Challenges in diagnosing scrub typhus among hospitalized patients with undifferentiated fever at a national tertiary hospital in northern Vietnam
Scrub typhus (ST) is a leading cause of non-malarial febrile illness in Southeast Asia, but evidence of its true disease burden is limited because of difficulties of making the clinical diagnosis and lack of adequate diagnostic tests. To describe the epidemiology and clinical characteristics of ST,...
Gespeichert in:
| Veröffentlicht in: | PLoS neglected tropical diseases Jg. 13; H. 12; S. e0007928 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
United States
Public Library of Science
01.12.2019
Public Library of Science (PLoS) |
| Schlagworte: | |
| ISSN: | 1935-2735, 1935-2727, 1935-2735 |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| Abstract | Scrub typhus (ST) is a leading cause of non-malarial febrile illness in Southeast Asia, but evidence of its true disease burden is limited because of difficulties of making the clinical diagnosis and lack of adequate diagnostic tests. To describe the epidemiology and clinical characteristics of ST, we conducted an observational study using multiple diagnostic assays at a national tertiary hospital in Hanoi, Vietnam.
We enrolled 1,127 patients hospitalized with documented fever between June 2012 and May 2013. Overall, 33 (2.9%) patients were diagnosed with ST by PCR and/or screening of ELISA for immunoglobulin M (IgM) with confirmatory tests: 14 (42.4%) were confirmed by indirect immunoperoxidase assay (IIP), and 19 (57.6%) were by IIP and PCR. Living by farming, conjunctival injection, eschar, aspartate aminotransferase elevation, and alanine aminotransferase elevation were significantly associated with ST cases (adjusted odds ratios (aORs): 2.8, 3.07, 48.8, 3.51, and 4.13, respectively), and having a comorbidity and neutrophilia were significantly less common in ST cases (aORs: 0.29 and 0.27, respectively). The majority of the ST cases were not clinically diagnosed with rickettsiosis (72.7%). Dominant IIP reactions against a single antigen were identified in 15 ST cases, whereas indistinguishably high reactions against multiple antigens were seen in 11 ST cases. The most frequently observed dominant IIP reaction was against Karp antigen (eight cases) followed by Gilliam (four cases). The highest diagnostic accuracy of IgM ELISA in acute samples was 78%. In a phylogenetic analysis of the 56-kDa type-specific antigen gene, the majority (14 cases) were located in the Karp-related branch followed by the Gilliam-related (two cases), Kato-related (two cases), and TA763-related clades (one case).
Both the clinical and laboratory diagnoses of ST remain challenging at a tertiary hospital. Implementation of both serological and nucleic acid amplification assays covering endemic O. tsutsugamushi strains is essential. |
|---|---|
| AbstractList | Scrub typhus (ST) is a leading cause of non-malarial febrile illness in Southeast Asia, but evidence of its true disease burden is limited because of difficulties of making the clinical diagnosis and lack of adequate diagnostic tests. To describe the epidemiology and clinical characteristics of ST, we conducted an observational study using multiple diagnostic assays at a national tertiary hospital in Hanoi, Vietnam.
We enrolled 1,127 patients hospitalized with documented fever between June 2012 and May 2013. Overall, 33 (2.9%) patients were diagnosed with ST by PCR and/or screening of ELISA for immunoglobulin M (IgM) with confirmatory tests: 14 (42.4%) were confirmed by indirect immunoperoxidase assay (IIP), and 19 (57.6%) were by IIP and PCR. Living by farming, conjunctival injection, eschar, aspartate aminotransferase elevation, and alanine aminotransferase elevation were significantly associated with ST cases (adjusted odds ratios (aORs): 2.8, 3.07, 48.8, 3.51, and 4.13, respectively), and having a comorbidity and neutrophilia were significantly less common in ST cases (aORs: 0.29 and 0.27, respectively). The majority of the ST cases were not clinically diagnosed with rickettsiosis (72.7%). Dominant IIP reactions against a single antigen were identified in 15 ST cases, whereas indistinguishably high reactions against multiple antigens were seen in 11 ST cases. The most frequently observed dominant IIP reaction was against Karp antigen (eight cases) followed by Gilliam (four cases). The highest diagnostic accuracy of IgM ELISA in acute samples was 78%. In a phylogenetic analysis of the 56-kDa type-specific antigen gene, the majority (14 cases) were located in the Karp-related branch followed by the Gilliam-related (two cases), Kato-related (two cases), and TA763-related clades (one case).
