Etiology of Acute, Non-Malaria, Febrile Illnesses in Jayapura, Northeastern Papua, Indonesia

We conducted a prospective, inpatient fever study in malaria-endemic Papua, Indonesia to determine nonmalaria fever etiologies. Investigations included malaria blood films, blood culture, paired serologic samples analysis for dengue, Japanese encephalitis, leptospirosis, scrub typhus, murine typhus,...

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Bibliographic Details
Main Authors: Punjabi, Narain H, Taylor, Walter R, Murphy, Gerald S, Purwaningsih, Sri, Picarima, Helena, Sisson, John, Olson, James G, Baso, Samuel, Wangsasaputra, Ferry, Lesmana, Murad
Format: Report
Language:English
Subjects:
BLOOD CULTURES
BLOOD DISEASES
CHAIN REACTIONS
Ecology
ESCHERICHIA COLI
ETIOLOGY
FEVERS
FOREIGN REPROTS
ILLNESS
INDONESIA
INFECTIOUS DISEASES
JAPANESE ENCEPHALITIS
KLEBSIELLA PNEUMONIAE
LEPTOSPIROSIS
MALARIA
Medicine and Medical Research
MENINGITIS
PATIENTS
PNEUMONIA
REPRINTS
RICKETTSIA
RICKETTSIA RICKETTSII
SALIVA
SALMONELLA TYPHI
SCRUB TYPHUS
SEROLOGY
STAPHYLOCOCCUS AUREUS
STREPTOCOCCUS
STREPTOCOCCUS PYOGENES
TYPHOID
TYPHUS
URINARY SYSTEM
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Summary:We conducted a prospective, inpatient fever study in malaria-endemic Papua, Indonesia to determine nonmalaria fever etiologies. Investigations included malaria blood films, blood culture, paired serologic samples analysis for dengue, Japanese encephalitis, leptospirosis, scrub typhus, murine typhus, and spotted fever group rickettsia. During 1997 2000, 226 patients (127 males and 99 females) 1 80 years of age (median age = 25 years) were enrolled. Positive blood cultures (n = 34, 15%) were obtained for Salmonella Typhi (n = 13), Escherichia coli (n = 8), Streptococcus pneumoniae (n = 6), Staphylococcus aureus (n = 5), Streptococcus pyogenes (n = 1), and Klebsiella pneumoniae (n = 1). Twenty (8.8%) patients were positive for leptospirosis by polymerase chain reaction. Eighty (35.4%) of 226 patients had 1 positive serology, diagnostic for 15 rickettsial and 9 dengue cases. Acid-fast bacilli positive sputum was obtained from three patients. Most common confirmed (81 of 226, 35.8%)/suspected diagnoses were typhoid fever (n = 41), pneumonia (n = 29), leptospirosis (n = 28), urinary tract infections (n = 20), rickettsioses (n = 19), dengue (n = 17), and meningitis/encephalitis (n = 15). There were 17 deaths, 7 (46.7%) were caused by meningitis/encephalitis. Multiple positive serologic results and few confirmed diagnoses indicate the need for improved diagnostics. Pub. in American Journal of Troical Medicine and Hygiene, v86 n1, pp. 46-51, 2012.