The dangerous Crimean-Congo hemorrhagic fever virus(CCHFV),an encapsulated negative-sense RNA virus of the family Nairoviridae,is transmitted from person to person via ticks.With a case fatality rate between 10%to 40%...The dangerous Crimean-Congo hemorrhagic fever virus(CCHFV),an encapsulated negative-sense RNA virus of the family Nairoviridae,is transmitted from person to person via ticks.With a case fatality rate between 10%to 40%,the most common ways that the disease may spread to humans are via tick bites or coming into touch with infected animals'blood or tissues.Furthermore,the transfer of bodily fluids between individuals is another potential route of infection.There is a wide range of symptoms experienced by patients throughout each stage,from myalgia and fever to extreme bruising and excess bleeding.Tick management measures include minimising the spread of ticks from one species to another and from people to animals via the use of protective clothing,repellents,and proper animal handling.In order to prevent the spread of illness,healthcare workers must adhere to stringent protocols.Despite the lack of an authorised vaccine,the main components of treatment now consist of preventative measures and supportive care,which may include the antiviral medicine ribavirin.We still don't know very much about the virus's mechanisms,even though advances in molecular virology and animal models have improved our understanding of the pathogenesis of CCHFV.A critical need for vaccination that is both safe and effective,as well as for quick diagnosis and efficient treatments to lessen the disease's impact in areas where it is most prevalent.Important steps towards lowering Crimean-Congo hemorrhagic fever mortality and morbidity rates were to anticipatethe future availability of immunoglobulin products.展开更多
Objective:To investigate the association between diagnosis delays and mortality in patients with haemorrhagic fever in Upper Southern Thailand.Methods:A hospital-based case control study was conducted between December...Objective:To investigate the association between diagnosis delays and mortality in patients with haemorrhagic fever in Upper Southern Thailand.Methods:A hospital-based case control study was conducted between December 2019 and January 2020.Cases were defined as patients who had been diagnosed with haemorrhagic fever and died during hospitalization,while controls were patients with similar conditions who survived.Medical records were retrospectively reviewed,with the primary variable being a diagnosis delay of more than three days after the onset of illness.The outcome of interest was mortality during hospitalization.Data analysis involved descriptive statistics and multiple logistic regression.Results:A total of 38815 haemorrhagic fever cases were reported from 2014 to 2019.The case-to-control ratio was 1:3,comprising 66 cases and 198 controls.Among 66 cases and 198 controls,the median(IQR)time from illness onset to diagnosis was 4(4)days in cases vs.1(0)day in controls.Diagnosis delays significantly increased mortality risk[adjusted OR(aOR)5.60,95%CI 2.74-11.46].Other risk factors for mortality included age≤5 years(aOR 16.15,95%CI 3.70-70.42)and overweight status(aOR 3.43,95%CI 1.57-7.52).Conclusions:Delayed diagnosis in patients with haemorrhagic fever was strongly associated with higher mortality rates.These findings highlight the critical importance of early diagnosis to reduce mortality in haemorrhagic fever cases.展开更多
Although African swine fever(ASF) has been prevalent for more than a century, it remains the number one swine disease that seriously endangers the global pig industry, and there is no effective means of prevention and...Although African swine fever(ASF) has been prevalent for more than a century, it remains the number one swine disease that seriously endangers the global pig industry, and there is no effective means of prevention and treatment(Wang et al. 2023). Due to its enormous economic and social impact, it is listed as a notifiable animal disease by the World Organization for Animal Health(Costard et al. 2013). Although ASF has been present in Sub-Saharan Africa since its first discovery in Kenya.展开更多
Dear Editor,Crimean–Congo hemorrhagic fever(CCHF),caused by the CCHF virus(CCHFV),is a severe tick-borne illness with a wide geographical distribution,posing a significant threat with case fatality rates ranging from...Dear Editor,Crimean–Congo hemorrhagic fever(CCHF),caused by the CCHF virus(CCHFV),is a severe tick-borne illness with a wide geographical distribution,posing a significant threat with case fatality rates ranging from 5%to 70%(Hawman and Feldmann,2023).Due to the lack of approved vaccines and therapeutics,the World Health Organization(WHO)has listed CCHF as one of the priority diseases(Semper et al.,2024).CCHF initially presents as a nonspecific febrile illness,characterized by fever,malaise,myalgia,and nausea,which can rapidly progress to hemorrhagic disease.The hemorrhagic stage is particularly pronounced in severe cases,with rapid progression to disseminated intravascular coagulation(DIC),overt bleeding,kidney or liver failure,and shock(Frank et al.,2024).Up to date,there is an absence of a suitable animal model that can accurately mimic the coagulopathy and bleeding associated with CCHFV infection.Consequently,our understanding of the pathogenic mechanisms underlying these conditions remains limited(Rodriguez et al.,2022).展开更多