Both the clinical and laboratory diagnoses of ST remain challenging at a tertiary hospital. Implementation of both serological and nucleic acid amplification assays covering endemic O. tsutsugamushi strains is essential. Scrub typhus (ST) is a leading cause of non-malarial febrile illness in Southeast Asia, but evidence of its true disease burden is limited because of difficulties of making the clinical diagnosis and lack of adequate diagnostic tests. To describe the epidemiology and clinical characteristics of ST, we conducted an observational study using multiple diagnostic assays at a national tertiary hospital in Hanoi, Vietnam.BACKGROUNDScrub typhus (ST) is a leading cause of non-malarial febrile illness in Southeast Asia, but evidence of its true disease burden is limited because of difficulties of making the clinical diagnosis and lack of adequate diagnostic tests. To describe the epidemiology and clinical characteristics of ST, we conducted an observational study using multiple diagnostic assays at a national tertiary hospital in Hanoi, Vietnam.We enrolled 1,127 patients hospitalized with documented fever between June 2012 and May 2013. Overall, 33 (2.9%) patients were diagnosed with ST by PCR and/or screening of ELISA for immunoglobulin M (IgM) with confirmatory tests: 14 (42.4%) were confirmed by indirect immunoperoxidase assay (IIP), and 19 (57.6%) were by IIP and PCR. Living by farming, conjunctival injection, eschar, aspartate aminotransferase elevation, and alanine aminotransferase elevation were significantly associated with ST cases (adjusted odds ratios (aORs): 2.8, 3.07, 48.8, 3.51, and 4.13, respectively), and having a comorbidity and neutrophilia were significantly less common in ST cases (aORs: 0.29 and 0.27, respectively). The majority of the ST cases were not clinically diagnosed with rickettsiosis (72.7%). Dominant IIP reactions against a single antigen were identified in 15 ST cases, whereas indistinguishably high reactions against multiple antigens were seen in 11 ST cases. The most frequently observed dominant IIP reaction was against Karp antigen (eight cases) followed by Gilliam (four cases). The highest diagnostic accuracy of IgM ELISA in acute samples was 78%. In a phylogenetic analysis of the 56-kDa type-specific antigen gene, the majority (14 cases) were located in the Karp-related branch followed by the Gilliam-related (two cases), Kato-related (two cases), and TA763-related clades (one case).METHODOLOGY/PRINCIPAL FINDINGSWe enrolled 1,127 patients hospitalized with documented fever between June 2012 and May 2013. Overall, 33 (2.9%) patients were diagnosed with ST by PCR and/or screening of ELISA for immunoglobulin M (IgM) with confirmatory tests: 14 (42.4%) were confirmed by indirect immunoperoxidase assay (IIP), and 19 (57.6%) were by IIP and PCR. Living by farming, conjunctival injection, eschar, aspartate aminotransferase elevation, and alanine aminotransferase elevation were significantly associated with ST cases (adjusted odds ratios (aORs): 2.8, 3.07, 48.8, 3.51, and 4.13, respectively), and having a comorbidity and neutrophilia were significantly less common in ST cases (aORs: 0.29 and 0.27, respectively). The majority of the ST cases were not clinically diagnosed with rickettsiosis (72.7%). Dominant IIP reactions against a single antigen were identified in 15 ST cases, whereas indistinguishably high reactions against multiple antigens were seen in 11 ST cases. The most frequently observed dominant IIP reaction was against Karp antigen (eight cases) followed by Gilliam (four cases). The highest diagnostic accuracy of IgM ELISA in acute samples was 78%. In a phylogenetic analysis of the 56-kDa type-specific antigen gene, the majority (14 cases) were located in the Karp-related branch followed by the Gilliam-related (two cases), Kato-related (two cases), and TA763-related clades (one case).Both the clinical and laboratory diagnoses of ST remain challenging at a tertiary hospital. Implementation of both serological and nucleic acid amplification assays covering endemic O. tsutsugamushi strains is essential.CONCLUSIONS/SIGNIFICANCEBoth the clinical and laboratory diagnoses of ST remain challenging at a tertiary hospital. Implementation of both serological and nucleic acid amplification assays covering endemic O. tsutsugamushi strains is essential. BackgroundScrub typhus (ST) is a