339) predominated for viral infections, culture (n = 131) for bacteria, and microscopy (n = 62) for fungi and parasites. The pathogen groups most frequently reported were viral infections (n = 277), bacterial infections (n = 265), parasitic infections (n = 59), fungal infections (n = 47), and more than one pathogen group (n = 24). The most frequently reported virus was dengue virus (n = 171), followed by other arboviruses (n = 55), and hantavirus (n = 18). For bacteria, Staphylococcus spp. (n = 82), Rickettsia spp. (n = 70), and Leptospira spp. (n = 55) were frequently reported. Areas with biggest gaps on etiology of fever were apparent.ConclusionsThis review provides a landscape of pathogens causing febrile illness other than malaria in LA for over 30 years. Our findings highlight the need to standardize protocols and report guidelines for fever etiology studies for better comparability of results and improved interpretation. Lastly, we should improve existing national laboratory surveillance systems, especially from low- to middle-income countries, to inform global fever policy priorities and timely identify emerging infections threats.Study registrationPROSPERO systematic review registration number: CRD42016049281

【 授权许可】

CC BY