AustralieFrV1, Main, Exploration, bibRecord, 004799

Causes of non-malarial fever in Laos: a prospective study

Identifieur interne : 004799 ( Main/Exploration ); précédent : 004798; suivant : 004800

Causes of non-malarial fever in Laos: a prospective study

Auteurs : Mayfong Mayxay [Laos, Royaume-Uni] ; Josée Castonguay-Vanier [Laos] ; Vilada Chansamouth [Laos] ; Audrey Dubot-Pérès [Laos, Royaume-Uni, France] ; Daniel H. Paris [Royaume-Uni] ; Rattanaphone Phetsouvanh [Laos, Royaume-Uni] ; Jarasporn Tangkhabuanbutra ; Phouvieng Douangdala [Laos] ; Saythong Inthalath [Laos] ; Phoutthalavanh Souvannasing [Laos] ; Günther Slesak [Allemagne] ; Narongchai Tongyoo ; Anisone Chanthongthip [Laos] ; Phonepasith Panyanouvong [Laos] ; Bountoy Sibounheuang [Laos] ; Koukeo Phommasone [Laos] ; Michael Dohnt [Australie] ; Darouny Phonekeo [Laos] ; Bouasy Hongvanthong [Laos] ; Sinakhone Xayadeth [Laos] ; Pakapak Ketmayoon [Laos] ; Stuart D. Blacksell [Royaume-Uni] ; Catrin E. Moore [Laos, Royaume-Uni] ; Scott B. Craig [Australie] ; Mary-Anne Burns [Australie] ; Frank Von Sonnenburg [Allemagne] ; Andrew Corwin [Laos] ; Xavier De Lamballerie [France] ; Iveth J. González [Suisse] ; Eva Maria Christophel [Philippines] ; Amy Cawthorne [Philippines] ; David Bell [Suisse] ; Paul N. Newton [Laos, Royaume-Uni]

Source :

The Lancet Global Health [ 2214-109X ] ; 2013.

RBID : PMC:3986032

Abstract

SummaryBackground

Because of reductions in the incidence of Plasmodium falciparum malaria in Laos, identification of the causes of fever in people without malaria, and discussion of the best empirical treatment options, are urgently needed. We aimed to identify the causes of non-malarial acute fever in patients in rural Laos.

Methods

For this prospective study, we recruited 1938 febrile patients, between May, 2008, and December, 2010, at Luang Namtha provincial hospital in northwest Laos (n=1390), and between September, 2008, and December, 2010, at Salavan provincial hospital in southern Laos (n=548). Eligible participants were aged 5–49 years with fever (≥38°C) lasting 8 days or less and were eligible for malaria testing by national guidelines.

Findings

With conservative definitions of cause, we assigned 799 (41%) patients a diagnosis. With exclusion of influenza, the top five diagnoses when only one aetiological agent per patient was identified were dengue (156 [8%] of 1927 patients), scrub typhus (122 [7%] of 1871), Japanese encephalitis virus (112 [6%] of 1924), leptospirosis (109 [6%] of 1934), and bacteraemia (43 [2%] of 1938). 115 (32%) of 358 patients at Luang Namtha hospital tested influenza PCR-positive between June and December, 2010, of which influenza B was the most frequently detected strain (n=121 [87%]). Disease frequency differed significantly between the two sites: Japanese encephalitis virus infection (p=0·04), typhoid (p=0·006), and leptospirosis (p=0·001) were more common at Luang Namtha, whereas dengue and malaria were more common at Salavan (all p<0·0001). With use of evidence from southeast Asia when possible, we estimated that azithromycin, doxycycline, ceftriaxone, and ofloxacin would have had significant efficacy for 258 (13%), 240 (12%), 154 (8%), and 41 (2%) of patients, respectively.

Interpretation

Our findings suggest that a wide range of treatable or preventable pathogens are implicated in non-malarial febrile illness in Laos. Empirical treatment with doxycycline for patients with undifferentiated fever and negative rapid diagnostic tests for malaria and dengue could be an appropriate strategy for rural health workers in Laos.