leading cause of non-malarial febrile illness in Southeast Asia, but evidence of its true disease burden is limited because of difficulties of making the clinical diagnosis and lack of adequate diagnostic tests. To describe the epidemiology and clinical characteristics of ST, we conducted an observational study using multiple diagnostic assays at a national tertiary hospital in Hanoi, Vietnam.Methodology/principal findingsWe enrolled 1,127 patients hospitalized with documented fever between June 2012 and May 2013. Overall, 33 (2.9%) patients were diagnosed with ST by PCR and/or screening of ELISA for immunoglobulin M (IgM) with confirmatory tests: 14 (42.4%) were confirmed by indirect immunoperoxidase assay (IIP), and 19 (57.6%) were by IIP and PCR. Living by farming, conjunctival injection, eschar, aspartate aminotransferase elevation, and alanine aminotransferase elevation were significantly associated with ST cases (adjusted odds ratios (aORs): 2.8, 3.07, 48.8, 3.51, and 4.13, respectively), and having a comorbidity and neutrophilia were significantly less common in ST cases (aORs: 0.29 and 0.27, respectively). The majority of the ST cases were not clinically diagnosed with rickettsiosis (72.7%). Dominant IIP reactions against a single antigen were identified in 15 ST cases, whereas indistinguishably high reactions against multiple antigens were seen in 11 ST cases. The most frequently observed dominant IIP reaction was against Karp antigen (eight cases) followed by Gilliam (four cases). The highest diagnostic accuracy of IgM ELISA in acute samples was 78%. In a phylogenetic analysis of the 56-kDa type-specific antigen gene, the majority (14 cases) were located in the Karp-related branch followed by the Gilliam-related (two cases), Kato-related (two cases), and TA763-related clades (one case).Conclusions/significanceBoth the clinical and laboratory diagnoses of ST remain challenging at a tertiary hospital. Implementation of both serological and nucleic acid amplification assays covering endemic O. tsutsugamushi strains is essential. Acute fever without localized signs is a common presentation of communicable neglected tropical diseases (NTDs). Scrub typhus, a potentially severe chigger-borne intracellular bacterial infection, is also an important differential diagnosis of acute febrile NTDs, which is endemic particularly in Asia. In Vietnam, the proportion of scrub typhus cases among patients with acute fever is currently unknown even in a tertiary hospital, because both clinical and laboratory diagnoses of scrub typhus are challenging. In this study, we enrolled acute fever patients hospitalized in the department of infectious diseases at a national tertiary hospital in Hanoi through a year. Scrub typhus was diagnosed using serological and PCR assays in 2.9% of enrolled patients. We found that the characteristics of scrub typhus patients were generally non-specific and most cases were missed based on clinical diagnosis alone. We also found that currently available serological assays were sub-optimal in Vietnam by comparing multiple diagnostic assays. Since the diagnostic antigens were not originally from Vietnam, the serological findings may underrepresent the actual number of cases. The presented data underlines the importance of a preemptive treatment strategy for scrub typhus among acute fever patients and adaptation of diagnostic assays to cover endemic strains. |
| Author | Anh, Le Kim Anh, Nguyen Thi Hien Fujita, Hiromi Katoh, Shungo Hamaguchi, Sugihiro Paris, Daniel Henry Suzuki, Motoi Cuong, Do Duy Yasunami, Michio Cuong, Ngo Chi Thuy, Pham Thanh Yoshihara, Keisuke Anh, Dang Duc Yoshida, Lay-Myint Sando, Eiichiro Ariyoshi, Koya |
| AuthorAffiliation | Uniformed Services University of the Health Sciences, UNITED STATES 12 Saga-Ken Medical Centre Koseikan, Saga, Japan 1 Department of Clinical Medicine, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan 10 School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan 15 Faculty of Medicine, University of Basel, Basel, Switzerland 8 National Institute of Hygiene and Epidemiology, Hanoi, Vietnam 9 Department of General Internal Medicine, Kameda Medical Center, Chiba, Japan 6 The Partnership for Health Advancement in Vietnam (HAIVN), Hanoi, Vietnam 14 Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland 4 Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam 7 Vietnam Research Station, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Hanoi, Vietnam 13 Department of Paediatric Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan 5 Department of Ge |
