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Supplementary Material

Search strategy

Query: What are the causes of fever in the South and South-East Asian countries?

Search String (Common for South and South-East Asia)

“fever” [tiab] OR “fever causes” [tiab] OR “causes of fever” [tiab] OR ”aetiologies of fever

“[tiab] OR “etiologies of fever” [tiab] OR “fever etiologies” [tiab] OR “undifferentiated

fever” [tiab] OR “non-malaria fever” [tiab] OR “non-malarial fever” [tiab] OR “febrile

illness” [tiab] OR “blood stream infections” [tiab] OR “blood stream infection” [tiab] OR

“bacteremia” [tiab] OR “bacteraemia” [tiab] OR “leptospirosis” OR “rickettsial

infection”[Mesh]) AND “English” [Language]) AND ("2012/01/01"[Date - Publication] :

"2017/08/31"[Date - Publication])

AND for South East Asia

“Cambodia” [tiab] OR “Lao PDR” [tiab] OR “Laos” [tiab] OR “Brunei” [tiab] OR

“Indonesia” [tiab] OR “Myanmar” [tiab] OR “Burma” [tiab] OR “Malaysia” [tiab] OR

“Thailand” [tiab] OR “Vietnam” [tiab] OR “Singapore” [tiab] OR “Philippines” [tiab] OR

“Timor-Leste” [tiab]

AND for South Asia

(“Afghanistan”[tiab] OR “Bangladesh”[tiab] OR “Nepal”[tiab] OR “India”[tiab] OR

“Pakistan”[tiab] OR “Bhutan”[tiab] OR “Sri Lanka”[tiab] OR “Maldives”[tiab])

NOT (("Animals"[Mesh] NOT ("Animals"[Mesh] AND "Humans"[Mesh]))

Filters used:

-Published – since 1st January 2012 - 31st August 2017

-Titles/abstract

- English Language

Exclude

- No full text found

- Non- English studies

- Published before 2012

- Studies dealing with travellers or mixed populations

- Studies concerned with other purposes (eg. patients without fever, respiratory infection

only, with no information on pathogens, with no information on or unclear laboratory

methods, with empirical clinical diagnosis, comparison/diagnostic evaluation studies or

mathematical modelling studies.)

- Other study designs - Case studies, reviews, clinical trials, opinion pieces, letter to editors,

conference proceedings and presentations

- Small sample sizes – studies with < 50 participants

- Studies that looked at only one pathogen genus

- Studies reporting same data or samples

Include

- Prospective studies, surveillance studies, primary studies, enteric fever, respiratory illness

with fever, undifferentiated fever, studies published since January 2012

Supplementary Table S1- studies on febrile illness in South Asia and SE Asia published between 2012 and 2017. Those in bold were classed by the authors as pivotal and listed in Table 1

First Author (Reference)

Year of publication

Country

Study Location - City (Region)

Study Dates

Health facility type

Inpatient / Outpatient

Inclusion criteria

Total no. of patients

Age (years)

Diagnostic testsconducted

Patients with infection (%, n = total tested)

Most commonpathogens

South AsiaElyan DS et al.(1)

2014

Afghanistan

Uruzgon, Helmand, Kandahar and Kabul

2008 – 2010

3 provinicial and 2 quaternary hospitals

Not specified

Acute febrile illness defined as “Any person of any age with a history of fever ( >38ºC by oral route mainly) for ≥2 days - including undulant fever- without obvious clinical diagnosis.”

913

Range: 20-59 Adults

West Nile (WNV), Dengue and tick-borne encephalitis viruses (TBEV) – Commercial IgM and IgG ELISA

WNV-IgG -277 (30.4%, n=913), TBEV-IgG – 214 (22.7%, n=943), DENV- IgG 180 (19.2%n=937); WNV-IgM -5 (0.5%, n=913), TBEV-IgM – 20 (2.2%, n=925 ), DENV- IgM - 8 (2.6%, n=312)

West Nile virus, Dengue virus, Tick borne encephalitis virus

Dhar-Chowdhury P et al (2)

2017

Bangladesh

Dhaka

2012

Not applicable (household survey)

Not applicable

Objective of determining seroprevalence of DENV in the target populations. Individual households sampled through a multi-stage,stratified sampling design

1,125

Mean – 31.9 (Range: 1-77) All ages

Dengue – IgM and IgG ELISA Dengue IgG seroprevalence – 900 (80%); Dengue IgM seroprevalence – 23 (2%)

Dengue virus

Faruque LI et al. (3, 4)

2017 and 2012

Bangladesh.

Nationwide

Dec 2008 - Nov 2009

Six tertiary level teaching hospitals


Fever with onset within the preceding 10 days. Excluded - presumed nosocomial cases and patients with symptoms of a focused infection.

720

Mean (Range) - 19.8 (0.08–85)

(All ages)

Dengue - IgM ELISA, Leptospira - Blood culture (EMJH medium), Malaria - Rapid test (FalciVax™; Zephyr Biomedicals, Goa, India) and thick and thin blood film slides to confirm specific malaria parasite species; Bartonella - Blood culture, Chikungunya - ELISA followed by plaque reduction neutralization test

Scrub typhus - 170 (24%), Spotted fever - 132 (18%), Dengue - 69 (9.6%), Typhus group - 10 (1%), Chikungunya - 10 (10%, n = 99) Coxiella - 10 (3%, n = 360), Malaria - 4 (0.56%) P. vivax - 1, P. falciparum - 3; Leptospira - 2 (0.3%), Bartonella - 1 (0.1%)

O. tsutsugamushi, Spotted fever group rickettsia, Dengue virus

(PRNT); Spotted fever and typhus group Rickettsia - immunoflourescence antibody test (IFAT) and PCR; Scrub typhus - ELISA (360 samples) and IFAT (360 samples). Coxiella burnetii - ELISA

Maude RR et al. (5)

2016

Bangladesh.

Chittagong

Jan - Jun 2012

Tertiary care hospital

Inpatient Documented axillary temperature ≥38 °C, a reported history of fever of <2 weeks, a negative malaria smear.

300

Median - 13 (IQR 5,31); >6 months (All ages)

Blood culture (BactAlerT); Dengue - ELISA for NS1 antigen; Leptospira spp, R. typhi and O. tsutsugamushi - Probe-based real-time PCR; S. enterica Typhi and S. Paratyphi - Real-time PCR; For cerebrospinal fluid (CSF): S pneumoniae, H influenzae type B, Neisseria meningitidis, Streptococcus suis, herpes simplex virus 1 and 2, varicella zoster virus, enteroviruses (generic and 71-specific), and human parechoviruses (generic) - Real time-PCR

In blood (n=300): Salmonella Typhi - 34 (11.3%), Burkholderia cepacia – 3, Dengue – 2, R. typhi – 2, Staphylococcus aureus – 2, Escherichia coli – 2, Enterobacter cloacae – 2, O tsutsugamushi – 1, Streptococcus pneumoniae – 1, Streptococcus acidominimus – 1, Enterrococcus sp - 1, Klebsiella pneumoniae -1, Acinetobacter spp – 1; In CSF (n=12): Neisseria menigitidis – 2, Streptococcus pneumoniae – 1, Japanese encephalitis virus - 1

S. Typhi

Maude RR et al. (6)

2014

Bangladesh.

Chittagong, Dhaka, Sir Salimullah (Dhaka), Comilla, Bogra, and Sylhet

Jun - Aug 2010

Government tertiary care hospitals

Outpatient Unselected patients having sufficient remaining serum or plasma from a blood test taken for another purpose.