Funding

Wellcome Trust, WHO–Western Pacific Region, Foundation for Innovative New Diagnostics, US Centers for Disease Control and Prevention.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3986032

DOI: 10.1016/S2214-109X(13)70008-1
PubMed: 24748368
PubMed Central: 3986032

Affiliations:

Le document en format XML

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<author><name sortKey="Dohnt, Michael" sort="Dohnt, Michael" uniqKey="Dohnt M" first="Michael" last="Dohnt">Michael Dohnt</name>
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<affiliation wicri:level="1"><nlm:aff id="aff10">School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia</nlm:aff>
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<author><name sortKey="Phonekeo, Darouny" sort="Phonekeo, Darouny" uniqKey="Phonekeo D" first="Darouny" last="Phonekeo">Darouny Phonekeo</name>
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<author><name sortKey="Burns, Mary Anne" sort="Burns, Mary Anne" uniqKey="Burns M" first="Mary-Anne" last="Burns">Mary-Anne Burns</name>
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<author><name sortKey="Von Sonnenburg, Frank" sort="Von Sonnenburg, Frank" uniqKey="Von Sonnenburg F" first="Frank" last="Von Sonnenburg">Frank Von Sonnenburg</name>
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<author><name sortKey="Corwin, Andrew" sort="Corwin, Andrew" uniqKey="Corwin A" first="Andrew" last="Corwin">Andrew Corwin</name>
<affiliation wicri:level="1"><nlm:aff id="aff15">Centers for Disease Control and Prevention, US Embassy, Vientiane, Laos</nlm:aff>
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<wicri:regionArea>Centers for Disease Control and Prevention, US Embassy, Vientiane</wicri:regionArea>
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<country xml:lang="fr">France</country>
<wicri:regionArea>UMR_D 190 “Emergence des Pathologies Virales”, Aix-Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille</wicri:regionArea>
<placeName><region type="region">Provence-Alpes-Côte d'Azur</region>
<region type="old region">Provence-Alpes-Côte d'Azur</region>
<settlement type="city">Marseille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Gonzalez, Iveth J" sort="Gonzalez, Iveth J" uniqKey="Gonzalez I" first="Iveth J" last="González">Iveth J. González</name>
<affiliation wicri:level="1"><nlm:aff id="aff16">Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Foundation for Innovative New Diagnostics (FIND), Geneva</wicri:regionArea>
<wicri:noRegion>Geneva</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Christophel, Eva Maria" sort="Christophel, Eva Maria" uniqKey="Christophel E" first="Eva Maria" last="Christophel">Eva Maria Christophel</name>
<affiliation wicri:level="1"><nlm:aff id="aff17">WHO–Regional Office for the Western Pacific, Manila, Philippines</nlm:aff>
<country xml:lang="fr">Philippines</country>
<wicri:regionArea>WHO–Regional Office for the Western Pacific, Manila</wicri:regionArea>
<wicri:noRegion>Manila</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Cawthorne, Amy" sort="Cawthorne, Amy" uniqKey="Cawthorne A" first="Amy" last="Cawthorne">Amy Cawthorne</name>
<affiliation wicri:level="1"><nlm:aff id="aff17">WHO–Regional Office for the Western Pacific, Manila, Philippines</nlm:aff>
<country xml:lang="fr">Philippines</country>
<wicri:regionArea>WHO–Regional Office for the Western Pacific, Manila</wicri:regionArea>
<wicri:noRegion>Manila</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bell, David" sort="Bell, David" uniqKey="Bell D" first="David" last="Bell">David Bell</name>
<affiliation wicri:level="1"><nlm:aff id="aff16">Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Foundation for Innovative New Diagnostics (FIND), Geneva</wicri:regionArea>
<wicri:noRegion>Geneva</wicri:noRegion>
</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 wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="aff3">Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford</wicri:regionArea>
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<region type="comté" nuts="2">Oxfordshire</region>
<settlement type="city">Oxford</settlement>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Causes of non-malarial fever in Laos: a prospective study</title>
<author><name sortKey="Mayxay, Mayfong" sort="Mayxay, Mayfong" uniqKey="Mayxay M" first="Mayfong" last="Mayxay">Mayfong Mayxay</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff2">Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Faculty of Postgraduate Studies, University of Health Sciences, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="aff3">Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford</wicri:regionArea>