| AuthorAffiliation_xml | – name: 1 Department of Clinical Medicine, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan – name: 8 National Institute of Hygiene and Epidemiology, Hanoi, Vietnam – name: 11 Mahara Institute of Medical Acarology, Tokushima, Japan – name: 6 The Partnership for Health Advancement in Vietnam (HAIVN), Hanoi, Vietnam – name: 3 Department of General Internal Medicine, Nagasaki Rosai Hospital, Nagasaki, Japan – name: 15 Faculty of Medicine, University of Basel, Basel, Switzerland – name: 5 Department of General Internal Medicine, Fukushima Medical University, Fukushima, Japan – name: 14 Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland – name: Uniformed Services University of the Health Sciences, UNITED STATES – name: 9 Department of General Internal Medicine, Kameda Medical Center, Chiba, Japan – name: 12 Saga-Ken Medical Centre Koseikan, Saga, Japan – name: 4 Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam – name: 13 Department of Paediatric Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan – name: 2 Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan – name: 7 Vietnam Research Station, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Hanoi, Vietnam – name: 10 School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan |
| Author_xml | – sequence: 1 givenname: Shungo surname: Katoh fullname: Katoh, Shungo – sequence: 2 givenname: Ngo Chi surname: Cuong fullname: Cuong, Ngo Chi – sequence: 3 givenname: Sugihiro orcidid: 0000-0001-9926-8098 surname: Hamaguchi fullname: Hamaguchi, Sugihiro – sequence: 4 givenname: Pham Thanh surname: Thuy fullname: Thuy, Pham Thanh – sequence: 5 givenname: Do Duy surname: Cuong fullname: Cuong, Do Duy – sequence: 6 givenname: Le Kim surname: Anh fullname: Anh, Le Kim – sequence: 7 givenname: Nguyen Thi Hien surname: Anh fullname: Anh, Nguyen Thi Hien – sequence: 8 givenname: Dang Duc surname: Anh fullname: Anh, Dang Duc – sequence: 9 givenname: Eiichiro surname: Sando fullname: Sando, Eiichiro – sequence: 10 givenname: Motoi surname: Suzuki fullname: Suzuki, Motoi – sequence: 11 givenname: Hiromi surname: Fujita fullname: Fujita, Hiromi – sequence: 12 givenname: Michio surname: Yasunami fullname: Yasunami, Michio – sequence: 13 givenname: Keisuke orcidid: 0000-0001-9567-6764 surname: Yoshihara fullname: Yoshihara, Keisuke – sequence: 14 givenname: Lay-Myint orcidid: 0000-0002-7567-3248 surname: Yoshida fullname: Yoshida, Lay-Myint – sequence: 15 givenname: Daniel Henry orcidid: 0000-0003-4743-5987 surname: Paris fullname: Paris, Daniel Henry – sequence: 16 givenname: Koya orcidid: 0000-0002-1468-5296 surname: Ariyoshi fullname: Ariyoshi, Koya |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31805053$$D View this record in MEDLINE/PubMed |
| BookMark | eNp9Uk1v1DAQjVAR_YB_gJCPXHbxR7xOOCChFYVKlbgAV2tiTzZeZe1gO0XlX_CP62W3VcuBi23NvHlvZvzOqxMfPFbVa0aXTCj2bhvm6GFcTj7bJaVUtbx5Vp2xVsgFV0KePHqfVucpbSmVrWzYi-pUsIZKKsVZ9Wc9wDii32AizhPrYONDcn5DkolzR_LtNMyJwC6U0BDS5DKM7jdaMkF26HMiv1weyOyt63uMJeIgl3SPNxgJZALEF2QorZKMsWTj7QPRXtKHmAeMnvxwmD3sXlbPexgTvjreF9X3y0_f1l8W118_X60_Xi-MZE1eNBwEyBY4L2NJWHU1V01vTS95g70ysqY1SrC8rk1ft2A6sxKmbVnXQsOFERfV1YHXBtjqKbpd6UwHcPpvIMSNhtKuGVFLUyuFtbSmLSdnUIPk2K1WwjLGlC1cHw5c09zt0JqyhQjjE9KnGe8GvQk3etUyxVtaCN4eCWL4OWPKeueSwXEEj2FOmgvOFVdlqAJ981jrQeT-Twvg_QFgYkgpYq9N2fX-C4q0GzWjem8gfTSQ3htIHw1Uiut_iu_5_1t2B1IQ074 |
| CitedBy_id | crossref_primary_10_3390_pathogens13090736 crossref_primary_10_1371_journal_pntd_0008937 crossref_primary_10_1186_s41182_024_00635_y crossref_primary_10_1371_journal_pntd_0009858 crossref_primary_10_1371_journal_pntd_0010281 crossref_primary_10_1186_s40249_021_00893_6 crossref_primary_10_3390_tropicalmed7060088 crossref_primary_10_1093_ofid_ofae215 crossref_primary_10_1128_JCM_01802_19 crossref_primary_10_3390_tropicalmed7020018 crossref_primary_10_1093_jme_tjae064 |
| Cites_doi | 10.3390/tropicalmed3030095 10.1007/BF02101694 10.7326/0003-4819-79-1-26 10.1371/journal.pone.0044269 10.4269/ajtmh.2010.09-0233 10.1093/trstmh/tru145 10.4269/ajtmh.14-0806 10.1371/journal.pntd.0005838 10.1093/molbev/mst197 10.1371/journal.pone.0114930 10.1371/journal.pntd.0007158 10.1128/CVI.00553-15 10.1093/trstmh/trx022 10.3390/tropicalmed3030074 10.1128/IAI.58.7.2076-2084.1990 10.1016/j.meegid.2011.01.004 10.4269/ajtmh.1973.22.796 10.1371/journal.pntd.0000909 10.1128/JCM.00997-08 10.4269/ajtmh.2004.70.351 10.1128/JCM.31.6.1637-1640.1993 10.1371/journal.pntd.0005397 10.1089/vbz.2012.1112 |