1,209

Median - 40 (IQR 26,55) (All ages)

O. tsutsugamushi and R. typhi - IgM ELISA.

R. typhi - 805 (66.6%), O. tsutsugamushi - 287 (23.7%), Both - 77 (6.4%)

O. tsutsugamushi, R. typhi

Kawle AP et al. (7)

2017

India

Central India

2011 – 2012

Rural, Seroprevalence survey

Not specified

Patients with symptoms of CHIKV infection such as fever, small and large joints pain with or without swelling, neck stiffness, back pain, vomiting, headache, without haemorrhagic rash, etc.. Patients with other focus of pain

482

>5 (All ages)

Chikungunya – IgG and IgM ELISA

Chikungunya (IgM) – 131 (27%); Chikungunya (IgG) – 73 (15%)

Chikungunya

or infection were excluded.

Abhilash KPP et al. (8)

2016

India

Tamil Nadu, South India

Oct 2012 - Sep 2013


Not specified

Acute undifferentiated febrile illness lasting 3-14 days wi th no evident focus of infection following initial clinical evaluation

1,258

Mean - 37.4, SD - 20; >15 (Adults)

Blood culture (BacT/Alert 3D), Malaria - Thin blood smear, Dengue - IgM ELISA, Scrub typhus - IgM ELISA, Leptospira - IgM ELISA, Widal test. Convalescent testing if initial diagnosis unclear and patient consented.

Scrub typhus - 452 (35.9%); Dengue fever - 386 (30.6%); Malaria - 131 (10.4%) P. vivax - 83 (63.3%), P. falciparum - 38 (26.6%), Mixed - 13 (10%); Enteric fever - 47 (3.7%); Leptospirosis - 8 (0.6%)

O. tsutsugamushi, Dengue virus, P. vivax, P. falciparum

Ahmad S et al. (9)

2016

India

Uttarkhand, North India

Dec 2012 - Dec 2013

Tertiary care teaching hospital

Inpatient Acute undifferentiated febrile illness (<2 wks duration of fever and nolocalising features of infection). Patients without an etiological diagnosis were excluded.

233

18-75 yrs (Adults)

Acute malaria - Leishman stained smear positivity; Dengue - IgM serology (rapid card test, SD Bioline); Scrub typhus - IgM ELISA (InBios International, Inc., USA)

Scrub typhus - 65 (22%); Dengue fever - 58 (19%); Dengue + Scrub typhus - 21 (7%)

O. tsutsugamushi, Dengue virus

Galate LB et al. (10)

2016

India

Western India

Apr 2012 – Oct 2013


Not specified

Acute febrile illness and joint pain with clinical suspicion of chikungunya/ dengue

200

>12 years (Adults)

Chikungunya – IgM ELISA; Dengue – IgM ELISA

Dengue – 151 (75.5%); Chikungunya – 6 (3%); Chikungunya and dengue – 19 (9.5%)

Chikungunya virus, Dengue virus

Kalal BS et al. (11)

2016

India

South India

Jan 2010 – Oct 2012

Urban, Tertiary care hospital

Inpatient Fever for >5 days without an identifiable infection or fever <5 days with any two clinical features strongly suggestive of rickettsial infection.

103

<18, Mean – 7.4 (Paediatric)

Scrub typhus – IgM ELISA, Spotted fever group (R. conorii) – IgM ELISA

Scrub typhus – 53 (51.5%); Spotted fever group – 23 (22.3%)

O. tstsugamushi, R. conorii

Khan SA et al. (12)

2016

India

Assam, Arunachal Pradesh and Nagaland (Northeast India)

Sep 2013 - Feb 2015

Sero-survey

Not applicable

Samples collected randomly from people residing in scrub typhus affected areas

1,265

All ages

Spotted fever group rickettsiae (SFGR), Typhus group rickettsiae(TGR) and Scrub typhus group orientiae (STGO) - Indirect ELISAto detect antibodies, PCR in seropositives.

STGO - 390 (30.8%); SFGR - 175 (13.8%); TGR - 53 (4.2%); STGO and SFGR -62 (4.9%); STGO and TGR - 21(1.6%); SFGR and TGR - 9 (0.7%); 9/1265); STGO, SFGR and TGR - 1 (0.1%)

O. tsutsugamushi, Rickettsia spp.

Ittyachen AM et al. (13)

2015

India

Kerala, South India

Jan 2002 - Dec 2011

Tertiary care referral hospital

Inpatient Acute febrile illness, defined as fever, documented as >38 C at the time of admission, on more than two occasions for 2 -10 days.

9,739

>18 (Adults)

Culture (blood, urine, stool); Acute and convalescent phase serology; Malaria - Peripheral smear

Leptospirosis 3251 (33.3%); Dengue fever 741 (7.6%); Typhoid fever 493 (5%); Malaria 80 (0.8%)

Leptospira, Dengue virus, Salmonella sp.

Mittal G et al. (14)

2015

India

Uttarakhand, North India

Dec 2012 - Nov 2013


Not specified

Acute undifferentiated febrile, duration of fever from 5-14 days, no specific single organ involvement by history and physical examination, normal or non-specific results of complete blood count, thick film for malaria, urinalysis and chest roentgenogram.

2,547

>18 (Adults)

Blood cultures (Bactec 9120); Malaria - microscopy slides stained with Leishman stain (Fisher scientific) and/or antigen detection by rapid diagnostic kits (QDX); Scrub typhus - IgM ELISA, Dengue Duo NS1/ IgM Cassette; Leptospira IgM Cassette, Widal Ag kit with titres of O≥80, H≥160 or four fold rise; Anti HEV IgM EIA and Anti HAV IgM EIA.

Dengue - 956 (37.54%), enteric fever- 424 (16.5%), scrub typhus - 367 (14.42%), bacterial sepsis (10.3%), malaria - 175 (6.8%); hepatitis A (1.9%), hepatitis E (1.4%), leptospirosis (0.14%)

Dengue virus, Salmonella spp., O. tsutsugamushi

Basker P et al. (15)

2014

India

South India

Aug 2011 – Jul 2012

Urban, 15 Private clinics

Not specified

Fever cases withleptospirosis as delineated by the National Vector Borne Diseases Control Programme, Government of India

1,502

Not specified

Leptospirosis – Macroscopic Slide Agglutination test (MSAT) and IgM ELISA

Leptospirosis – 65 (4.3%) Leptospira

Singh R et al. (16)

2014

India

Uttarakhand, North India

Jul - Nov 2013


Inpatient Presenting with acute febrile illness, who tested positive for dengue serology, malaria antigen or slide test, Salmonella Typhi or Paratyphi and scrub typhus.

1,141

>=12

Dengue -ELISA NS 1 antigen and IgM; Malaria - malaria antigen or slide test; Enteric fever - Blood culture; Scrub typhus - IgM antibody against O. tsutsugamushi

Dengue - 812 (71.2 %), Malaria – 146 (12.8%), Typhoid - 92 (8.1%), Scrub typhus - 69 (6.0%)

Dengue virus, malaria, Salmonella sp., O. tsutsugamushi

Taraphdar D et al. (17)

2012

India

NorthEast India

2006 – 2009

Indian Council of Medical Research Virus Unit (Kolkata, India)

Not specified

Patients with a history of high fever (≥39 ◦C) for 3–10 days with any two of the following symptoms: joint pain; rashes all over the body; backache; and retro-orbital pain.