Background:Fever is characterized by an upregulation of the thermoregulatory set-point after the body encounters any pathological challenge.It is accompanied by uncomfortable sickness behaviors and may be harmful in p...Background:Fever is characterized by an upregulation of the thermoregulatory set-point after the body encounters any pathological challenge.It is accompanied by uncomfortable sickness behaviors and may be harmful in patients with other comor-bidities.We have explored the impact of an Ayurvedic medicine,Fevogrit,in an endo-toxin(lipopolysaccharide)-induced fever model in Wistar rats.Methods:Active phytoconstituents of Fevogrit were identified and quantified using ultra-high-performance liquid chromatography(UHPLC)platform.For the in-vivo study,fever was induced in male Wistar rats by the intraperitoneal administration of lipopolysaccharide(LPS),obtained from Escherichia coli.The animals were allocated to normal control,disease control,Paracetamol treated and Fevogrit treated groups.The rectal temperature of animals was recorded at different time points using a digital thermometer.At the 6-h time point,levels of TNF-α,IL-1βand IL-6 cytokines were analyzed in serum.Additionally,the mRNA expression of these cytokines was deter-mined in hypothalamus,24 h post-LPS administration.Results:UHPLC analysis of Fevogrit revealed the presence of picroside I,picroside II,vanillic acid,cinnamic acid,magnoflorine and cordifolioside A,as bioactive constitu-ents with known anti-inflammatory properties.Fevogrit treatment efficiently reduces the LPS-induced rise in the rectal temperature of animals.The levels and gene ex-pression of TNF-α,IL-1βand IL-6 in serum and hypothalamus,respectively,was also significantly reduced by Fevogrit treatment.Conclusion:The findings of the study demonstrated that Fevogrit can suppress LPS-induced fever by inhibiting peripheral or central inflammatory signaling pathways and could well be a viable treatment for infection-induced increase in body temperatures.展开更多
Objective This study reports the first imported case of Lassa fever(LF)in China.Laboratory detection and molecular epidemiological analysis of the Lassa virus(LASV)from this case offer valuable insights for the preven...Objective This study reports the first imported case of Lassa fever(LF)in China.Laboratory detection and molecular epidemiological analysis of the Lassa virus(LASV)from this case offer valuable insights for the prevention and control of LF.Methods Samples of cerebrospinal fluid(CSF),blood,urine,saliva,and environmental materials were collected from the patient and their close contacts for LASV nucleotide detection.Whole-genome sequencing was performed on positive samples to analyze the genetic characteristics of the virus.Results LASV was detected in the patient’s CSF,blood,and urine,while all samples from close contacts and the environment tested negative.The virus belongs to the lineage IV strain and shares the highest homology with strains from Sierra Leone.The variability in the glycoprotein complex(GPC)among different strains ranged from 3.9%to 15.1%,higher than previously reported for the seven known lineages.Amino acid mutation analysis revealed multiple mutations within the GPC immunogenic epitopes,increasing strain diversity and potentially impacting immune response.Conclusion The case was confirmed through nucleotide detection,with no evidence of secondary transmission or viral spread.The LASV strain identified belongs to lineage IV,with broader GPC variability than previously reported.Mutations in the immune-related sites of GPC may affect immune responses,necessitating heightened vigilance regarding the virus.展开更多
Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has ...Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has been proved that traditional Chinese medicine(TCM)has displayed definite therapeutic effects on viral hemorrhagic fever,indicating its potential to treat SFTS.In this study,SFTS-relative key targets were predicted via gene ontology(GO)analysis and kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis.Molecular docking was then used to select stable binders.Molecules matched TCMs were identified,and a new prescription,Qingqi Guxue decoction(QQGX),was formulated to clear heat and nourish blood,with a resulting drug composition network.We explored the optimal drug proportion for QQGX.Through an in-depth study of molecular mechanisms,we found that QQGX induces S phase arrest by promoting the degradation of cyclin A2(CCNA2)and cyclin-dependent kinase 2(CDK2),thereby inhibiting SFTSV replication.Finally,we verified the effectiveness and safety of QQGX based on the mouse liver bile duct organoid model infected with SFTSV.In summary,our study prepared a TCM decoction using the method of network pharmacology.This decoction has a significant inhibitory effect on the replication of SFTSV and provides a new treatment strategy for hemorrhagic fever with TCM.展开更多
BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment...BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment.Yellow fever(YF)is an infectious disease that primarily affects the liver and has a high mortality rate.However,LT can be a viable option for treating rare cases with extensive liver involvement.However,the criteria for assessing the severity of ALF and determining the indications for transplantation have not been specifically validated for cases caused by YF.AIM To present necessary adjustments to established scoring systems for ALF secondary to YF.METHODS This was an observational,retrospective,single-center study.Fourteen consecutive patients with confirmed ALF due to YF were monitored in the intensive care unit by a specialized liver transplant team during a three-month epidemic outbreak in Brazil.During hospitalization,general supportive therapeutic measures were implemented,and the patients were regularly assessed using the King's College criteria and the Clichy-Villejuif criteria to determine the severity of liver failure.LT is considered a viable measure for patients with signs of end-stage liver failure.RESULTS Eight of 14(57%)patients developed severe neurological alterations within the first 96 hours after hospital admission.Four patients underwent emergency LT,and despite a moderate viral infection of the graft after transplantation,the 5-year survival rate was 50%.Although the King's College criteria and the Clichy-Villejuif criteria are the main scoring systems for ALF,they are insufficient for predicting the risk of mortality in this context,primarily because of low serum bilirubin levels in the final stage of the disease and significant disparities between coagulation abnormalities and patient severity.CONCLUSION To ensure good applicability in cases of YF-induced ALF,the authors suggest adaptations to the King's College and Clichy-Villejuif criteria.展开更多
Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 -...Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 - 15 years. Patients and Methods: This was a prospective cross-sectional study from April 1, 2021 to March 31, 2022 and affected all children aged 0 to 15 years old with a temperature of 39˚C or higher (≥), having less than five days and hospitalized in the pediatric department of the Gabriel Touré University Hospital. Results: During the study period, 150 children were included, the sex-ratio was 0.85. Children aged 0 - 5 years represented 71.4% of the sample. References represented more than half of the sample, or 58% of cases. Body temperature was above 40˚C in 18.7% of cases. Functional signs were dominated by respiratory signs in 28% and digestive signs in 18%. Clinical pallor was found in 55.3% of children associated with signs of respiratory struggle in 70% of cases and tachycardia in 40% of patients. Anemia was present in 65.3% of patients. Hyperleucocytosis and leukopenia were found in 45.3% and 43.3% of patients respectively. The C-reactive protein was positive in 44.7% of patients and Cytobacteriological Examination and Chemistry of Cerebrospinal Fluid was positive in 8.7% of cases. The thick drop was positive in 44.7% of patients and blood cultures grew in 6 patients. Etiology was dominated by severe malaria 54 cases (36%), pneumonia (19.3%), meningitis (12.6%), and in those under one month it was bacterial neonatal infection (8.6%). In our study, slightly more than one patient out of three died during hospitalization, 36% (54 cases/150) and among these 70% (38 cases/54) were under 5 years old. The most lethal pathologies were severe malaria (36%), bacterial pneumonia (19.3%), meningitis (12.6%), bacterial neonatal infections (8.6%) and measles complicated by pneumonia (5.3%). Mortality during hospitalization was 36% of deaths (54 out of 150 patients) and 70.3% (38/54) of the deceased patients were under 5 years old. Conclusion: This study shows that fever is a frequent symptom and a sign of serious and very lethal pathologies. The cause of fever can be a diagnostic challenge for health workers. However, early identification of children at risk for serious illness could allow for prompt and appropriate management in appropriate settings.展开更多