| ContentType | Journal Article |
| Copyright | 2019 Katoh et al 2019 Katoh et al |
| Copyright_xml | – notice: 2019 Katoh et al 2019 Katoh et al |
| DBID | AAYXX CITATION CGR CUY CVF ECM EIF NPM 7X8 5PM DOA |
| DOI | 10.1371/journal.pntd.0007928 |
| DatabaseName | CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic PubMed Central (Full Participant titles) DOAJ Directory of Open Access Journals |
| DatabaseTitle | CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website – sequence: 2 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 3 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| DocumentTitleAlternate | Scrub typhus among patients with undifferentiated fever |
| EISSN | 1935-2735 |
| ExternalDocumentID | oai_doaj_org_article_5c477e45dc9e4521a4a52eb663d1117d PMC6917290 31805053 10_1371_journal_pntd_0007928 |
| Genre | Research Support, Non-U.S. Gov't Journal Article Observational Study |
| GeographicLocations | Vietnam |
| GeographicLocations_xml | – name: Vietnam |
| GroupedDBID | --- 123 29O 2WC 53G 5VS 7X7 88E 8C1 8FI 8FJ AAFWJ AAUCC AAWOE AAYXX ABDBF ABUWG ACCTH ACGFO ACIHN ACPRK ACUHS ADBBV AEAQA AENEX AEUYN AFFHD AFKRA AFPKN AFRAH AHMBA ALMA_UNASSIGNED_HOLDINGS AOIJS BAIFH BAWUL BBTPI BCNDV BENPR BPHCQ BVXVI BWKFM CCPQU CITATION CS3 DIK DU5 E3Z EAP EAS EBD ECGQY EMOBN ESX F5P FPL FYUFA GROUPED_DOAJ GX1 HMCUK HYE IAO IHR IHW ITC KQ8 M1P M48 O5R O5S OK1 OVT P2P PGMZT PHGZM PHGZT PIMPY PJZUB PPXIY PQQKQ PROAC PSQYO PV9 RNS RPM RZL SV3 TR2 TUS UKHRP 3V. ADRAZ ALIPV CGR CUY CVF ECM EIF H13 IPNFZ M~E NPM RIG WOQ 7X8 PUEGO 5PM |
| ID | FETCH-LOGICAL-c518t-82a3a59a220055a6b4278fdcf528ef7c5404e5ad244cf49acbc63c991b9a823c3 |
| IEDL.DBID | DOA |
| ISICitedReferencesCount | 13 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000559317800046&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1935-2735 1935-2727 |
| IngestDate | Fri Oct 03 12:52:40 EDT 2025 Tue Nov 04 02:01:12 EST 2025 Thu Oct 02 05:55:46 EDT 2025 Wed Feb 19 02:31:33 EST 2025 Tue Nov 18 21:29:08 EST 2025 Sat Nov 29 06:02:29 EST 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 12 |
| Language | English |
| License | This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c518t-82a3a59a220055a6b4278fdcf528ef7c5404e5ad244cf49acbc63c991b9a823c3 |
| Notes | new_version ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 The authors have declared that no competing interests exist. |
| ORCID | 0000-0002-7567-3248 0000-0001-9567-6764 0000-0003-4743-5987 0000-0002-1468-5296 0000-0001-9926-8098 |
| OpenAccessLink | https://doaj.org/article/5c477e45dc9e4521a4a52eb663d1117d |
| PMID | 31805053 |
| PQID | 2322727540 |
| PQPubID | 23479 |
| ParticipantIDs | doaj_primary_oai_doaj_org_article_5c477e45dc9e4521a4a52eb663d1117d pubmedcentral_primary_oai_pubmedcentral_nih_gov_6917290 proquest_miscellaneous_2322727540 pubmed_primary_31805053 crossref_citationtrail_10_1371_journal_pntd_0007928 crossref_primary_10_1371_journal_pntd_0007928 |
| PublicationCentury | 2000 |
| PublicationDate | 2019-12-01 |
| PublicationDateYYYYMMDD | 2019-12-01 |
| PublicationDate_xml | – month: 12 year: 2019 text: 2019-12-01 day: 01 |
| PublicationDecade | 2010 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States – name: San Francisco, CA USA |
| PublicationTitle | PLoS neglected tropical diseases |
| PublicationTitleAlternate | PLoS Negl Trop Dis |
| PublicationYear | 2019 |
| Publisher | Public Library of Science Public Library of Science (PLoS) |
| Publisher_xml | – name: Public Library of Science – name: Public Library of Science (PLoS) |