2,134

All ages

Chikungunya – IgM ELISA; Dengue – IgM ELISA

Chikungunya – 403 (18.9%); Dengue – 199 (9.3%)

Chikungunya virus; Dengue virus

Dahal KP et al. (18)

2016

Nepal

Province no. 3

Jul – Nov 2011

National Public Health Laboratory (NPHL)

Not specified

Patients referred to NPHL for a test on leptospirosis were included into the study. Any ictericsample or sample exhibiting haemolysis, lipaemia, or microbialgrowth was excluded from the study.

178

All ages

Leptospirosis – IgM ELISA Leptospirosis – 51 (28.7%) Leptospira

Pandey BD et al. (19)

2015

Nepal

Kanchanpur, Dang, Parsa

Aug - Nov 2013

Tertiary level hospitals

Inpatient Patients initially diagnosed clinically as dengue. Blood sample collected from all febrile patients at time of admission (1–7 days after fever onset).

169

Not specified

Dengue -IgG and IgM ELISA; Chikungunya virus (CHIKV) - IgG, IgM ELISA and confirmation by 50% focal reduction neutralization test (FRNT50).

DENV IgM only - 47 (27.8%), CHIKV IgM only - 6 (3.6%), Both CHIKV and DENV IgM positive - 3 (1.8%)

Dengue virus, Chikungunya virus

Pandey BD et al. (20)

2015

Nepal

12 Southern districts

2007 – 2013

District hospitals

Not specified

Presence of fever and any two of the following symptoms: myalgia, headache, arthralgia, skin rash, retro-

2,002

Mean – 31 (All ages)

Dengue – IgM ELISA Dengue – 523 (26.1%) Dengue virus

orbital pain, hemorrhagic manifestation(s), or leucopenia.

Thompson CN et al. (21)

2015

Nepal

Kathmandu

Jul 2008 - Aug 2011

Urban, General hospital

Outpatient An untreated undifferentiated febrile illness for > 3 days, and could be treated in the community.

627

>2 (All ages)

Blood culture (627); Randomly selected 125 from 627 for testing for O. tsutsugamushi and R. typhi (IgM/IgG ELISA, IgM/IgG IFA and RT-PCR); Rickettsia spp. (RT-PCR); Coxiella burnetti (Phase II IgM ELISA and Phase I/II IFA); Hantavirus Puumala (IgM ELISA and Anti-Hantavirus IIFT Mosaic II Test); Leptospira (IgM ELISA and Microscopic agglutination test); Brucella spp. (Rose–Bengal); Dengue (SD NS1 Ag ELISA)

S. Typhi and S. Paratyphi A - 218 (34.8%), murine typhus - 21 (17%, n=125), Hanta virus - 2 (1.6%, n=125), Q fever - 1 (0.8%, n=125)

S. Typhi,S. Paratyphi, R. typhi

Pradhan R et al. (22)

2012

Nepal

Kathmandu

Apr 2006 - Aug 2006 and Dec 2006 - Feb 2007

Urban, General hospital

Outpatient Consecutive children in hospital OPD with axillary temperature >=38oC.

1,084

Median - 4 (Range: 2 mths - 14yrs) (Paediatric)

Blood culture (BACTECTM PEDS PLUS/F blood culture bottles); R. typhi - Real-time PCR.

Salmonella Typhi - 107 (9.9%), Salmonella Paratyphi A - 30 (2.8%), R. typhi - 22 (2%), Streptococcus pneumoniae - 6 (0.6%), S. typhimurium - 2 (0.2%), Haemophilus influenzae type b - 1 (0.1%), Escherichia coli – 1 (0.1%)

S. Typhi, S. Paratyphi A, R. typhi

Naqvi S et al. (23)

2017

Pakistan

Karachi, Sindh

Jan-May 2017

Four tertiary care hospitals

Not specified

Consenting patients from the emergency department

1,275

Mean - 9.52, SD - 12.42 years

Chikungunya - Antibody testing. Confirmed by PCR

Chikungunya - 199 (15.6%) Chikungunya virus

Suleman M et al. (24)

2017

Pakistan

Nationwide

Jan 2009 – Dec 2014

National Institute of Health, Islamabad

Not specified

Patients with prolonged fever, defined as those with body temperatures >38°C on several occasions and lasting over a period of three weeks.

9,493

All ages

Dengue – IgM ELISA Dengue – 3,504 (37%) Dengue virus

Khan E et al. (25)

2016

Pakistan

Sindh

May - Oct 2015

Five study sites including four medical colleges

Not specified

Patients recruited with a case definition incorporating syndromic findings of acute hemorrhagic fever, acute flaccid paralysis, or unexplained fever

467

10-50 (All ages)

Dengue - NS1 Early Rapid Test. All negative sera were tested for Japanese Encephalitis virus (JEV) and West Nile virus (WNV) - IgM capture ELISA.

Dengue - 63 (13.5%, n=467), Japanese encephalitis virus - 32 (7.7%, n=414), West Nile virus - 16 (6.6%, n=241)

Dengue virus, Japanese encephalitis virus, West Nile virus

Ali A et al. (26)

2013

Pakistan

Khyber Pakhtunkhawa

Aug 2011 - Oct 2011

Primary, secondary, and tertiary collection centers

Not specified

Patients suspected of dengue.

612

Mean - 53.16, SD 44.22 , Range (4 - 85) (All ages)

Dengue - IgG and IgM ELISA Dengue - IgM - 195 (31.9%); IgG - 124 (20.3%); Both IgG and IgM - 23 (3.8%)

Dengue virus

Bandara K et al. (27)

2016

Sri Lanka

Western and Southern provinces

Jan 2013 - Jan 2014


Inpatient Patients suspected of leptospirosis admitted to medical wards.

168

Not specified

Leptospira - IgM immunochromatographic assay and microscopicagglutination test (MAT); PCR for Leptospira spp. DNA

Leptospira - 66 (39.3%) MAT and/or PCR positive

Leptospira spp.

Bodinayake CK et al. (28)

2016

Sri Lanka

Southern Province

Jun 2012 – May 2013

Teaching hospital

Inpatient Consecutive patients with documented fever at presentation or within 48 hoursof hospital admission. Excluded patients who presented withfocal bacterial infections, such as pneumonia or soft tissue infection.

976

≥1 (All ages)

Dengue – IgG ELISA (Paired serum), Virus isolation, RT-PCR

Dengue – 388 (39.8%) Dengue

Tissera H et al. (29)

2016

Sri Lanka

Colombo

Apr 2012 - Mar 2014

Three Government hospitals and three general practitioner clinics


Undifferentiated febrile illness with a duration of less than 7 days

3,127

Mean - 22.3, SD - 17.5, Range (0 - 90) (All ages)

Dengue - NS1 antigen ELISA, IgM capture ELISA and PCR

Dengue – 1,363 (43.6%) PCR and/or NS1 positive

Dengue virus

Tissera H et al. (30)

2014

Sri Lanka

Western Province

Nov 2008 – Jan 2010

Urban, Tertiary care hospital

Not Specified

Febrile illness was defined as a temperature≥38°C lasting ≤ 7 days in any child in the study cohort documentedby a parent, research assistant, or health care professional.

681

≤12 (Paediatric)

Dengue – RT-PCR, IgM ELISA Dengue – 27 (3.96%) Dengue virus

Kularatne SAM et al. (31)

2013

Sri Lanka

Central province

Jan 2002 - Dec 2007

Teaching hospital

Inpatient Patients with clinically diagnosed rickettsial infections.

