Etiology of acute, non-malaria, febrile illnesses in Jayapura, northeastern Papua, Indonesia.
We conducted a prospective, inpatient fever study in malaria-endemic Papua, Indonesia to determine non-malaria fever etiologies. Investigations included malaria blood films, blood culture, paired serologic samples analysis for dengue, Japanese encephalitis, leptospirosis, scrub typhus, murine typhus, and spotted fever group rickettsia. During 1997-2000, 226 patients (127 males and 99 females) 1-80 years of age (median age = 25 years) were enrolled. Positive blood cultures (n = 34, 15%) were obtained for Salmonella Typhi (n = 13), Escherichia coli (n = 8), Streptococcus pneumoniae (n = 6), Staphylococcus aureus (n = 5), Streptococcus pyogenes (n = 1), and Klebsiella pneumoniae (n = 1). Twenty (8.8%) patients were positive for leptospirosis by polymerase chain reaction. Eighty (35.4%) of 226 patients had ≥ 1 positive serology, diagnostic for 15 rickettsial and 9 dengue cases. Acid-fast bacilli-positive sputum was obtained from three patients. Most common confirmed (81 of 226, 35.8%)/suspected diagnoses were typhoid fever (n = 41), pneumonia (n = 29), leptospirosis (n = 28), urinary tract infections (n = 20), rickettsioses (n = 19), dengue (n = 17), and meningitis/encephalitis (n = 15). There were 17 deaths, 7 (46.7%) were caused by meningitis/encephalitis. Multiple positive serologic results and few confirmed diagnoses indicate the need for improved diagnostics.
Narain H
NH
Punjabi
Walter R J
WRJ
Taylor
Gerald S
GS
Murphy
Sri
S
Purwaningsih
Helena
H
Picarima
John
J
Sisson
James G
JG
Olson
Samuel
S
Baso
Ferry
F
Wangsasaputra
Murad
M
Lesmana
Buhari A
BA
Oyofo
Cyrus H
CH
Simanjuntak
Decy
D
Subekti
Andrew L
AL
Corwin
Thomas L
TL
Richie
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000150:complications / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D001424:Bacterial Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D002494:Central Nervous System Infections / Q000150:complications / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010219:Papua New Guinea / Q000453:epidemiology; D014777:Virus Diseases / Q000150:complications* / Q000453:epidemiology / Q000401:mortality / Q000821:virology; D055815:Young Adult