<placeName><settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
<settlement type="city">Oxford</settlement>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
</author>
<author><name sortKey="Castonguay Vanier, Josee" sort="Castonguay Vanier, Josee" uniqKey="Castonguay Vanier J" first="Josée" last="Castonguay-Vanier">Josée Castonguay-Vanier</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Chansamouth, Vilada" sort="Chansamouth, Vilada" uniqKey="Chansamouth V" first="Vilada" last="Chansamouth">Vilada Chansamouth</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Dubot Peres, Audrey" sort="Dubot Peres, Audrey" uniqKey="Dubot Peres A" first="Audrey" last="Dubot-Pérès">Audrey Dubot-Pérès</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="aff3">Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford</wicri:regionArea>
<placeName><settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
<settlement type="city">Oxford</settlement>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff4">UMR_D 190 “Emergence des Pathologies Virales”, Aix-Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>UMR_D 190 “Emergence des Pathologies Virales”, Aix-Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille</wicri:regionArea>
<placeName><region type="region">Provence-Alpes-Côte d'Azur</region>
<region type="old region">Provence-Alpes-Côte d'Azur</region>
<settlement type="city">Marseille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Paris, Daniel H" sort="Paris, Daniel H" uniqKey="Paris D" first="Daniel H" last="Paris">Daniel H. Paris</name>
<affiliation wicri:level="4"><nlm:aff id="aff3">Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford</wicri:regionArea>
<placeName><settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
<settlement type="city">Oxford</settlement>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
<affiliation><nlm:aff id="aff5">Mahidol–Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok</nlm:aff>
<wicri:noCountry code="subfield">Bangkok</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Phetsouvanh, Rattanaphone" sort="Phetsouvanh, Rattanaphone" uniqKey="Phetsouvanh R" first="Rattanaphone" last="Phetsouvanh">Rattanaphone Phetsouvanh</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="aff3">Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford</wicri:regionArea>
<placeName><settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
<settlement type="city">Oxford</settlement>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
</author>
<author><name sortKey="Tangkhabuanbutra, Jarasporn" sort="Tangkhabuanbutra, Jarasporn" uniqKey="Tangkhabuanbutra J" first="Jarasporn" last="Tangkhabuanbutra">Jarasporn Tangkhabuanbutra</name>
<affiliation><nlm:aff id="aff5">Mahidol–Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok</nlm:aff>
<wicri:noCountry code="subfield">Bangkok</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Douangdala, Phouvieng" sort="Douangdala, Phouvieng" uniqKey="Douangdala P" first="Phouvieng" last="Douangdala">Phouvieng Douangdala</name>
<affiliation wicri:level="1"><nlm:aff id="aff6">Luang Namtha Provincial Hospital, Luang Namtha, Luang Namtha Province, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Luang Namtha Provincial Hospital, Luang Namtha, Luang Namtha Province</wicri:regionArea>
<wicri:noRegion>Luang Namtha Province</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Inthalath, Saythong" sort="Inthalath, Saythong" uniqKey="Inthalath S" first="Saythong" last="Inthalath">Saythong Inthalath</name>
<affiliation wicri:level="1"><nlm:aff id="aff6">Luang Namtha Provincial Hospital, Luang Namtha, Luang Namtha Province, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Luang Namtha Provincial Hospital, Luang Namtha, Luang Namtha Province</wicri:regionArea>
<wicri:noRegion>Luang Namtha Province</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Souvannasing, Phoutthalavanh" sort="Souvannasing, Phoutthalavanh" uniqKey="Souvannasing P" first="Phoutthalavanh" last="Souvannasing">Phoutthalavanh Souvannasing</name>
<affiliation wicri:level="1"><nlm:aff id="aff7">Salavan Provincial Hospital, Salavan, Salavan Province, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Salavan Provincial Hospital, Salavan, Salavan Province</wicri:regionArea>