122

Mean - 40, Range (11 to 83)

Rickettsioses - IgG and IgM antibody titers (O. tsutsugamushi, R. typhi, and R. conorii) using Indirect immunofluorescent antibody assay (IFA)

Spotted fever - 55 (45.1%), Scrub typhus infections - 7 (5.7%), Murine typhus - 1 (0.8%)

R. conorii, O. tsutsugamushi, R. typhi

Reller ME et al. (32-34)

2012 (I), 2012 (II) and 2013

Sri Lanka

South

Feb - Nov 2007

Teaching hospital


Febrile (>38°C tympanic) patients without trauma orhospitalization within the previous 7 days.

1,079

>=2 ; Median - 30.8 [IQR 19, 48]) (All ages)

Dengue - Paired serum samples tested by ELISA (IgG and IgM) and acute-phase serum samples were cultured and tested by PCR; Ricketssioses - Paired serum samples tested by IgG indirect immunofluorescence assay (IFA) and Rickettsia rickettsii and R. typhi antigens (Focus Diagnostics, Cypress, CA, USA). Scrub typhus (ST) -paired serum samples using IgG ELISA; CHIKV - IgG indirect immunoflorescence (IFA)

Acute dengue infection- 54 (6.3%, n=859), Past dengue infection - 410 (47.7%), Dengue virus isolated - 12 (22.2%, n=54); ; Rickettsioses - Spotted fever group rickettsiae (SFGR) - 118 (13.4%, n=883), Typhus group rickettsiae (TGR) - 61 (6.9%), O. tsutsugamushi - 17 (1.9%); Acute CHIKV - 28 (3.5%, n=797), Past CHIKV infection - 12(1.5%), CHIKV isolated -10 (35.7%, n=28)

Dengue virus, Chikungunya virus, O. tsutsugamushi, R. typhi, Spotted fever group rickettsia

South- East Asia

Kuijpers LMF et al. (35)

2017

Cambodia

Phnom Penh (South Central)

2008-2015

Non-government referral hospital

Inpatient/outpatient

Blood cultures positive for Salmonella sp between 2008-2015

18,927 blood cultures

Median for S. Typhi 23 (18-30), for Paratyphi A 26 (22-31)

Blood culture system, biochemicals, antisera and CLSI for susceptibilities

1,654 (8.7%) positive

Salmonella Paratyphi A 11.5%, n=190; Salmonella Typhi 3.9%, n=64; nontyphoidal Salmonella 2.9%, n=49. Increase in Paratyphi A seen from 2013

S. Paratyphi A

Bousfield R et al. (36)

2016

Cambodia

Siem Reap (North-western)

2010-2012

Tertiary hospital & district hospital

Inpatient History of fever, discharge diagnosis of typhoid or paratyphoid fever

227 children

Median 8.0 (5.5–11.6). Blood culture positive (n=160), 8.9 (7.0–11.1)

Blood culture 70% S. enterica serovar Typhi and serovar Paratyphi A (n=160)

Salmonella sp.

Pham Thanh D et al. (37)

2016

Cambodia


2007-2014

Tertiary childrens hospital

Inpatient Children with S. Typhi blood infection

262

Median 8.2 (IQR 5.1-11.5)

Blood cultures, Salmonella serotype-specific antisera (Murex Biotech), CLSI, WGS

All 262 had S. Typhi S.Typhi

Bosman P et al. (38)

2014

Cambodia

Chhaeb and Chey Saen, Preah Vihear Province (North East)

Sep- Oct 2013

Community

Community People in the village 2,499

Approximately 60% < 24

Malaria RDT (SD Bioline Ag P.f./Pan; Standard Diagnostics Ref 05FK60, Inc: Suwon City, Republic of Korea), PCR of dried blood spots

Overall Plasmodium prevalence 1.49% in Chhaeb and 2.61% in Chey Saen. 0.16% P. falciparum in Chhaeb, 2.04% in Chey Saen.

P. falciparum

Mueller TC et al. (39)

2014

Cambodia

Kratie Province (East), Pailin Province (Western)

Jan 2008- Dec 2010

Health centre; Rural

Inpatient For the febrile group- patients aged 7-49 with acute febrile illness and temp ≥38°C no longer than 8 days. Non-febrile control group were 7- 49 years and temp <38°C with no history of febrile illness

1,193 febrile, 282 non-febrile

Patients mean 23.4, controls mean 31.4

Malaria RDT(CareStart),Nested-PCR to detect Plasmodium, Leptospira, O. tsutsugamushi & Rickettsia. RT- PCR for DENV & Influenza-Virus

73.3% of febrile patients had a pathogen: P. vivax 33.4%, n=398; P. falciparum 26.5%, n=316; leptospirosis 9.4%, n=112; influenza 8.9%, n=107; dengue 6.3%, n=75; O. tsutsugamushi 3.9%, n=46; Rickettsia 0.2%, n=3; P. knowlesi-0.1%, n=2

P. vivax,P. falciparum,Leptospira sp,

Chheng K et al. (40)

2013

Cambodia

Siem Reap province (North-western)

2009-2010

Tertiary

Inpatient Febrile children admitted to hospital < 16 years, temp ≥ 38°C within 48 hrs of admission

1,180

Median 2 (IQR 0.8-6.4)

Blood culture, API (bioMe´rieux, France), CLSI, JEV and DENV IgM combo ELISA (Panbio), DENV NS1 ELISA (Standard diagnostics), pairs

Dengue 16.2%, n=198; Scrub typhus 7.8%, n=96; Japanese encephalitis 5.8%, n=71; 6.3% blood culture positive S. aureus

Dengue virus,O. tsutsugamushi,JEV

hospital; Urban serum tested for O. tsutsugamushi & R. typhi IgM ELISA. PCR to detect Leptospira spp, O. tsutsugamushi & R. typhi. rRT-PCR to detect HSV, VZV, enteroviruses & parechoviruses.

3.0%, n=37; S. Typhi-1.8%, n=22; S. pneumonia 1.5%, n=18; B. pseudomallei 1.1%, n=14; E. coli-1.1%, n=13; H. influenza-0.7%, n=9

Emary K et al. (41)

2012

Cambodia


2007-2012

Tertiary

Inpatient Children with salmonella

162

Median for S. Typhi 7 (IQR 4.5-10.4), Non typhoidal salmonella cases 0.9( IQR 0.3-2.9)

Blood culture, API (bioMérieux, Marcy l’Etoile, France), CLSI, agglutination with specific antisera (Bio-Rad, Hemel Hempstead, Hertfordshire,UK) sequencing

100% Salmonella

91% S. Typhi, 6.8% non-typhoidal salmonella, 1.8% S. Paratyphi A

S. Typhi

Kasper MR et al. (42)

2012

Cambodia

Phnom Penh (South Central)

2006-2009

Five peri-urban and four ruralhealth care clinics

Outpatient People presenting with acute febrile illness, temp ≥ 38°C (tympanic), fever duration <10 days, 2 years or older

9,997

Median 13 (IQR 6-28)

Giemsa stain, Dengue IgM ELISA (Focus Diagnostics), PCR, blood culture BacT/Alert (bioMerieux,) API20E (bioMerieux), HEV IgM ELISA (MP Biomedicals), HAV IgM and HepB HBsAg (PT INDEC DIAGNOSTICS); Dengue IgG, Lepstospira IgM ELISA (PANBIO), Hantavirus IgG ELISA DxSelect (Focus)

Leptospirosis- 2079 (20.8%); Influenza- 1983 (19.9%); typhus group- 1339 (13.4%); spotted fever group- 1159 (11.6%); scrub typhus- 700 (7%); Hep E- 1109 (11.1%); dengue- 883 (8.9%); Hantavirus- 809 (8.1%); malaria- 716 (7.2%), (30.2% P. falciparum); ; blood culture positive- 629 (6.3%) (S. Typhi most common); Hep A- 56 (1.7%); Hep B- 26 (5.8%)

