The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos
Identifieur interne : 002968 ( Istex/Curation ); précédent : 002967; suivant : 002969The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos
Auteurs : Bounkong Syhavong ; Bouachanh Rasachack ; Lee Smythe [Australie] ; Jean-Marc Rolain [France] ; Anne-Marie Roque-Afonso [France] ; Kemajittra Jenjaroen [Thaïlande] ; Vimone Soukkhaserm ; Simmaly Phongmany ; Rattanaphone Phetsouvanh [Royaume-Uni] ; Sune Soukkhaserm ; Te Thammavong ; Mayfong Mayxay [Royaume-Uni] ; Stuart D. Blacksell [Thaïlande, Royaume-Uni] ; Eleanor Barnes [Royaume-Uni] ; Philippe Parola [France] ; Elisabeth Dussaix [France] ; Didier Raoult [France] ; Isla Humphreys [Royaume-Uni] ; Paul Klenerman [Royaume-Uni] ; Nicholas J. White [Thaïlande, Royaume-Uni] ; Paul N. Newton [Royaume-Uni]Source :
- Transactions of The Royal Society of Tropical Medicine and Hygiene [ 0035-9203 ] ; 2010-07.
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- geographic : Laos.
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Abstract
There is little information on the diverse infectious causes of jaundice and hepatitis in the Asiatic tropics. Serology (hepatitis A, B, C and E, leptospirosis, dengue, rickettsia), antigen tests (dengue), PCR assays (hepatitis A, C and E) and blood cultures (septicaemia) were performed on samples from 392 patients admitted with jaundice or raised transaminases (≥ × 3) to Mahosot Hospital, Vientiane, Laos over 3 years. Conservative definitions suggested diagnoses of dengue (8.4%), rickettsioses (7.3%), leptospirosis (6.8%), hepatitis B (4.9%), hepatitis C (4.9%), community-acquired septicaemia (3.3%) and hepatitis E (1.6%). Although anti-hepatitis A virus (HAV) IgM antibody results suggested that 35.8% of patients had acute HAV infections, anti-HAV IgG antibody avidity and HAV PCR suggested that 82% had polyclonal activation and not acute HAV infections. Scrub typhus, murine typhus or leptospirosis were present in 12.8% of patients and were associated with meningism and relatively low AST and ALT elevation. These patients would be expected to respond to empirical doxycycline therapy which, in the absence of virological diagnosis and treatment, may be an appropriate cost-effective intervention in Lao patients with jaundice/hepatitis.
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DOI: 10.1016/j.trstmh.2010.03.002
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Bounkong Syhavong<affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation><affiliation><mods:affiliation>National Blood Transfusion Centre, Lao Red Cross, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation>Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos</title><author><name sortKey="Syhavong, Bounkong" sort="Syhavong, Bounkong" uniqKey="Syhavong B" first="Bounkong" last="Syhavong">Bounkong Syhavong</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Rasachack, Bouachanh" sort="Rasachack, Bouachanh" uniqKey="Rasachack B" first="Bouachanh" last="Rasachack">Bouachanh Rasachack</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry 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Thailand</mods:affiliation><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea></affiliation></author><author><name sortKey="Soukkhaserm, Vimone" sort="Soukkhaserm, Vimone" uniqKey="Soukkhaserm V" first="Vimone" last="Soukkhaserm">Vimone Soukkhaserm</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Phongmany, Simmaly" sort="Phongmany, Simmaly" uniqKey="Phongmany S" first="Simmaly" last="Phongmany">Simmaly Phongmany</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry 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last="Soukkhaserm">Sune Soukkhaserm</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Thammavong, Te" sort="Thammavong, Te" uniqKey="Thammavong T" first="Te" last="Thammavong">Te Thammavong</name><affiliation><mods:affiliation>National Blood Transfusion Centre, Lao Red Cross, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Mayxay, Mayfong" sort="Mayxay, Mayfong" uniqKey="Mayxay M" first="Mayfong" last="Mayxay">Mayfong Mayxay</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation><affiliation wicri:level="1"><mods:affiliation>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea></affiliation><affiliation><mods:affiliation>Faculty