<wicri:noRegion>Salavan Province</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Slesak, Gunther" sort="Slesak, Gunther" uniqKey="Slesak G" first="Günther" last="Slesak">Günther Slesak</name>
<affiliation wicri:level="3"><nlm:aff id="aff8">Tropical Hospital Paul-Lechler-Krankenhaus, Tübingen, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Tropical Hospital Paul-Lechler-Krankenhaus, Tübingen</wicri:regionArea>
<placeName><region type="land" nuts="1">Bade-Wurtemberg</region>
<region type="district" nuts="2">District de Tübingen</region>
<settlement type="city">Tübingen</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Tongyoo, Narongchai" sort="Tongyoo, Narongchai" uniqKey="Tongyoo N" first="Narongchai" last="Tongyoo">Narongchai Tongyoo</name>
<affiliation><nlm:aff id="aff5">Mahidol–Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok</nlm:aff>
<wicri:noCountry code="subfield">Bangkok</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Chanthongthip, Anisone" sort="Chanthongthip, Anisone" uniqKey="Chanthongthip A" first="Anisone" last="Chanthongthip">Anisone Chanthongthip</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Panyanouvong, Phonepasith" sort="Panyanouvong, Phonepasith" uniqKey="Panyanouvong P" first="Phonepasith" last="Panyanouvong">Phonepasith Panyanouvong</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Sibounheuang, Bountoy" sort="Sibounheuang, Bountoy" uniqKey="Sibounheuang B" first="Bountoy" last="Sibounheuang">Bountoy Sibounheuang</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Phommasone, Koukeo" sort="Phommasone, Koukeo" uniqKey="Phommasone K" first="Koukeo" last="Phommasone">Koukeo Phommasone</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Dohnt, Michael" sort="Dohnt, Michael" uniqKey="Dohnt M" first="Michael" last="Dohnt">Michael Dohnt</name>
<affiliation wicri:level="1"><nlm:aff id="aff9">WHO/FAO/OIE Collaborating Centre for Leptospirosis Reference and Research, Queensland, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>WHO/FAO/OIE Collaborating Centre for Leptospirosis Reference and Research, Queensland</wicri:regionArea>
<wicri:noRegion>Queensland</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff10">School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>School of Biomedical Sciences, Queensland University of Technology, Queensland</wicri:regionArea>
<wicri:noRegion>Queensland</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Phonekeo, Darouny" sort="Phonekeo, Darouny" uniqKey="Phonekeo D" first="Darouny" last="Phonekeo">Darouny Phonekeo</name>
<affiliation wicri:level="1"><nlm:aff id="aff11">National Centre for Laboratory and Epidemiology, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>National Centre for Laboratory and Epidemiology, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Hongvanthong, Bouasy" sort="Hongvanthong, Bouasy" uniqKey="Hongvanthong B" first="Bouasy" last="Hongvanthong">Bouasy Hongvanthong</name>
<affiliation wicri:level="1"><nlm:aff id="aff12">Centre for Malariology, Parasitology, and Entomology, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Centre for Malariology, Parasitology, and Entomology, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Xayadeth, Sinakhone" sort="Xayadeth, Sinakhone" uniqKey="Xayadeth S" first="Sinakhone" last="Xayadeth">Sinakhone Xayadeth</name>
<affiliation wicri:level="1"><nlm:aff id="aff11">National Centre for Laboratory and Epidemiology, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>National Centre for Laboratory and Epidemiology, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ketmayoon, Pakapak" sort="Ketmayoon, Pakapak" uniqKey="Ketmayoon P" first="Pakapak" last="Ketmayoon">Pakapak Ketmayoon</name>
<affiliation wicri:level="1"><nlm:aff id="aff13">WHO, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>WHO, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</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 wicri:level="4"><nlm:aff id="aff3">Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford</wicri:regionArea>
<placeName><settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
<settlement type="city">Oxford</settlement>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
<affiliation><nlm:aff id="aff5">Mahidol–Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok</nlm:aff>