Leptospira sp.,Influenza virus,typhus group,spotted fever group

Wijedoru LP et al. (43)

2012

Cambodia


Apr- Jun 2009

Tertiary

Inpatient Children < 16 years with fever ≥ 38°C

134

Media 3 (IQR 1.45-7.25)

Blood cultures, IgMFA (Royal Tropical Institute), PCR

3.7% S. Typhi based on blood culture, 22.4% based on all 3 diagnostic tests

S. Typhi

Hardjo Lugito NP et al.(44)

2017

Indonesia

Karawaci, Tangerang, Banten

Jan 2011- Dec 2015

Teachinghospital

Inpatient Patients with typhoid fever

168

Median 19 (1-80)

Blood culture BACTEC (Becton-Dickinson, New Jersey, USA), CLSI, VITEK 2

100% Salmonella

55.4% S. Typhi, 44.6% S. Paratyphi

S.Typhi

Wardahani P et al. (45)

Indonesia

Surabaya

Feb- Aug 2012

Tertiary hospital

Inpatient/outpatient

Patients suspected of dengue fever with temp ≥38°C with at

148

68% children,

IgG, IgM (PanBio Dengue Duo), RT-PCR

53% DENV

73% DENV-1,

DENV-1

2017 least one symptom of dengue

32% adult age range 0-60 years

8% DENV-2,8% DENV-4,6% DENV-3,5% mixed

Kosasih H et al. (46)

2016

Indonesia

West Java

2000-2004, 2006-2009

Community

Outpatient Factory workers volunteering

2,167

Mean 35.6 (range 18-66)

IgM and IgG ELISA (Focus technology), hemagglutination inhibition assays, RT-PCR, sequencing for subtyping

268 (12.4%) Dengue. 1734 cases/100,000 person year

28.6% DENV-4, 26.5% DENV-3, 22.4% DENV-1,22.4% DENV-2

Dengue

Karyanti MR et al. (47)

2014

Indonesia

Country-wide

1968- 2013

All

Not reported

Patients with dengue haemorrhagic fever registered on the registry

Not reported IgG and IgM ELISA and RDT Incidence of dengue haemorrhagic fever went from 0.05/100,000 in 1968 to 35-40/100,000 in 2013

Dengue

Myint KS et al. (48)

2014

Indonesia

Bandung (West Java)

2004-2005 Inpatient Patients ≥10 years with fever of unknown etiology and one of hemorrhagic manifestation, platelet count <100,000/mm, renal insufficiency, liver dystunction or non-cardiogenic pulmonary edema

406

Not reported

RT-PCR, IgG ELISA (Focus Diagnostics, Cypress, CA)

249 positive.

Recent dengue 61%; hantavirus 0.2%, n=1; West Nile virus 0.2%, n=1

Dengue

Kosasih H et al. (49)

2013

Indonesia

Bandung (West Java)

2000-2004, 2006-2008

Community

Community Volunteers 4,380

Mean 37.1

RT-PCR, CHIKV IgG and IgM ELISA

12.2% dengue, first phase 6.7% Chikunginya, incidence of 10.1/1,000 person years, second phase 8.3% Chikungunya, 10.3/1,000 person years

Dengue, chikungunya

Punjabi NH et al. (50)

2013

Indonesia

North Jakarta

2001-2003

Hospital

Inpatient Fever for 3 days or diarhhoea

160,261

58% aged 5-20

Blood culture (BD Bactec system, Franklin Lakes, USA) polyvalent O Salmonella, specific O and Vi antisera (Difco Laboratories, Franklin Lakes, USA)

0.18% Salmonella. Incidence of S. Typhi and S. Paratyphi 1.4 and 0.5 per thousand population per year respectively

75% typhoid, 25% paratyphoid

Yoshikawa MJ et al. (51)

2013

Indonesia

Bali Province

2009-2011

Community

Not reported

People with dengue and chikungunya

12,490

Not reported

Surveys of charts 12,490 cases of Dengue, 1,211 chikungunya

Dengue, chikungunya

Punjabi NH et al. (52)

2012

Indonesia

North-eastern Papua

1997-2000

Provincial hospital; Rural

Inpatient History of fever ≥38°C, negative malaria slide

226

Median 25 (1-80)

Blood cultures, ELISA IgM and IgG for R. typhi, O.tsutsugamushi, spotted fever (PanBio), IgM ELISA for Leptospira (Panbio), PCR, MAT, HI assay for dengue and in house HI for JEV and IgM ELSIA (PanBio)

Blood culture positive- 34 (15%), (S. Typhi- 13 (5.72%), E. coli- 8 (3.53%), S. pneumoniae- 6 (2.65%), S. aureus- 5 (2.21%)); leptospirosis- 20 (8.8%); rickettsia- 19 (8.4%); dengue- 17 (7.5%)

Leptospira sp,Rickettsia sp,DENV

Chansamouth V et al. (53)

2016

Lao PDR

Vientiane (Central)

2006-2010

Tertiaryhospital

Inpatient Pregnant woman with temp ≥37.5°C

250

Median 24 (16-45)

Rickettsias- RDT, IFA, PCR Lepto- MAT, Dengue ELISA (Panbio), RT-PCR HepE ELISA, nested RT-PCR, Malaria stain, blood and urine cultures

60% positive. Dengue 30%, n=76; pyelonephritis 9%, n=23; murine typhus 4%, n=10; scrub typhus 3.6%, n=9; Salmonella Typhi 2%, n=6

Dengue

Dittrich S et al. (54)

2015

Lao PDR

Vientiane(Central)

Jan 2003- Nov 2011

Tertiaryhospital

Inpatient Patients of all ages with CNS symptoms or signs requiring a lumbar puncture

1,112

Median 24 (0-85)

Culture, scrub typhus IgM rapid test (Standard Diagnostics), PCR

24% positive

35% had either O. tsutsugamushi, R. typhi/rickettsia spp or leptospira, 4% bacterial

O. tsutsugamushi, R. typhi/rickettsia spp, leptospira

Mayxay M et al. (55)

2015

Lao PDR

Savannakhet (South)

May-Aug 2003, May-Aug 2004

DistrictHospital; Rural

Inpatient Patients presenting with fever with negative malaria smears or fever <21 days

229

Median 15 (1-80)

Dengue & JEV ELISA (Panbio), RT-PCR for dengue serotyping, leptospirosis MAT, typhus, murine tuphus & SFG IFA

52% positive. Dengue 30.1%, n=69 (8 PCR patients. DENV-1 n=5, DENV-2 n=3); leptospirosis 7%, n=16; JEV 3.5%, n=8; Scrub typhus 2.6%, n=6; Spotted fever group 0.9%; unspecified flavivirus 0.9% n=2; murine typhus 0.4%, n=1

Dengue,Leptospira sp.

