PDF(Pubmed)
Abstract：
UNASSIGNED: The study of the etiology of acute febrile illness (AFI) has historically been designed as a prevalence of pathogens detected from a case series. This strategy has an inherent unrealistic assumption that all pathogen detection allows for causal attribution, despite known asymptomatic carriage of the principal causes of acute febrile illness in most low- and middle-income countries (LMICs). We designed a semi-quantitative PCR in a modular format to detect bloodborne agents of acute febrile illness that encompassed common etiologies of AFI in the region, etiologies of recent epidemics, etiologies that require an immediate public health response and additional pathogens of unknown endemicity. We then designed a study that would delineate background levels of transmission in the community in the absence of symptoms to provide corrected estimates of attribution for the principal determinants of AFI.
UNASSIGNED: A case-control study of acute febrile illness in patients ten years or older seeking health care in Iquitos, Loreto, Peru, was planned. Upon enrollment, we will obtain blood, saliva, and mid-turbinate nasal swabs at enrollment with a follow-up visit on day 21-28 following enrollment to attain vital status and convalescent saliva and blood samples, as well as a questionnaire including clinical, socio-demographic, occupational, travel, and animal contact information for each participant. Whole blood samples are to be simultaneously tested for 32 pathogens using TaqMan array cards. Mid-turbinate samples will be tested for SARS-CoV-2, Influenza A and Influenza B. Conditional logistic regression models will be fitted treating case/control status as the outcome and with pathogen-specific sample positivity as predictors to attain estimates of attributable pathogen fractions for AFI.
UNASSIGNED: The modular PCR platforms will allow for reporting of all primary results of respiratory samples within 72 hours and blood samples within one week, allowing for results to influence local medical practice and enable timely public health responses. The inclusion of controls will allow for a more accurate estimate of the importance of specific, prevalent pathogens as a cause of acute illness.
UNASSIGNED: Project 1791, Registro de Proyectos de Investigación en Salud Pública (PRISA), Instituto Nacional de Salud, Perú.
UNASSIGNED: A case-control study of acute febrile illness in patients ten years or older seeking health care in Iquitos, Loreto, Peru, was planned. Upon enrollment, we will obtain blood, saliva, and mid-turbinate nasal swabs at enrollment with a follow-up visit on day 21-28 following enrollment to attain vital status and convalescent saliva and blood samples, as well as a questionnaire including clinical, socio-demographic, occupational, travel, and animal contact information for each participant. Whole blood samples are to be simultaneously tested for 32 pathogens using TaqMan array cards. Mid-turbinate samples will be tested for SARS-CoV-2, Influenza A and Influenza B. Conditional logistic regression models will be fitted treating case/control status as the outcome and with pathogen-specific sample positivity as predictors to attain estimates of attributable pathogen fractions for AFI.
UNASSIGNED: The modular PCR platforms will allow for reporting of all primary results of respiratory samples within 72 hours and blood samples within one week, allowing for results to influence local medical practice and enable timely public health responses. The inclusion of controls will allow for a more accurate estimate of the importance of specific, prevalent pathogens as a cause of acute illness.
UNASSIGNED: Project 1791, Registro de Proyectos de Investigación en Salud Pública (PRISA), Instituto Nacional de Salud, Perú.
摘要：
背景：历史上，对急性发热性疾病（AFI）病因的研究被设计为从病例系列中检测到的病原体的患病率。这种策略具有固有的不切实际的假设，即所有病原体检测都允许因果归因，尽管在大多数低收入和中等收入国家（LMICs）已知无症状携带急性高热病的主要原因。我们设计了模块化格式的半定量PCR，以检测包括该地区AFI常见病因的急性发热性疾病的血液传播因子。最近流行病的病因，需要立即公共卫生反应的病因和未知地方性的其他病原体。然后，我们设计了一项研究，该研究将描述在没有症状的情况下社区中传播的背景水平，以提供对AFI主要决定因素的归因的校正估计。方法：对在伊基托斯寻求保健的10岁或10岁以上患者的急性高热疾病进行病例对照研究，洛雷托,秘鲁,是计划好的。注册后，我们会得到血,唾液,和入组时鼻甲中段鼻拭子，并在入组后第21-28天进行随访，以获得生命状态和恢复期唾液和血液样本，以及包括临床问卷，社会人口统计学，职业,旅行,以及每个参与者的动物联系信息。使用TaqMan阵列卡同时测试全血样品的32种病原体。将对中鼻甲样品进行SARS-CoV-2，流感A和流感B的测试。将拟合条件逻辑回归模型，将病例/对照状态作为结果，并以病原体特异性样品阳性作为预测因子，以获得AFI的可归因病原体分数。讨论：模块化PCR平台将允许在72小时内报告呼吸道样本的所有主要结果，并在一周内报告血液样本。允许结果影响当地医疗实践，并能够及时做出公共卫生反应。纳入控制将允许更准确地估计具体的重要性，流行的病原体作为急性疾病的原因。StudyRegistration:Project1791,RegistrodeProyectosdeInvestigaciónenSaludPública(PRISA),国立卫生研究院，秘鲁。
