title: Intestinal Infections Among Febrile Hospitalized Patients in the Republic of Armenia: A Retrospective Chart Review.
abstract: In the past, several enteric outbreaks in 1996, 1998, 1999, and 2003 caused by Salmonella typhi, a Gram-negative bacterium, have occurred in Armenia. This study describes the demographic, epidemiological, and clinical characteristics of febrile hospitalized patients with intestinal infections in Armenia. Using a chart review study design, medical data from adult patients who were hospitalized at the Nork hospital during 2010-2012 were reviewed. A total of 600 medical charts were reviewed. Of these, 51 % were diagnosed with intestinal infections. Among these patients, 59 % had an intestinal infection of known etiology, with three main pathogens identified: Salmonella sp. (32 %), Shigella sp. (32 %), and Staphylococcus aureus (18 %). After controlling for the calendar year, age in years, and gender, patients detected with Salmonella sp. were more likely to reported the presence of a family member with similar signs or symptoms [odds ratio (OR) 9.0; 95 % CI 2.4-33.7] and the lack of a water tap at home (OR 3.9; 95 % CI 1.7-9.5). Evidence indicates that Salmonella sp., Shigella sp., and S. aureus as the most common etiologies reported among febrile hospitalized patients. A high percentage of patients had intestinal infections of unknown etiology; thus, improvement in laboratory capacity (enabling more advanced tests, such as polymerase chain reaction) would increase the identification of the enteropathogens causing disease in Armenia.
authors.affiliation: The Nork Infectious Clinical Hospital, Yerevan, Armenia. Zardaryan@doctor.com.
authors.forename: Eduard
authors.initials: E
authors.lastname: Zardaryan
authors.affiliation: National Center for Disease Control and Prevention, Yerevan, Armenia.
authors.forename: Lusine
authors.initials: L
authors.lastname: Paronyan
authors.affiliation: National Center for Disease Control and Prevention, Yerevan, Armenia.
authors.forename: Vahe
authors.initials: V
authors.lastname: Bakunts
authors.affiliation: The Nork Infectious Clinical Hospital, Yerevan, Armenia.
authors.forename: Zaruhi
authors.initials: Z
authors.lastname: Gevorgyan
authors.affiliation: The Nork Infectious Clinical Hospital, Yerevan, Armenia.
authors.forename: Vigen
authors.initials: V
authors.lastname: Asoyan
authors.affiliation: The Nork Infectious Clinical Hospital, Yerevan, Armenia.
authors.forename: Hripsime
authors.initials: H
authors.lastname: Apresyan
authors.affiliation: The Nork Infectious Clinical Hospital, Yerevan, Armenia.
authors.forename: Alvard
authors.initials: A
authors.lastname: Hovhannisyan
authors.affiliation: National Center for Disease Control and Prevention, Yerevan, Armenia.
authors.forename: Karo
authors.initials: K
authors.lastname: Palayan
authors.affiliation: U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.
authors.forename: Tinatin
authors.initials: T
authors.lastname: Kuchuloria
authors.affiliation: U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Rivard
authors.affiliation: Walter Reed Army Institute of Research, Silver Spring, MD, USA.
authors.forename: Christian T
authors.initials: CT
authors.lastname: Bautista
mesh_terms: D000328:Adult; D001136:Armenia / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D005334:Fever / Q000209:etiology / Q000503:physiopathology; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D012485:Salmonella typhi / Q000302:isolation & purification; D012760:Shigella / Q000302:isolation & purification; D013210:Staphylococcus / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification
keywords: Armenia; Enteric; Epidemiology; Etiology; Surveillance