Anderson et al. (56)

2014

Lao PDR

Vientiane(Central)

2000 -2011

Tertiaryhospital

Inpatient Infants aged 0- 60 days within 72 hrs of admission with sepsis

1,438

3 days (0-60)

Blood culture, CLSI 5.9% grew a clinically significant pathogen

46% S. aureus, 13% E. coli, 11% K. pneumoniae, 6% E. aerogenes, 5% E. faecalis

S. aureus, E. coli, K. pneumoniae

Mayxay M et al. (57)

2013

Lao PDR

Laung Namtha (Northwest), Salavan (South)

May 2008 Dec 2010

Provincial hospitals; Rural

Inpatient Patients aged between 5-49 with fever ≥ 38°C for 8 or < days

1,938

Median 19 (5-49)

Malaria smear & plasmodium immunochromatographic (ICT diangstics)NSI, IgM and IgG Dengue ELISA (Panbio), anti- Japanese encephalistis virus IgM ELISA (Panbio), RT-PCR( MJ research) for P,vivax & P.falciparium; RT PCR for O. tsutsugamushi, rickettsia, R.typhi

41% positive. Dengue- 156 (8%); scrub typhus- 122 (7%); influenza- 115 (32%); JEV- 112 (6%); leptospirosis- 109 (6%); bacteremia- 53 (8%) (S. Typhi n=38)

Influenza,Dengue,Leptospira sp,

Suppiah J et al. (58)

2017

Malaysia

Serdang, Selangor (West)

2014-2016

Tertiary hospital

Inpatient Randomly selected patients admitted for dengue fever

268 confirmed dengue patients

Mean SD: 32.3 ± 9.4

Real-Time PCR, MAT 4.1% dengue-leptospirosis co-infection.

67.5% DENV-1, 15.7% DENV-2, 6.3% DENV-3

DENV-1

Nor Aizah A et al. (59)

2016

Malaysia

Selayang, Selangor state (West)

2001-2011

Tertiaryhospital

Inpatient CAI patients with bacteraemia

222

Median 11.7 months

Blood cultures, API, VITEK (bioMérieux, France), CLSI

S. aureus 17.1%, n=38; nontyphoidal salmonella 16.2%, n=36; S. pneumoniae 12.6%, n=28; E.coli 6.3%, n=14; Strep. B 5%, n=11; Klebsiella pneumoniae 4.5%, n=10

S. aureus,nontyphoidal salmonella,S. pneumonia

Mallhi T H et al. (60)

2015

Malaysia

Kelantan (North East)

2008-2013

Teaching hospital

Inpatient >12yrs, confirmed dengue

667 dengue patients

Mean 30.69 ± 16.13 years

RT-PCR, IgM IgG (PanBio) Dengue IgM ELISA, Dengue IgM Dot Enzyme Immunoassay, (SD Dengue) IgM and IgG capture ELISA (Standard Diagnostics, Korea), NS1

100% dengue Dengue

Mia MS et al. (61)

2013

Malaysia

Country-wide

2000-2010

All

All Patients with dengue Not reported Not reported All 4 subtypes circulating at different times. Mean incidence for time period was 84.71 per 100000 populations per year

Dengue

Rafizah AA et al. (62)

2013

Malaysia

North East

Aug 2010- Feb 2011

Provincialhospital

Inpatient Patients with febrile illness >18 years, oral temp >37°C

999

Mean 30.4, range 18-94

IgM leptospira ELISA (PanBio), MAT

8.4% Seroprevalence of leptospirosis

Leptospirosis

Kyaw, AK. et al. (63)

2017

Myanmar

Mandalay (Mandalay Region), Myeik (Tanintharyi Region)

July-August 2015

2 Tertiary hospitals; Urban

Inpatient Fever with clinically diagnosed dengue fever

332 clinically diagnosed dengue infection

All ages

ELISA DENV-IgM; Dengue NS1 antigen rapid test, virus isolation and serotyping by RT-PCR

280 (84.3%)

DENV-1 (27.1%); DENV-2 (5.7%); DENV-4 (1.8%); DENV-3 (0.4%)

DENV-1

Win Kay Khine et al. (64)

2017

Myanmar

Yangon (Yangon Region)

Jan to July 2015

Tertiary hospital; Urban


234

12* years

ICT Dengue (NS1 Ag and IgM/IgG) virus isolation and serotyping by IFA

178 (76%) seropositive

DENV-1 (70.0%); DENV-3 (15.0%); DENV-2 (10%)

DENV-1

Ngwe Tun, MM. et al. (65)

2016

Myanmar

Mandalay Paediatric Hospital

June-August 2013


Inpatient Fever with clinically diagnosed DHF/DSS

300

12* years

Dengue virus IgM, Virus isolation, RT-PCR, sequencing

175 (58.3%) DENV -1,2, 3

Nyein PP et al.(66)

2016

Myanmar


Jan 2014- Sep 2015

Tertiary referral hospital; Urban

Inpatient Patients with diagnosis of P. falciparum

67

Median without bacteraemia 34 (25-44), with bacteraemia 32 (22-46)

Malaria RDT (SD Bioline), Routine blood cultures (BACTEC), VITEK

9 with bacteraemia

7 (78%) with GNR (3 E.coli, 3 S. Typhi, 1 non typhoid salmonella)

E.coli, S.Typhi

Saw Myat Thwe et al. (67)

2016

Myanmar

Mandalay (Mandalay Region)

1 Feb 2012 to 13 Nov 2013

2 Tertiary hospitals; Urban

Inpatient and outpatient

Fever 324

> 2 months

Blood culture; Salmonella serotyping

109 (33.6%)

S. aureus 43/109 (39.4%); Salmonella enterica ser Typhi 8/109 (7.3%); P. aeruginosa 7/109 (6.4%)

S. aureus

Theingi Win Myat et al. (68)

2016

Myanmar


Jan-Sept 2014



139

12* years

ICT Dengue (NS1 Ag and IgM/IgG) virus isolation and serotyping by IFA

76 (55.0%) seropositive

DENV-1 (47.0%); DENV-4 (30.0%); DENV-2 (17.0%); DENV-3 (6.0%)

DENV-1

Thant, KZ. et al. (69)

2015

Myanmar


2006



110

12* years

DENV IgM- and IgG- capture ELISA; Virus isolation and RT-PCR

96 (87.3%)

DENV-4 (2.1%); DENV-3 (1.0%)

Dengue

Myat TO et al. (70)

2014

Myanmar


2005-2013

Tertiary hospital

Inpatient Any outpatient or inpatient with suspected bloodstream infection or prolonged fever

3,865

Median 40 (12–100)

Blood culture 11.6%

S. aureus (38.1%); Pseudomonas spp. (4%); Citrobacter spp. (10.7%); E. coli (10%)

S. aureus

Ngwe Tun, MM et al. (71)

2014

Myanmar


July-October 2010


Inpatient Fever with clinically diagnosed DF/DHF/ DSS

116

12* years

ELISA DENV-IgM and CHIKV-IgM;

53 (45.7%) DENV (40.5%); CHIKV (5.2%)

Ngwe Tun, MM et al. (72)

2013

Myanmar

Pyinmana, Mandalay (Mandalay Region)

Pyinmana (2004); Mandalay (2006)


Inpatient Fever with clinically diagnosed DHF/DSS

160

12* years

DENV IgM- and IgG- capture ELISA; serotyping by DENV FRNT50

139 (86.8%) DENV-1-4

Undurrage EA et al. (73)

2017

The Philippines

Cebu city, Visayas region

2010-2014

Not reported

Not reported

People with dengue 1,008

Approximately 20% per age group

IgG/IgM ELISA, RT-PCR 794,255 annual dengue episodes and 535 DALYs per million population

Dengue

Alera MT et al. (74)

2016

The Philippines

Cebu city, Visayas region

Mar- May 2012

Community

Outpatient People ≥6 mths, residence in Punta Princesa

854

Approximately 20% per age group

DENV IgM/IgG ELISA (in-house), PCR

100% dengue Dengue

Capeding MR et al. (75)

The Philippines

Luzon, Mindanao and

2009-2010

Regional hospitals

Inpatient Patients ≤18 years and hospitalized for suspected dengue,

2,103 suspected dengue

Serotype-specific RT-PCR and IgM immunoassay (PanBio;Alere, Brisbane, Australia)

