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Evaluations of Diagnostic Tests for Undifferentiated Febrile Illness on the Thailand-Myanmar (Burma) Border.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Evaluations of Diagnostic Tests for Undifferentiated Febrile Illness on the Thailand-Myanmar (Burma) Border./
Author:	Watthanaworawit, Wanitda.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2018,
Description:	369 p.
Notes:	Source: Dissertations Abstracts International, Volume: 80-10, Section: B.
Contained By:	Dissertations Abstracts International80-10B.
Subject:	Medicine. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=13872617
ISBN:	9781658459525

Evaluations of Diagnostic Tests for Undifferentiated Febrile Illness on the Thailand-Myanmar (Burma) Border.
Watthanaworawit, Wanitda.

Evaluations of Diagnostic Tests for Undifferentiated Febrile Illness on the Thailand-Myanmar (Burma) Border. - Ann Arbor : ProQuest Dissertations & Theses, 2018 - 369 p.

Source: Dissertations Abstracts International, Volume: 80-10, Section: B.

Thesis (Ph.D.)--Open University (United Kingdom), 2018.

This item must not be sold to any third party vendors.

Dengue, leptospirosis and rickettsial infections are the most common non-malaria causes of acute undifferentiated febrile illness in Southeast Asia. Current diagnostic tests are inadequate for clinical use.We conducted a two year prospective fever study in three outpatient clinics on the Thailand-Myanmar border, recruiting patients aged at least five years with acute undifferentiated febrile illness. The study was divided into two parts: non-malaria and malaria patients. Specimens were tested to determine the causes of fever and to evaluate the clinical diagnostic accuracy of the tests for early diagnosis of dengue, leptospirosis and rickettsial infections.A total of 1,029 febrile patients were recruited: 908 non-malaria and 121 malaria patients. A laboratory confirmed diagnosis was made in 34.5% of non-malaria patients, of which 15.9% were dengue, 6.0% leptospirosis, 6.0% murine typhus, and 3.2% scrub typhus. Co-infection was found in 1.7% with mostly leptospirosis and scrub typhus (1.5%). In malaria patients, co-infection was found in 8.3% in most cases with scrub typhus (7.4%).An immunochromatographic test (ICT) (Non-structural protein 1 [NS1] and Immunoglobulin M [IgM]/Immunoglobulin G [IgG] detection) and real-time reverse transcriptase polymerase chain reaction (rRT-PCR) were evaluated for dengue diagnosis using acute plasma specimens. Sensitivities of the ICT and rRT-PCR were 86.1% (95% confidence interval [CI] 79.4-91.3) and 97.2% (95% CI 93.0-99.2), and specificities were94.9% (95% CI 93.0-96.4) and 99.1% (95% CI 98.1-99.7), respectively compared against IgM/IgG enzyme-linked immunosorbent assay (ELISA). Combining rRT-PCR with ICT improved the sensitivity of the diagnostic process to 98.6% (95% CI 95.1-99.8).

ISBN: 9781658459525Subjects--Topical Terms:

641104
Medicine.
Subjects--Index Terms:

Dengue

Evaluations of Diagnostic Tests for Undifferentiated Febrile Illness on the Thailand-Myanmar (Burma) Border.
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502 $a Thesis (Ph.D.)--Open University (United Kingdom), 2018.
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520 $a Dengue, leptospirosis and rickettsial infections are the most common non-malaria causes of acute undifferentiated febrile illness in Southeast Asia. Current diagnostic tests are inadequate for clinical use.We conducted a two year prospective fever study in three outpatient clinics on the Thailand-Myanmar border, recruiting patients aged at least five years with acute undifferentiated febrile illness. The study was divided into two parts: non-malaria and malaria patients. Specimens were tested to determine the causes of fever and to evaluate the clinical diagnostic accuracy of the tests for early diagnosis of dengue, leptospirosis and rickettsial infections.A total of 1,029 febrile patients were recruited: 908 non-malaria and 121 malaria patients. A laboratory confirmed diagnosis was made in 34.5% of non-malaria patients, of which 15.9% were dengue, 6.0% leptospirosis, 6.0% murine typhus, and 3.2% scrub typhus. Co-infection was found in 1.7% with mostly leptospirosis and scrub typhus (1.5%). In malaria patients, co-infection was found in 8.3% in most cases with scrub typhus (7.4%).An immunochromatographic test (ICT) (Non-structural protein 1 [NS1] and Immunoglobulin M [IgM]/Immunoglobulin G [IgG] detection) and real-time reverse transcriptase polymerase chain reaction (rRT-PCR) were evaluated for dengue diagnosis using acute plasma specimens. Sensitivities of the ICT and rRT-PCR were 86.1% (95% confidence interval [CI] 79.4-91.3) and 97.2% (95% CI 93.0-99.2), and specificities were94.9% (95% CI 93.0-96.4) and 99.1% (95% CI 98.1-99.7), respectively compared against IgM/IgG enzyme-linked immunosorbent assay (ELISA). Combining rRT-PCR with ICT improved the sensitivity of the diagnostic process to 98.6% (95% CI 95.1-99.8).
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