Still common in developing countries, acute rheumatic fever (ARF) is not only a disease of children and adolescents, but can also occur in adults. At this age, the diagnosis of rheumatic flare-ups can be difficult due...Still common in developing countries, acute rheumatic fever (ARF) is not only a disease of children and adolescents, but can also occur in adults. At this age, the diagnosis of rheumatic flare-ups can be difficult due to the frequency of other types of joint diseases and the existence of degenerative and dystrophic valve disease. In adults, the initial rheumatic attack is marked by the predominance of joint damage over cardiac damage. However, it is often at this age that rheumatic valve disease is discovered. The revised Jones criteria also find their place in the diagnosis of AAR in adults. Objective: To study the demographic, clinical, and biological characteristics of acute rheumatic fever (ARF) in the General Medicine Department of the Siguiri Prefectural Hospital. Materials and Methods: This descriptive observational study examined the demographic, clinical and biological characteristics of acute rheumatic fever (ARF) at the Siguiri Prefectural Hospital, Guinea, between April 1 and September 31, 2021 according to Jones criteria. The data were collected on a form containing sociodemographic variables (age, sex, profession), rheumatological, cardiac, pulmonary and neurological clinical signs, biological variables and treatment. Results: Figure 1 shows the flow of the hospital frequency of the RAA in the General Medicine Department of the Prefectural Hospital of Siguiri. During the study period, 420 patients were hospitalized, of whom 161 patients had AAR, a frequency of 38.33%. Table 1 shows the distribution of patients diagnosed with ARB, by sociodemographic characteristics. The average age was 44.7 ± 19.78 years and the extremes of 14 and 90 years, the female sex dominated with a ratio of 0.75. The informal sector was in the majority in 45.34% of cases and most were illiterate, i.e. 53.42%. In our study, the incidence was lower during the dry season than during the rainy season, a hot season with high rainfall and humidity, the rainy period was a provider with a peak in August and September. The lifestyle was characterized by overcrowding in 87.58% of patients. The main complaint was fever, i.e. 88.82%. Rheumatological manifestations such as arthritis were 98.14%, chest pain was 37.89% (61 cases). The diagnosis was confirmed by ASLO titration in 85.71% of patients and 98.55% (136 cases) had a titration greater than 400 U/ml. Conclusion: The results obtained from our study show a high prevalence of acute rheumatic fever, which makes it a worrying health problem in the Siguiri health district. Young female adult patients, married with an informal profession and not in school residing in Siguiri were the most encountered in our study. The main functional signs mentioned by the patients were fever, cough and abdominal pain;osteoarticular pain and chest pain dominated the clinical picture. Almost all of our patients had an ASLO titer greater than 400 U/ml and a positive C-reactive protein. Our results show a high risk of spread of acute rheumatic fever within the population of Siguiri. Due to the serious complications caused by acute rheumatic fever, particular attention must be paid to it by carrying out other, much larger studies in order to identify the problem of RAA.展开更多
BACKGROUND There is a need to synthesize the different patterns of fever treatment and phobias in Nigeria and to document these behavioral issues among caregivers.Although,fever is commonly seen in children and this m...BACKGROUND There is a need to synthesize the different patterns of fever treatment and phobias in Nigeria and to document these behavioral issues among caregivers.Although,fever is commonly seen in children and this make the mothers to seek medical care when all effort of theirs have failed.Yet,this behavioral and anxiety disorders among mothers still persists several years after the word“Fever phobia”was coined.AIM To document the knowledge of fever among Nigerian mothers and to determine heterogeneity in these practices across the nation.METHODS A search of articles on fever phobias among mothers or caregivers in Nigeria was performed via the Cochrane Database of Systematic Reviews,PubMed,Google Scholar,and MEDLINE.Articles published between 2008,and 2023 were included in the study.The keywords used in the literature search included fever,phobias,perceptions,mothers,caregivers,perceptions,drugs,knowledge,and practices.Boolean operators were also used in the search for items,such as“fever AND phobia”,“fever AND perception”,“fever AND mothers”,“fevers AND/OR phobia”,“AND OR mothers/caregivers”,to help narrow parameters in the search engine and enhance reproducibility.Studies that fulfilled the inclusion criteria were presented via the PRISMA model.I2 statistics were used to assess heterogeneity.RESULTS The studies show wide variation in the reported levels of knowledge about fever,with proportions ranging from as low as 35%to as high as 94%.The pooled proportion estimate using the common effect