86.1% dengue Dengue

2015 the Visayas temperature ≥38°C for 2−7 days and 2 or more dengue-associated symptoms

Mean 9.0 ± 3.5 (1-18yrs)

Hapuarachchi HC et al.(76)

2016

Singapore 2013-2014

All

All Patients with dengue 40,508

Not reported

NS1 antigen test or RNA PCR 410.6 per 100,000 in 2013 and 335 per 100,000 people in 2014

61.7% DENV-1 in 2013, 79.2% 2014

Thein TL et al. (77)

2015

Singapore

Tan Tock Seng

2004-2008

Not reported

Inpatient Laboratory diagnosed adult dengue patients

9,553 dengue patients

Not reported

RT-PCR, Rapid Strip Test (Panbio Diagnostic, Queensland, Australia), blood culture

29 (0.3%) dengue patients with bacteraemia

48.3% S. aureus, 17% S. Typhi, 10% E. coli, 6.9% K. pneumoniae, 6.9% Streptococcus species (alpha-hemolytic Streptococcus and S. milleri), 3.4% P. aeruginosa, 3.4% A. Baumannii

Dengue, S. aureus, S. Typhi

Yung CF et al. (78)

2015

Singapore

Tan Tock Seng

2005-2011

Teaching hospital

Inpatient Adults presenting with acute undifferentiated fever within 3 days of onset without alternate diagnosis

3,468 patients

Median 31

RT-PCR, NS1 antigen (Bio-Rad), Dengue IgG Indirect, IgG Capture, and IgM Capture ELISAs (Alere Inc., Waltham, MA).

18.7% Dengue

22% DENV-1, 57.1% DENV-2, 17.1% DENV-3, 3.8% DENV-4

DENV-2

Lim, C et al. (79)

2016

Thailand

9 provinces (North East)

2004-2010

Provincial hospitals

Inpatient Hospitals who agreed to participate and admission records were available

1,255,571

All ages

Blood culture system , CLSI 20,803 patients positive (1.2%)

E. coli- 4279 (48%); S. aureus- 1881 (19%); K. pneumoniae- 1661 (17%); Acinetobacter spp.- 1065 (11%); P. aeruginosa- 568 (5.8%); Enterococcus spp.- 342 (3.5%)

E. coli, S. aureus, K. pneumoniae

Thipmontree W et al. (80)

2016

Thailand

Nakhon Ratchasima(North-East)

Jun 2011- Dec 2012

Tertiary hospital

Outpatient Patients with acute undifferentied fever ≥18 years with temp ≥38°C <14 days

495

Mean 54.1

IgM, IgG antibody test IFA, RT-PCR, nested PCR

146 positive for scrub typhus (29.5%)

Scrub typhus

Bhoomiboonchoo P et al. (81)

2015

Thailand

Bangkok and Kamphaeng Phet

1994-2010

Tertiary and provincial hospitals

Inpatient Patients with dengue 38,740

Mean 7.6 at infection one, 11.2 at infection two

RT-PCR, IgM/IgG ELISA 100% dengue Dengue

Blacksell SD et al. (82)

2015

Thailand

Chiang Rai, Mae Sot

Chiang Rai 2006-2007, Mae Sot March- May 2011

Tertiary Hospital

Inpatient Chiang Rai- > 15 years old with acute fever of < 2 weeks duration, no evidence of primary focus of infection, and three negative malaria blood smears. Mae Sot- Patients aged > 5 years old and presenting to these clinics with undifferentiated febrile illness

375 serum samples

Not reported

IgG, IFA (Fuller Laboratories, Fullerton, CA)

E. chaffeensis- 60.4% Mae Sot, B. henselae- 18.1% Chiang Rai, 8.6% Mae Sot and C. burnetii- 6.4% Chiang Rai, 0.5% Mae Sot

E. chaffeensis, B. henselae, C. burnetii

Khongwichit s et al. (83)

2015

Thailand

Nakhon Ratchasima(North- East)

July 2011- Dec 2012

Tertiaryhospital

Inpatient Patients with fever who gave a serum sample

274

Not reported

IgG, IgM serology and NSI ELISA, RT-PCR pan flavivirus primers

38 patients positive

19 dengue,10% DENV-1, 10% DENV-2, 15.8%DENV-3.10 leptospirosis, 9 scrub typhus

Dengue, leptospirosis, scrub typhus

Olsen SJ et al. (84)

2015

Thailand

Bangkok, Hat Yai (South)

2003-2005

Referral hospital & district hospital

Inpatient Patients with acute (<14 day) onset of brain dysfunction with fever or hypothermia ((>38°C), history of fever) and with abnormalities seen on neuroimages or electroencephalograms or with cerebrospinal fluid pleocytosis

149

Median 12 (range 0–83)

PCR, culture, antigen, or pathogen-specific IgM in CSF

25% etiology confirmed, 11% probable, 30% possible and 34% unknown

40% JEV, 16% enteroviruses, 8% Cryptococcus spp., 8% H. influenzae, 8% S. pneumoniae, 5% varicella-zoster virus, 5% dengue,

JEV, enterovirus

Srisawat N et al. (85)

2015

Thailand

9 centres in 8 provinces

2012-2014

2 referral/tertiary care hospital, 7 provincial hospital

Inpatient fever > 38°C, severe myalgia and history of exposure to reservoir animals

221 recruited cases, 113 cases were leptospirosis confirmed cases

Mean 15.5

Agglutination test, uNGAL ELISA (R&D, Minneapolis, MN, USA), Plasma NGAL Triage NGAL kit (Alere, San Diego, CA, USA), MAT, direct culture, PCR

100% leptospirosis Leptospirosis

Hongsuwan M et al. (86)

2014

Thailand

North-East

2004-2010

Multi-centre Provincialhospitals

Inpatient Patients in hospital with hospital or healthcare associated infection

1,069,443 at risk of HAB, 119,286 at risk of HCAB

HAI median 51 (0-88), HCAI medial 57 (0-89)

Not reported 0.32% HAI, 1.83% HCAI

HAI= 16.2% Acinetobacter sp, 13.9% K. pneumoniae, 13.9% S. aureus. HCAI= 26.3% E.coli, 14% S. aureus, 9.7% K. pneumoniae

E. coli, Acinetobacter, S. aureus

Thipmontree W et al. (87)

2014

Thailand

Nakhon Ratchasima (North- East)

Jul 2001- Dec 2002 and Jul 2011- Dec 2012

Provincialhospital

Inpatient People >18 years presenting with acute undifferentiated fever temp ≥38°C for <15 days

2,726

2001-2002 mean 45, 2011-2012 mean 47

For leptospirosis- EMJH medium, IFA, RT-PCR. Rickettsia- IgG and IgM IFA

First period- 40% leptospirosis, 24.1% scrub typhus, 2nd period 28.3% scrub typhus, 12.7% leptospirosis

Leptospirosis, scrub typhus

Kanoksil, M et al. (88)

2013

Thailand

20 provinces from North East

2004-2010

Provincialhospitals

Inpatient Patients with community acquired bacteremia who had pathogenic organisms isolated from blood within 2 days of hospitalisation without a prior inpatient episode in the preceding 30 days

15,251

Median 57 (0-104)

Microbiology laboratory data Incidence of 38.1 per 100,000 people per year at 2010

E. coli 23.1%, n=3,525; B.pseudomallei 19.3%, n=2,943; S. aureus 8.2%, n=127

E. coli, B. pseudomallei

Laoprasopwattana K et al. (89)