of Post Graduate Studies, University of Health Sciences, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Blacksell, Stuart D" sort="Blacksell, Stuart D" uniqKey="Blacksell S" first="Stuart D." last="Blacksell">Stuart D. Blacksell</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation><affiliation wicri:level="1"><mods:affiliation>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand</mods:affiliation><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="Barnes, Eleanor" sort="Barnes, Eleanor" uniqKey="Barnes E" first="Eleanor" last="Barnes">Eleanor Barnes</name><affiliation wicri:level="1"><mods:affiliation>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="Parola, Philippe" sort="Parola, Philippe" uniqKey="Parola P" first="Philippe" last="Parola">Philippe Parola</name><affiliation wicri:level="1"><mods:affiliation>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea></affiliation></author><author><name sortKey="Dussaix, Elisabeth" sort="Dussaix, Elisabeth" uniqKey="Dussaix E" first="Elisabeth" last="Dussaix">Elisabeth Dussaix</name><affiliation wicri:level="1"><mods:affiliation>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif, 94804 France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif</wicri:regionArea></affiliation></author><author><name sortKey="Raoult, Didier" sort="Raoult, Didier" uniqKey="Raoult D" first="Didier" last="Raoult">Didier Raoult</name><affiliation wicri:level="1"><mods:affiliation>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea></affiliation></author><author><name sortKey="Humphreys, Isla" sort="Humphreys, Isla" uniqKey="Humphreys I" first="Isla" last="Humphreys">Isla Humphreys</name><affiliation wicri:level="1"><mods:affiliation>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="Klenerman, Paul" sort="Klenerman, Paul" uniqKey="Klenerman P" first="Paul" last="Klenerman">Paul Klenerman</name><affiliation wicri:level="1"><mods:affiliation>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="White, Nicholas J" sort="White, Nicholas J" uniqKey="White N" first="Nicholas J." last="White">Nicholas J. White</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation><affiliation wicri:level="1"><mods:affiliation>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand</mods:affiliation><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="Newton, Paul N" sort="Newton, Paul N" uniqKey="Newton P" first="Paul N." last="Newton">Paul N. Newton</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation><affiliation wicri:level="1"><mods:affiliation>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea></affiliation><affiliation><mods:affiliation>E-mail: paul@tropmedres.ac</mods:affiliation><wicri:noCountry code="no comma">E-mail: paul@tropmedres.ac</wicri:noCountry></affiliation><affiliation><mods:affiliation>Corresponding author. Tel.: +856 21 242168; fax: +856 21 242168. E-mail address: paul@tropmedres.ac</mods:affiliation><wicri:noCountry code="no comma">Corresponding author. Tel.: +856 21 242168; fax: +856 21 242168. E-mail address: paul@tropmedres.ac</wicri:noCountry></affiliation><affiliation><mods:affiliation>E-mail: paul@tropmedres.ac</mods:affiliation><wicri:noCountry code="no comma">E-mail: paul@tropmedres.ac</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:DEC1F87054742B503CEF494BE7745DBFB1A60E95</idno><date when="2010" year="2010">2010</date><idno type="doi">10.1016/j.trstmh.2010.03.002</idno><idno type="url">https://api.istex.fr/document/DEC1F87054742B503CEF494BE7745DBFB1A60E95/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">002968</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002968</idno><idno type="wicri:Area/Istex/Curation">002968</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">The infective causes of hepatitis and jaundice amongst hospitalised patients in Vientiane, Laos</title><author><name sortKey="Syhavong, Bounkong" sort="Syhavong, Bounkong" uniqKey="Syhavong B" first="Bounkong" last="Syhavong">Bounkong Syhavong</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Rasachack, Bouachanh" sort="Rasachack, Bouachanh" uniqKey="Rasachack B" first="Bouachanh" last="Rasachack">Bouachanh Rasachack</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Smythe, Lee" sort="Smythe, Lee" uniqKey="Smythe L" first="Lee" last="Smythe">Lee