Causes of fever in adults on the Thai-Myanmar border.
A hospital-based study was conducted along the Thai-Myanmar border to provide greater knowledge of the causes of febrile illness and to determine what zoonotic and vector-borne emerging infectious diseases might be present. A total of 613 adults were enrolled from June 1999 to March 2002. Cases were classified based on clinical findings and laboratory results. An etiologic diagnosis was made for 48% of subjects. Malaria was the most common diagnosis, accounting for 25% of subjects, with two-thirds Plasmodium falciparum. Serologic evidence for leptospirosis was found in 17% of subjects. Other etiologic diagnoses included rickettsial infections, dengue fever, and typhoid. The most frequent clinical diagnoses were nonspecific febrile illness, respiratory infections, and gastroenteritis. Clinical associations were generally not predictive of etiologic diagnosis. Apparent dual diagnoses were common, particularly for malaria and leptospirosis. Findings have been used to modify treatment of unspecified febrile illness in the area.
Ellis
Ruth D
RD
Armed Forces Research Institute for Medical Sciences (AFRIMS), Bangkok, Thailand.
Fukuda
Mark M
MM
McDaniel
Philip
P
Welch
Katherine
K
Nisalak
Ananda
A
Murray
Clinton K
CK
Gray
Michael R
MR
Uthaimongkol
Nichapat
N
Buathong
Nillawan
N
Sriwichai
Sabaithip
S
Phasuk
Rungnapha
R
Yingyuen
Kritsanai
K
Mathavarat
Chaiyawat
C
Miller
Robert S
RS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology* / Q000821:virology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007922:Leptospirosis / Q000175:diagnosis / Q000453:epidemiology; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008554:Melioidosis / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D002052:Myanmar / Q000453:epidemiology; D011778:Q Fever / Q000175:diagnosis / Q000453:epidemiology; D012282:Rickettsia Infections / Q000175:diagnosis / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology; D014435:Typhoid Fever / Q000175:diagnosis / Q000453:epidemiology