<wicri:noCountry code="subfield">Bangkok</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Moore, Catrin E" sort="Moore, Catrin E" uniqKey="Moore C" first="Catrin E" last="Moore">Catrin E. Moore</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="aff3">Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford</wicri:regionArea>
<placeName><settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
<settlement type="city">Oxford</settlement>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
</author>
<author><name sortKey="Craig, Scott B" sort="Craig, Scott B" uniqKey="Craig S" first="Scott B" last="Craig">Scott B. Craig</name>
<affiliation wicri:level="1"><nlm:aff id="aff9">WHO/FAO/OIE Collaborating Centre for Leptospirosis Reference and Research, Queensland, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>WHO/FAO/OIE Collaborating Centre for Leptospirosis Reference and Research, Queensland</wicri:regionArea>
<wicri:noRegion>Queensland</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff10">School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>School of Biomedical Sciences, Queensland University of Technology, Queensland</wicri:regionArea>
<wicri:noRegion>Queensland</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Burns, Mary Anne" sort="Burns, Mary Anne" uniqKey="Burns M" first="Mary-Anne" last="Burns">Mary-Anne Burns</name>
<affiliation wicri:level="1"><nlm:aff id="aff9">WHO/FAO/OIE Collaborating Centre for Leptospirosis Reference and Research, Queensland, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>WHO/FAO/OIE Collaborating Centre for Leptospirosis Reference and Research, Queensland</wicri:regionArea>
<wicri:noRegion>Queensland</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff10">School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>School of Biomedical Sciences, Queensland University of Technology, Queensland</wicri:regionArea>
<wicri:noRegion>Queensland</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Von Sonnenburg, Frank" sort="Von Sonnenburg, Frank" uniqKey="Von Sonnenburg F" first="Frank" last="Von Sonnenburg">Frank Von Sonnenburg</name>
<affiliation wicri:level="4"><nlm:aff id="aff14">Department of Infectious Diseases and Tropical Medicine, University of Munich, Munich, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Infectious Diseases and Tropical Medicine, University of Munich, Munich</wicri:regionArea>
<placeName><region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
<settlement type="city">Munich</settlement>
<settlement type="city">Munich</settlement>
</placeName>
<orgName type="university">Université Louis-et-Maximilien de Munich</orgName>
</affiliation>
</author>
<author><name sortKey="Corwin, Andrew" sort="Corwin, Andrew" uniqKey="Corwin A" first="Andrew" last="Corwin">Andrew Corwin</name>
<affiliation wicri:level="1"><nlm:aff id="aff15">Centers for Disease Control and Prevention, US Embassy, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Centers for Disease Control and Prevention, US Embassy, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="De Lamballerie, Xavier" sort="De Lamballerie, Xavier" uniqKey="De Lamballerie X" first="Xavier" last="De Lamballerie">Xavier De Lamballerie</name>
<affiliation wicri:level="3"><nlm:aff id="aff4">UMR_D 190 “Emergence des Pathologies Virales”, Aix-Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>UMR_D 190 “Emergence des Pathologies Virales”, Aix-Marseille University, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille</wicri:regionArea>
<placeName><region type="region">Provence-Alpes-Côte d'Azur</region>
<region type="old region">Provence-Alpes-Côte d'Azur</region>
<settlement type="city">Marseille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Gonzalez, Iveth J" sort="Gonzalez, Iveth J" uniqKey="Gonzalez I" first="Iveth J" last="González">Iveth J. González</name>
<affiliation wicri:level="1"><nlm:aff id="aff16">Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Foundation for Innovative New Diagnostics (FIND), Geneva</wicri:regionArea>
<wicri:noRegion>Geneva</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Christophel, Eva Maria" sort="Christophel, Eva Maria" uniqKey="Christophel E" first="Eva Maria" last="Christophel">Eva Maria Christophel</name>
<affiliation wicri:level="1"><nlm:aff id="aff17">WHO–Regional Office for the Western Pacific, Manila, Philippines</nlm:aff>
<country xml:lang="fr">Philippines</country>
<wicri:regionArea>WHO–Regional Office for the Western Pacific, Manila</wicri:regionArea>
<wicri:noRegion>Manila</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Cawthorne, Amy" sort="Cawthorne, Amy" uniqKey="Cawthorne A" first="Amy" last="Cawthorne">Amy Cawthorne</name>