| References | NQ Anh (pntd.0007928.ref023) 2013 J Vallee (pntd.0007928.ref024) 2010; 4 R Core Team (pntd.0007928.ref022) 2019 H Fujita (pntd.0007928.ref014) 2013 SD Blacksell (pntd.0007928.ref010) 2015; 23 K Tamura (pntd.0007928.ref019) 2013; 30 SJ Berman (pntd.0007928.ref003) 1973; 22 C Lim (pntd.0007928.ref011) 2015; 10 M Hasegawa (pntd.0007928.ref021) 1985; 22 K Saraswati (pntd.0007928.ref025) 2019; 13 CK Stover (pntd.0007928.ref029) 1990; 58 K Tamura (pntd.0007928.ref020) 1993; 10 V Duong (pntd.0007928.ref028) 2013; 15 SJ Berman (pntd.0007928.ref008) 1973; 79 J Jiang (pntd.0007928.ref017) 2013; 13 S Blacksell (pntd.0007928.ref026) 2018; 3 HLK Nguyen (pntd.0007928.ref027) 2017; 111 N Le Viet (pntd.0007928.ref006) 2017; 11 J Jiang (pntd.0007928.ref016) 2004; 70 B Nadjm (pntd.0007928.ref004) 2014; 108 Y Furuya (pntd.0007928.ref018) 1993; 31 N Acestor (pntd.0007928.ref001) 2012; 7 E Sando (pntd.0007928.ref015) 2018; 3 S Kramme (pntd.0007928.ref007) 2009; 47 GC Koh (pntd.0007928.ref009) 2010; 82 S Hamaguchi (pntd.0007928.ref005) 2015; 92 A Bonell (pntd.0007928.ref002) 2017; 11 T. Suto (pntd.0007928.ref012) 1991; 35 H Fujita (pntd.0007928.ref013) 2012 |
| References_xml | – volume: 3 start-page: 95 issue: 3 year: 2018 ident: pntd.0007928.ref026 article-title: Diagnostic Accuracy of the InBios Scrub Typhus Detect ELISA for the Detection of IgM Antibodies in Chittagong, Bangladesh publication-title: Tropical Medicine and Infectious Disease doi: 10.3390/tropicalmed3030095 – volume: 22 start-page: 160 issue: 2 year: 1985 ident: pntd.0007928.ref021 article-title: Dating of the human-ape splitting by a molecular clock of mitochondrial DNA publication-title: J Mol Evol doi: 10.1007/BF02101694 – volume: 79 start-page: 26 issue: 1 year: 1973 ident: pntd.0007928.ref008 article-title: Scrub typhus in South Vietnam. A study of 87 cases publication-title: Ann Intern Med doi: 10.7326/0003-4819-79-1-26 – volume: 7 start-page: e44269 issue: 9 year: 2012 ident: pntd.0007928.ref001 article-title: Mapping the aetiology of non-malarial febrile illness in Southeast Asia through a systematic review—terra incognita impairing treatment policies publication-title: PLoS One doi: 10.1371/journal.pone.0044269 – volume: 82 start-page: 368 issue: 3 year: 2010 ident: pntd.0007928.ref009 article-title: Diagnosis of scrub typhus publication-title: Am J Trop Med Hyg doi: 10.4269/ajtmh.2010.09-0233 – volume: 108 start-page: 739 issue: 11 year: 2014 ident: pntd.0007928.ref004 article-title: Scrub typhus in the northern provinces of Vietnam: an observational study of admissions to a national referral hospital publication-title: Trans R Soc Trop Med Hyg doi: 10.1093/trstmh/tru145 – volume: 92 start-page: 972 issue: 5 year: 2015 ident: pntd.0007928.ref005 article-title: Clinical and Epidemiological Characteristics of Scrub Typhus and Murine Typhus among Hospitalized Patients with Acute Undifferentiated Fever in Northern Vietnam publication-title: Am J Trop Med Hyg doi: 10.4269/ajtmh.14-0806 – start-page: 109 volume-title: Diagnostics and Therapeutics for Tick-Borne Bacterial Diseases year: 2013 ident: pntd.0007928.ref014 – volume: 11 start-page: e0005838 issue: 9 year: 2017 ident: pntd.0007928.ref002 article-title: Estimating the burden of scrub typhus: A systematic review publication-title: PLoS Negl Trop Dis doi: 10.1371/journal.pntd.0005838 – start-page: 95 volume-title: Diagnostics and Therapeutics for Tick-Borne Bacterial Diseases year: 2012 ident: pntd.0007928.ref013 – volume: 30 start-page: 2725 issue: 12 year: 2013 ident: pntd.0007928.ref019 article-title: MEGA6: Molecular Evolutionary Genetics Analysis version 6.0 publication-title: Mol Biol Evol doi: 10.1093/molbev/mst197 – volume: 10 start-page: e0114930 issue: 5 year: 2015 ident: pntd.0007928.ref011 article-title: How to Determine the Accuracy of an Alternative Diagnostic Test when It Is Actually Better than the Reference Tests: A Re-Evaluation of Diagnostic Tests for Scrub Typhus Using Bayesian LCMs publication-title: PLoS One doi: 10.1371/journal.pone.0114930 – volume: 13 start-page: e0007158 issue: 2 year: 2019 ident: pntd.0007928.ref025 article-title: The validity of diagnostic cut-offs for commercial and in-house scrub typhus IgM and IgG ELISAs: A review of the evidence publication-title: PLoS Negl Trop Dis doi: 10.1371/journal.pntd.0007158 – volume: 23 start-page: 148 issue: 2 year: 2015 ident: pntd.0007928.ref010 article-title: Diagnostic Accuracy of the InBios Scrub Typhus Detect Enzyme-Linked Immunoassay for the Detection of IgM Antibodies in Northern Thailand publication-title: Clin Vaccine Immunol doi: 10.1128/CVI.00553-15 – volume: 111 start-page: 137 issue: 3 year: 2017 ident: pntd.0007928.ref027 article-title: The genotypes of Orientia tsutsugamushi, identified in scrub typhus patients in northern Vietnam publication-title: Trans R Soc Trop Med Hyg doi: 10.1093/trstmh/trx022 – volume: 3 start-page: 74 issue: 3 year: 2018 ident: pntd.0007928.ref015 article-title: Serological Cross-Reactivity among Orientia tsutsugamushi Serotypes but Not with Rickettsia japonica in Japan publication-title: Trop Med Infect Dis doi: 10.3390/tropicalmed3030074 – volume: 58 start-page: 2076 issue: 7 year: 1990 ident: pntd.0007928.ref029 article-title: The 56-kilodalton major protein antigen of Rickettsia tsutsugamushi: molecular cloning and sequence analysis of the sta56 gene and precise identification of a strain-specific epitope publication-title: Infect Immun doi: 10.1128/IAI.58.7.2076-2084.1990 – volume: 15 start-page: 35 year: 2013 ident: pntd.0007928.ref028 article-title: Molecular epidemiology of Orientia tsutsugamushi in Cambodia and Central Vietnam reveals a broad region-wide genetic diversity publication-title: Infect Genet Evol doi: 10.1016/j.meegid.2011.01.004 – volume: 22 start-page: 796 issue: 6 year: 1973 ident: pntd.0007928.ref003 article-title: Epidemiology of the acute fevers of unknown origin in South Vietnam: effect of laboratory support upon clinical diagnosis publication-title: Am J Trop Med Hyg doi: 10.4269/ajtmh.1973.22.796 – volume: 35 start-page: 580 issue: 6 year: 1991 ident: pntd.0007928.ref012 article-title: A ten years experience on diagnosis of rickettsial diseases using the indirect immunoperoxidase methods publication-title: Acta Virol – volume: 4 start-page: e909 issue: 12 year: 2010 ident: pntd.0007928.ref024 article-title: Contrasting spatial distribution and risk factors for past infection with scrub typhus and murine typhus in Vientiane City, Lao PDR publication-title: PLoS Negl Trop Dis doi: 10.1371/journal.pntd.0000909 – volume: 10 start-page: 512 issue: 3 year: 1993 ident: pntd.0007928.ref020 article-title: Estimation of the number of nucleotide substitutions in the control region of mitochondrial DNA in humans and chimpanzees publication-title: Mol Biol Evol – volume: 47 start-page: 586 issue: 3 year: 2009 ident: pntd.0007928.ref007 article-title: Orientia tsutsugamushi bacteremia and cytokine levels in Vietnamese scrub typhus patients publication-title: J Clin Microbiol doi: 10.1128/JCM.00997-08 – volume-title: R: A language and environment for statistical computing year: 2019 ident: pntd.0007928.ref022 – volume: 70 start-page: 351 issue: 4 year: 2004 ident: pntd.0007928.ref016 article-title: Development of a quantitative real-time polymerase chain reaction assay specific for Orientia tsutsugamushi publication-title: Am J Trop Med Hyg doi: 10.4269/ajtmh.2004.70.351 – volume: 31 start-page: 1637 issue: 6 year: 1993 ident: pntd.0007928.ref018 article-title: Serotype-specific amplification of Rickettsia tsutsugamushi DNA by nested polymerase chain reaction publication-title: J Clin Microbiol doi: 10.1128/JCM.31.6.1637-1640.1993 – start-page: 753 year: 2013 ident: pntd.0007928.ref023 article-title: Bach Mai Hospital Guidelines for diagnosis and treatment of internal medicine [in Vietnamese] publication-title: NXB Y hoc – volume: 11 start-page: e0005397 issue: 2 year: 2017 ident: pntd.0007928.ref006 article-title: Use of eschar swabbing for the molecular diagnosis and genotyping of Orientia tsutsugamushi causing scrub typhus in Quang Nam province, Vietnam publication-title: PLoS Negl Trop Dis doi: 10.1371/journal.pntd.0005397 – volume: 13 start-page: 367 issue: 6 year: 2013 ident: pntd.0007928.ref017 article-title: Diversity of the 47-kD HtrA nucleic acid and translated amino acid sequences from 17 recent human isolates of Orientia publication-title: Vector Borne Zoonotic Dis doi: 10.1089/vbz.2012.1112 |
| SSID | ssj0059581 |
| Score | 2.3369253 |
| Snippet | Scrub typhus (ST) is a leading cause of non-malarial febrile illness in Southeast Asia, but evidence of its true disease burden is limited because of... Acute fever without localized signs is a common presentation of communicable neglected tropical diseases (NTDs). Scrub typhus, a potentially severe... BackgroundScrub typhus (ST) is a leading cause of non-malarial febrile illness in Southeast Asia, but evidence of its true disease burden is limited because of... |
| SourceID | doaj pubmedcentral proquest pubmed crossref |
| SourceType | Open Website Open Access Repository Aggregation Database Index Database Enrichment Source |
| StartPage | e0007928 |