2012

Thailand

South

Apr- Jul 2009

Tertiary hospital

Outpatient Children between 1 month and 15 years with fever <7 days with arthralgia/arthritis, myalgia or rash

50

Not reported

Chikungunya IFA IgM (IFA; EUROIMMUNAG, Luebeck, Germany)

64% chikungunya, 20% dengue

Chikungunya, dengue

Rattanaumpawan P et al. (90)

2013

Thailand

Bangkok

Jul 2007- Dec 2008

Tertiary hospital

Inpatient Patients with at least 1 blood culture positive for a non-fermenting gram negative bacilli and met criteria for systemic inflammatory response syndrome with 24hrs before/after obtaining the blood culture

221

Median 54 (IQR 37-71)

Blood culture, biochemicals, sequencing

100%

32.7% A. baumannii, 27.8% P. aeruginosa, 5.4% S. maltophilia, 4.9% A. lwoffi, 2.7% B. pseudomallei

A. baumannii, P. aeruginosa

Rhodes J et al. (91)

2013

Thailand

Sa Kaeo and NakhonPhanom provinces

May 2005- Mar 2010

Provincialhospital

Inpatient People with S. pneumoniae bacteremia

196

25% < 5, 9.7% <5-9, 21.8% 20-49, 18.3% 50-64, 25% >65

BactT/ALERTH 3D microbial detectionsystem (bioMerie´ux), PCR

3.5 per 100,000 person years S. pneumoniae

Sriwongpan P et al. (92)

2013

Thailand

Chiang Rai and Chiang Mai (North)

2004-2010

Tertiary hospital

Outpatient Patients with scrub typhus as defined by WHO

526

Mean non severe 25.0, severe 32.6

Not reported 100% scrub typhus Scrub typhus

Watt G et al. (93)

2013

Thailand

Khon kaen (Northeast)

2010-2012

2 university hospitals

Inpatient Patients >16 years who met modified Duke criteria for endocarditis

132

Median 47 (16–85)

Blood culture (BD BACTEC Plus Aerobic/F Medium; Becton Dickinson, Franklin Lakes, NJ, USA), IFA, DNA was extracted from surgically excised heart valves QIAamp DNA FFPE Tissue Kit (QIAGEN, Courtaboeuf, France), 16S rRNA; fungi (18S rRNA)

45%; 25.0% zoonotic bacteria

C. burnetti (5 cases); B. henselae (4cases); Streptococcus suis (4 cases); Erysipelothrix rhusiopathiae (1 case); and Campylobacter fetus (1 case)

C. burnetti, B. henselae, Streptococcus suis

Punpanich W et al. (94)

2012

Thailand

Bangkok

Jan 2001- Dec 2010

Tertiary hospital

Inpatient Children aged 0-18 years diagnosed with invasive salmonellosis

229

Median 10 months (IQR 19.5)

Culture, serogroup agglutination 100% salmonella Salmonella

Sirivichayahul C et al. (95)

2012

Thailand

Muang District, Ratchaburi Province

2006-2008

Provincialhospital

Outpatient Healthy children aged 3-10

9,448 person years

Median for undifferentiated

IgM and IgG ELISA 12.1% dengue Dengue

fever 9.3, dengue fever 9.6 and dengue haemorrhagic fever 10.0

Sabchareon et al. (96)

2012

Thailand

Muang District, Ratchaburi Province

2006-2009

Community

Community Children aged 3-13 years

5,842

Median in 2006/2007 9, 2008/2009 11

IgM/IgG EIA, RT-PCR 6.74% dengue

43% DENV-1, 29% DENV-2, 20% DENV-3, 8% DENV-4

DENV-1

Dat VQ et al. (97)

2017

Viet Nam

Hanoi (North)

2011-2013

Tertiary referral clinic

Inpatient and outpatient

All cases of bloodstream infection in the 3 year period

738

Median 48 (36-60)

Blood culture (Bactec,Becton Dickinson, USA), VITEK, API API testing (bioMérieux,France), CLSI

100% positive, case fatality among blood stream infections 28.9%

K. pneumoniae- 129 (17.5%); E. coli- 128 (17.3%) (25.1% Enterobacteriaceae ESBL); S. aureus- 110 (14.9%) (37% MRSA); S. maltophilia- 71 (9.6%); S. suis- 56 (7.6%)

K. pneumoniae, E. coli, S. aureus

Vo NTT et al. (98)

2017

Viet Nam

Ho Chi Minh City(South)

2013-2015

Tertiary hospital

Inpatient Patients with dengue 1,672Mean 24.98

Not reported 100% dengue Dengue

Hamaguchi S et al. (99)

2015

Viet Nam

Hanoi(North)

Mar 2001- Feb 2003

Tertiary hospital

Inpatient Patients with acute undifferentiated fever, >15 years, fever ≥37.5°C, had atleast 1 of 5 secondary findings- nonspecific rash, multiple lyphadenopathy, eschar, hepatomegaly and/or spelomegaly and no receovery after beta lactom antibiotic

579

Mean 46.2

IgM ELISA for O. tsutsugamushi, IgG IFA for R. typhi (Focus Diagnostics, Cypress, CA)

74% positive40.9% scrub typhus, 33.3% murine typhus

Scrub typhus, murine typhus

Nadjm B et al. (100)

2014

Viet Nam

North

2001-2003

Tertiary referral

Inpatient People presenting with fever, eschar, lyphadenopathy and rash or fever with no other signs

749

3.2% ≤15

Scrub typhus IgG, IgM ELISA (Panbio), O tsutsugamushi RDT (SD Bioline)

3.5% scrub typhus Scrub typhus

Nguyen DNet al. (101)

2014

Viet Nam

Hanoi (North)

Sep 2009- Sep 2010

Referral hospital

Inpatients Patients with fever and suspected of TB

94

Median 33

Bactec mycolytic blood cultures (Becton Dickinson, USA), ZN stain, MAC PCR, GenoType MTBDRplus assay (HainLifesciences, Nehren, Germany)

14 positive 3 M. avium

Parry CM et al. (102)

2014

Viet Nam

Ho Chi Minh City, Cao Lanh, Dong Thap Province (South)

1993-1994, 1997- 1999

Tertiary hospital

Inpatient Patients with typhoid fever

581

7.6% < 5, 38.9% ≥16

Blood culture (BACTEC), biochemical tests, Salmonella specific antisera (Murex diagnostics), CLSI

100% S.Typhi S. Typhi

Capeding MR et al. (103)

2013

Indonesia, Malaysia, Philippines, Thailand and Viet Nam

Indonesia (Jakarta, West Java, Bali), Malaysia (Kuala Lumpur, Penang), Philippines (Muntinlupa city, Cebu City), Thailand (Ratchaburi, Kamphaeng Phet) and Viet Nam (TienGiang province)

Jun 2010- Jul 2011

Community

Outpatient Healthy children aged 2-14 years, not received a vaccine in the 4 weeks before

1,500

Mean 8.4. median 8.5 (2-15)

IgM ELISA for chikungunya (NovaTec), culture, NS1 (BioRad) and IgM Capture DxSelect ELISA (Focus) for dengue, IHA for leptospirosis, rickettsia IFA IgG/IgM (Focus), hepatitis A Anti-HAV IgM ELISA (DIAsource), S. Typhi IgM ELISA (Calbiotech), Influenza A (NovaLisa NovaTec)

19% had acute fever with incidence density of 33.6 per 100 person years

35% of febrile patients had chikungunya, 29.4% S. Typhi, 11.4% dengue

References

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