<affiliation wicri:level="1"><nlm:aff id="aff17">WHO–Regional Office for the Western Pacific, Manila, Philippines</nlm:aff>
<country xml:lang="fr">Philippines</country>
<wicri:regionArea>WHO–Regional Office for the Western Pacific, Manila</wicri:regionArea>
<wicri:noRegion>Manila</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bell, David" sort="Bell, David" uniqKey="Bell D" first="David" last="Bell">David Bell</name>
<affiliation wicri:level="1"><nlm:aff id="aff16">Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Foundation for Innovative New Diagnostics (FIND), Geneva</wicri:regionArea>
<wicri:noRegion>Geneva</wicri:noRegion>
</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 wicri:level="1"><nlm:aff id="aff1">Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos</nlm:aff>
<country xml:lang="fr">Laos</country>
<wicri:regionArea>Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane</wicri:regionArea>
<wicri:noRegion>Vientiane</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="aff3">Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford</wicri:regionArea>
<placeName><settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
<settlement type="city">Oxford</settlement>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
</author>
</analytic>
<series><title level="j">The Lancet Global Health</title>
<idno type="eISSN">2214-109X</idno>
<imprint><date when="2013">2013</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
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<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><title>Summary</title>
<sec><title>Background</title>
<p>Because of reductions in the incidence of <italic>Plasmodium falciparum</italic>
 malaria in Laos, identification of the causes of fever in people without malaria, and discussion of the best empirical treatment options, are urgently needed. We aimed to identify the causes of non-malarial acute fever in patients in rural Laos.</p>
</sec>
<sec><title>Methods</title>
<p>For this prospective study, we recruited 1938 febrile patients, between May, 2008, and December, 2010, at Luang Namtha provincial hospital in northwest Laos (n=1390), and between September, 2008, and December, 2010, at Salavan provincial hospital in southern Laos (n=548). Eligible participants were aged 5–49 years with fever (≥38°C) lasting 8 days or less and were eligible for malaria testing by national guidelines.</p>
</sec>
<sec><title>Findings</title>
<p>With conservative definitions of cause, we assigned 799 (41%) patients a diagnosis. With exclusion of influenza, the top five diagnoses when only one aetiological agent per patient was identified were dengue (156 [8%] of 1927 patients), scrub typhus (122 [7%] of 1871), Japanese encephalitis virus (112 [6%] of 1924), leptospirosis (109 [6%] of 1934), and bacteraemia (43 [2%] of 1938). 115 (32%) of 358 patients at Luang Namtha hospital tested influenza PCR-positive between June and December, 2010, of which influenza B was the most frequently detected strain (n=121 [87%]). Disease frequency differed significantly between the two sites: Japanese encephalitis virus infection (p=0·04), typhoid (p=0·006), and leptospirosis (p=0·001) were more common at Luang Namtha, whereas dengue and malaria were more common at Salavan (all p<0·0001). With use of evidence from southeast Asia when possible, we estimated that azithromycin, doxycycline, ceftriaxone, and ofloxacin would have had significant efficacy for 258 (13%), 240 (12%), 154 (8%), and 41 (2%) of patients, respectively.</p>
</sec>
<sec><title>Interpretation</title>
<p>Our findings suggest that a wide range of treatable or preventable pathogens are implicated in non-malarial febrile illness in Laos. Empirical treatment with doxycycline for patients with undifferentiated fever and negative rapid diagnostic tests for malaria and dengue could be an appropriate strategy for rural health workers in Laos.</p>
</sec>
<sec><title>Funding</title>
<p>Wellcome Trust, WHO–Western Pacific Region, Foundation for Innovative New Diagnostics, US Centers for Disease Control and Prevention.</p>
</sec>
</div>
</front>
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</analytic>
</biblStruct>
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<li>Australie</li>
<li>France</li>
<li>Laos</li>
<li>Philippines</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
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<li>Bade-Wurtemberg</li>