| SubjectTerms | Adolescent Adult Aged Aged, 80 and over Biology and Life Sciences Computer and Information Sciences Diagnostic Tests, Routine - methods Female Fever - diagnosis Fever - etiology Humans Male Medicine and Health Sciences Middle Aged Molecular Diagnostic Techniques - methods People and Places Prospective Studies Research and Analysis Methods Scrub Typhus - diagnosis Scrub Typhus - epidemiology Scrub Typhus - pathology Serologic Tests - methods Tertiary Care Centers Vietnam - epidemiology Young Adult |
| Title | Challenges in diagnosing scrub typhus among hospitalized patients with undifferentiated fever at a national tertiary hospital in northern Vietnam |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/31805053 https://www.proquest.com/docview/2322727540 https://pubmed.ncbi.nlm.nih.gov/PMC6917290 https://doaj.org/article/5c477e45dc9e4521a4a52eb663d1117d |
| Volume | 13 |
| WOSCitedRecordID | wos000559317800046&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVAON databaseName: DOAJ Directory of Open Access Journals customDbUrl: eissn: 1935-2735 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0059581 issn: 1935-2735 databaseCode: DOA dateStart: 20070101 isFulltext: true titleUrlDefault: https://www.doaj.org/ providerName: Directory of Open Access Journals – providerCode: PRVPQU databaseName: Health & Medical Collection customDbUrl: eissn: 1935-2735 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0059581 issn: 1935-2735 databaseCode: 7X7 dateStart: 20071001 isFulltext: true titleUrlDefault: https://search.proquest.com/healthcomplete providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Central customDbUrl: eissn: 1935-2735 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0059581 issn: 1935-2735 databaseCode: BENPR dateStart: 20071001 isFulltext: true titleUrlDefault: https://www.proquest.com/central providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Publicly Available Content Database customDbUrl: eissn: 1935-2735 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0059581 issn: 1935-2735 databaseCode: PIMPY dateStart: 20071001 isFulltext: true titleUrlDefault: http://search.proquest.com/publiccontent providerName: ProQuest – providerCode: PRVPQU databaseName: Public Health Database customDbUrl: eissn: 1935-2735 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0059581 issn: 1935-2735 databaseCode: 8C1 dateStart: 20071001 isFulltext: true titleUrlDefault: https://search.proquest.com/publichealth providerName: ProQuest – providerCode: PRVATS databaseName: Public Library of Science (PLoS) Journals Open Access customDbUrl: eissn: 1935-2735 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0059581 issn: 1935-2735 databaseCode: FPL dateStart: 20070101 isFulltext: true titleUrlDefault: http://www.plos.org/publications/ providerName: Public Library of Science |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1bi9QwFA66ivgi3q2XIYKvdW3aTJpHd9hBYXcoojI-ldzKFDQ7TDvC7r_Yf-w5TTrMiLAvvuShTduQnOR8Jzn9PkLeNU5K8MIybbRWacFznZbcsVQDWjY6U1K4gTL_TCwW5XIpqz2pL8wJC_TAoeOOuSmEcAW3RkLJMlUozpwGR2lhmgqLqy-gnjGYCmswl3yQJwV0gn9cMRF_mstFdhzH6P3a9xbZC4VEJfY9pzRw9_8LcP6dN7nniOYPyYOIIOnH0PJH5Jbzj8m983hG_oRcz0Z9lI62ntqQSwceinYoR0P7y_Vq29FBZYiuomxIe-UsjRyrHcXNWbr1o3gKLAKAS2njwOyp6qmi4xYixYyCVm0udy_CT3o8C3IbT7-3rvfq11PybX76dfYpjcILqeFZ2aclU7niUjHccuJqqlGPo7Gm4ax0jTCA8grHlQVoYJpCKqPNNDeANLVUJctN_owc-QvvXhAK8MQ4wCzKAnJTWpfCwPusERCnQezEEpKPPV-byEqO4hg_6-GoTUB0Erq1xvGq43glJN09tQ6sHDfUP8FB3dVFTu3hAlhaHS2tvsnSEvJ2NIka5iAerCjvLrZdDagUjQy6JSHPg4nsPgVrJooF5gkRB8Zz0JbDO75dDTzfUwilmfzw8n80_hW5D1BPhkSc1-So32zdG3LX_O7bbjMht8VSDGUJZTnLJuTOyemi-jIZphWU8-oMrlWfz6sffwAqOCvl |
| linkProvider | Directory of Open Access Journals |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Challenges+in+diagnosing+scrub+typhus+among+hospitalized+patients+with+undifferentiated+fever+at+a+national+tertiary+hospital+in+northern+Vietnam&rft.jtitle=PLoS+neglected+tropical+diseases&rft.au=Shungo+Katoh&rft.au=Ngo+Chi+Cuong&rft.au=Sugihiro+Hamaguchi&rft.au=Pham+Thanh+Thuy&rft.date=2019-12-01&rft.pub=Public+Library+of+Science+%28PLoS%29&rft.issn=1935-2727&rft.eissn=1935-2735&rft.volume=13&rft.issue=12&rft.spage=e0007928&rft_id=info:doi/10.1371%2Fjournal.pntd.0007928&rft.externalDBID=DOA&rft.externalDocID=oai_doaj_org_article_5c477e45dc9e4521a4a52eb663d1117d |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1935-2735&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1935-2735&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1935-2735&client=summon |