Smythe</name><affiliation wicri:level="1"><mods:affiliation>WHO/AO/OIE Collaborating Centre for Reference & Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Coopers Plains, Queensland, 4108, Australia</mods:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>WHO/AO/OIE Collaborating Centre for Reference & Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Coopers Plains, Queensland, 4108</wicri:regionArea></affiliation></author><author><name sortKey="Rolain, Jean Marc" sort="Rolain, Jean Marc" uniqKey="Rolain J" first="Jean-Marc" last="Rolain">Jean-Marc Rolain</name><affiliation wicri:level="1"><mods:affiliation>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea></affiliation></author><author><name sortKey="Roque Afonso, Anne Marie" sort="Roque Afonso, Anne Marie" uniqKey="Roque Afonso A" first="Anne-Marie" last="Roque-Afonso">Anne-Marie Roque-Afonso</name><affiliation wicri:level="1"><mods:affiliation>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif, 94804 France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif</wicri:regionArea></affiliation></author><author><name sortKey="Jenjaroen, Kemajittra" sort="Jenjaroen, Kemajittra" uniqKey="Jenjaroen K" first="Kemajittra" last="Jenjaroen">Kemajittra Jenjaroen</name><affiliation wicri:level="1"><mods:affiliation>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand</mods:affiliation><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea></affiliation></author><author><name sortKey="Soukkhaserm, Vimone" sort="Soukkhaserm, Vimone" uniqKey="Soukkhaserm V" first="Vimone" last="Soukkhaserm">Vimone Soukkhaserm</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Phongmany, Simmaly" sort="Phongmany, Simmaly" uniqKey="Phongmany S" first="Simmaly" last="Phongmany">Simmaly Phongmany</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Phetsouvanh, Rattanaphone" sort="Phetsouvanh, Rattanaphone" uniqKey="Phetsouvanh R" first="Rattanaphone" last="Phetsouvanh">Rattanaphone Phetsouvanh</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation></affiliation><affiliation wicri:level="1"><mods:affiliation>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="Soukkhaserm, Sune" sort="Soukkhaserm, Sune" uniqKey="Soukkhaserm S" first="Sune" last="Soukkhaserm">Sune Soukkhaserm</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Thammavong, Te" sort="Thammavong, Te" uniqKey="Thammavong T" first="Te" last="Thammavong">Te Thammavong</name><affiliation><mods:affiliation>National Blood Transfusion Centre, Lao Red Cross, Vientiane, Lao PDR</mods:affiliation><wicri:noCountry code="subField">PDR</wicri:noCountry></affiliation></author><author><name sortKey="Mayxay, Mayfong" sort="Mayxay, Mayfong" uniqKey="Mayxay M" first="Mayfong" last="Mayxay">Mayfong Mayxay</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation></affiliation><affiliation wicri:level="1"><mods:affiliation>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea></affiliation><affiliation><mods:affiliation>Faculty of Post Graduate Studies, University of Health Sciences, Vientiane, Lao PDR</mods:affiliation></affiliation></author><author><name sortKey="Blacksell, Stuart D" sort="Blacksell, Stuart D" uniqKey="Blacksell S" first="Stuart D." last="Blacksell">Stuart D. Blacksell</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation></affiliation><affiliation wicri:level="1"><mods:affiliation>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand</mods:affiliation><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="Barnes, Eleanor" sort="Barnes, Eleanor" uniqKey="Barnes E" first="Eleanor" last="Barnes">Eleanor Barnes</name><affiliation wicri:level="1"><mods:affiliation>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="Parola, Philippe" sort="Parola, Philippe" uniqKey="Parola P" first="Philippe" last="Parola">Philippe Parola</name><affiliation wicri:level="1"><mods:affiliation>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea></affiliation></author><author><name sortKey="Dussaix, Elisabeth" sort="Dussaix, Elisabeth" uniqKey="Dussaix E" first="Elisabeth" last="Dussaix">Elisabeth Dussaix</name><affiliation wicri:level="1"><mods:affiliation>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif, 94804 France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, National Reference Centre for HAV, Hôpital