<li>Bavière</li>
<li>District de Haute-Bavière</li>
<li>District de Tübingen</li>
<li>Oxfordshire</li>
<li>Provence-Alpes-Côte d'Azur</li>
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<settlement><li>Marseille</li>
<li>Munich</li>
<li>Oxford</li>
<li>Tübingen</li>
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<orgName><li>Université Louis-et-Maximilien de Munich</li>
<li>Université d'Oxford</li>
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<name sortKey="Mayxay, Mayfong" sort="Mayxay, Mayfong" uniqKey="Mayxay M" first="Mayfong" last="Mayxay">Mayfong Mayxay</name>
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<name sortKey="Phommasone, Koukeo" sort="Phommasone, Koukeo" uniqKey="Phommasone K" first="Koukeo" last="Phommasone">Koukeo Phommasone</name>
<name sortKey="Phonekeo, Darouny" sort="Phonekeo, Darouny" uniqKey="Phonekeo D" first="Darouny" last="Phonekeo">Darouny Phonekeo</name>
<name sortKey="Sibounheuang, Bountoy" sort="Sibounheuang, Bountoy" uniqKey="Sibounheuang B" first="Bountoy" last="Sibounheuang">Bountoy Sibounheuang</name>
<name sortKey="Souvannasing, Phoutthalavanh" sort="Souvannasing, Phoutthalavanh" uniqKey="Souvannasing P" first="Phoutthalavanh" last="Souvannasing">Phoutthalavanh Souvannasing</name>
<name sortKey="Xayadeth, Sinakhone" sort="Xayadeth, Sinakhone" uniqKey="Xayadeth S" first="Sinakhone" last="Xayadeth">Sinakhone Xayadeth</name>
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<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Mayxay, Mayfong" sort="Mayxay, Mayfong" uniqKey="Mayxay M" first="Mayfong" last="Mayxay">Mayfong Mayxay</name>
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<name sortKey="Blacksell, Stuart D" sort="Blacksell, Stuart D" uniqKey="Blacksell S" first="Stuart D" last="Blacksell">Stuart D. Blacksell</name>
<name sortKey="Dubot Peres, Audrey" sort="Dubot Peres, Audrey" uniqKey="Dubot Peres A" first="Audrey" last="Dubot-Pérès">Audrey Dubot-Pérès</name>
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<name sortKey="Phetsouvanh, Rattanaphone" sort="Phetsouvanh, Rattanaphone" uniqKey="Phetsouvanh R" first="Rattanaphone" last="Phetsouvanh">Rattanaphone Phetsouvanh</name>
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<country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Dubot Peres, Audrey" sort="Dubot Peres, Audrey" uniqKey="Dubot Peres A" first="Audrey" last="Dubot-Pérès">Audrey Dubot-Pérès</name>
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<name sortKey="De Lamballerie, Xavier" sort="De Lamballerie, Xavier" uniqKey="De Lamballerie X" first="Xavier" last="De Lamballerie">Xavier De Lamballerie</name>
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<name sortKey="Burns, Mary Anne" sort="Burns, Mary Anne" uniqKey="Burns M" first="Mary-Anne" last="Burns">Mary-Anne Burns</name>
<name sortKey="Craig, Scott B" sort="Craig, Scott B" uniqKey="Craig S" first="Scott B" last="Craig">Scott B. Craig</name>
<name sortKey="Craig, Scott B" sort="Craig, Scott B" uniqKey="Craig S" first="Scott B" last="Craig">Scott B. Craig</name>
<name sortKey="Dohnt, Michael" sort="Dohnt, Michael" uniqKey="Dohnt M" first="Michael" last="Dohnt">Michael Dohnt</name>
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<country name="Suisse"><noRegion><name sortKey="Gonzalez, Iveth J" sort="Gonzalez, Iveth J" uniqKey="Gonzalez I" first="Iveth J" last="González">Iveth J. González</name>
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<name sortKey="Bell, David" sort="Bell, David" uniqKey="Bell D" first="David" last="Bell">David Bell</name>
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<country name="Philippines"><noRegion><name sortKey="Christophel, Eva Maria" sort="Christophel, Eva Maria" uniqKey="Christophel E" first="Eva Maria" last="Christophel">Eva Maria Christophel</name>
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<name sortKey="Cawthorne, Amy" sort="Cawthorne, Amy" uniqKey="Cawthorne A" first="Amy" last="Cawthorne">Amy Cawthorne</name>
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</record>

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Serveur d'exploration sur les relations entre la France et l'Australie

Causes of non-malarial fever in Laos: a prospective study

Causes of non-malarial fever in Laos: a prospective study

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	Serveur d'exploration sur les relations entre la France et l'Australie
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