Paul Brousse, Villejuif</wicri:regionArea></affiliation></author><author><name sortKey="Raoult, Didier" sort="Raoult, Didier" uniqKey="Raoult D" first="Didier" last="Raoult">Didier Raoult</name><affiliation wicri:level="1"><mods:affiliation>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>URMITE CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille</wicri:regionArea></affiliation></author><author><name sortKey="Humphreys, Isla" sort="Humphreys, Isla" uniqKey="Humphreys I" first="Isla" last="Humphreys">Isla Humphreys</name><affiliation wicri:level="1"><mods:affiliation>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="Klenerman, Paul" sort="Klenerman, Paul" uniqKey="Klenerman P" first="Paul" last="Klenerman">Paul Klenerman</name><affiliation wicri:level="1"><mods:affiliation>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="White, Nicholas J" sort="White, Nicholas J" uniqKey="White N" first="Nicholas J." last="White">Nicholas J. White</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation></affiliation><affiliation wicri:level="1"><mods:affiliation>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400, Thailand</mods:affiliation><country xml:lang="fr">Thaïlande</country><wicri:regionArea>Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Rd., Bangkok 10400</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea></affiliation></author><author><name sortKey="Newton, Paul N" sort="Newton, Paul N" uniqKey="Newton P" first="Paul N." last="Newton">Paul N. Newton</name><affiliation><mods:affiliation>Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR</mods:affiliation></affiliation><affiliation wicri:level="1"><mods:affiliation>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford</wicri:regionArea></affiliation><affiliation><mods:affiliation>E-mail: paul@tropmedres.ac</mods:affiliation></affiliation><affiliation><mods:affiliation>Corresponding author. Tel.: +856 21 242168; fax: +856 21 242168. E-mail address: paul@tropmedres.ac</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: paul@tropmedres.ac</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Transactions of The Royal Society of Tropical Medicine and Hygiene</title><title level="j" type="abbrev">Trans R Soc Trop Med Hyg</title><idno type="ISSN">0035-9203</idno><idno type="eISSN">1878-3503</idno><imprint><publisher>Royal Society of Tropical Medicine and Hygiene</publisher><date type="published" when="2010-07">2010-07</date><biblScope unit="volume">104</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="475">475</biblScope><biblScope unit="page" to="483">483</biblScope></imprint><idno type="ISSN">0035-9203</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0035-9203</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Hepatitis E virus</term><term>Jaundice</term><term>Laos</term><term>Leptospirosis</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Laos</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">There is little information on the diverse infectious causes of jaundice and hepatitis in the Asiatic tropics. Serology (hepatitis A, B, C and E, leptospirosis, dengue, rickettsia), antigen tests (dengue), PCR assays (hepatitis A, C and E) and blood cultures (septicaemia) were performed on samples from 392 patients admitted with jaundice or raised transaminases (≥ × 3) to Mahosot Hospital, Vientiane, Laos over 3 years. Conservative definitions suggested diagnoses of dengue (8.4%), rickettsioses (7.3%), leptospirosis (6.8%), hepatitis B (4.9%), hepatitis C (4.9%), community-acquired septicaemia (3.3%) and hepatitis E (1.6%). Although anti-hepatitis A virus (HAV) IgM antibody results suggested that 35.8% of patients had acute HAV infections, anti-HAV IgG antibody avidity and HAV PCR suggested that 82% had polyclonal activation and not acute HAV infections. Scrub typhus, murine typhus or leptospirosis were present in 12.8% of patients and were associated with meningism and relatively low AST and ALT elevation. These patients would be expected to respond to empirical doxycycline therapy which, in the absence of virological diagnosis and treatment, may be an appropriate cost-effective intervention in Lao patients with jaundice/hepatitis.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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