model is 65%(95%CI:64%-67%),assuming that all studies reflect a single underlying value.However,the random effects model,which accounts for differences among studies,yields a higher estimate of 70%(95%CI:56%-82%).This divergence reflects significant heterogeneity in the data,with a Tau^(2)of 0.7007,I²of 95.7%,and,an H statistic of 4.80,all indicating that most of the variability is due to actual differences among studies rather than random chance.The Q test further confirms this,with a P value less than 0.0001,reinforcing that the variability across studies is statistically significant.The subgroup analysis revealed that studies in Group A(six studies)reported a pooled knowledge proportion of 75%,with a confidence interval ranging from 56%to 88%,and relatively lower heterogeneity(Tau^(2)=0.5709,Tau=0.7556),indicating greater consistency in their findings.In contrast,Group B(four studies)had a lower pooled estimate of 62%,but with a much wider confidence interval(27%to 88%)and greater heterogeneity(Tau^(2)=0.8380,Tau=0.9154),suggesting greater variation across studies in that group.Fear of brain damage,convulsions,witches/wizards,and death was high in many of the studies.Herbal concoctions,and prayers were the mostly used measures to cure fever by mothers.CONCLUSION Mothers’knowledge of fever detection in children is low.There was heterogeneity in the sample size of the studies,which may have affected the knowledge of fever.展开更多
Objective:Children below 14 years of age are highly vulnerable to dengue infection and are at a greater risk of developing severe dengue illness.This study aimed to investigate the trends in the burden of dengue fever...Objective:Children below 14 years of age are highly vulnerable to dengue infection and are at a greater risk of developing severe dengue illness.This study aimed to investigate the trends in the burden of dengue fever among children below 14 years of age in China from 1990 to 2021 and to project the disease burden from 2022 to 2035.Methods:Based on the datasets derived from the Global Burden of Disease Study 2021,the following data were collected from dengue-affected children aged ≤14 years in China from 1990 to 2021:number and rate of incident dengue cases,number of prevalent dengue cases,number of deaths due to dengue,and disability-adjusted life years(DALYs) lost due to dengue.The trends in disease burden were examined based on average annual percent change(AAPC) and annual percent change,and the burdens were proj ected from 2022 to 2035 by using a Bayesian age-period-cohort model.Results:The incidence and prevalence of dengue fever were increased in children aged ≤ 14 years in China from1990 to 2021(AAPC=5.42 % and 5.44 %,respectively,P <0.001),while the mortality and DALYs rates were reduced(AAPC=-8.21 % and-7.55 %,respectively,P <0.001).The burden was comparable between genders,with numerically lower incidence and prevalence in boys than in girls.The lowest incidence and prevalence and the highest mortality and DALYs rates were observed in children aged <5 years.The incidence and prevalence rates were projected to increase from 2022 to 2035;in contrast,the mortality and DALYs rates were projected to decrease during this period.Conclusions:Although the mortality and DALYs rates of dengue fever decreased significantly in children aged0-14 years in China from 1990 to 2021,the incidence and prevalence increased remarkably.Enhanced surveillance and ample health education programs and preventive interventions are recommended for targeting this high-risk population.展开更多
Fever of unknown origin(FUO)is recognized as fever with uncertain diagnosis despite three days of hospital admission or three or more outpatient visits.[1]Acute liver fluke infection is characterized by fever,right up...Fever of unknown origin(FUO)is recognized as fever with uncertain diagnosis despite three days of hospital admission or three or more outpatient visits.[1]Acute liver fluke infection is characterized by fever,right upper quadrant pain,hepatomegaly,jaundice,and peripheral blood eosinophilia.By contrast,chronic liver fluke infection is asymptomatic in its early stage,but can easily progress to cirrhosis,cancer,or bile duct cancer initslaterstages.The diagnosis of clonorchiasis is particularly challenging in non-endemic areas.We herein report an unusual case of liver fluke infection in a patient who presented with FUO and eosinophilia.A 38-year-old male was admitted to our hospital with a history of intermittent and recurrent fever for over 10 d and a history of sudden abdominal pain for1 h.He had no other medical history.More than 10d ago,he visited our emergency department because of FUO,with his body temperature reaching 39.7℃,and he had no other symptoms at that time.Laboratory and radiological examinations revealed:white blood cell(WBC)counts,10.9×10^(9)/L;neutrophil percentage,84.5%;eosinophil percentage,3.1%;C-reactive protein(CRP),141 mg/L;liver and kidney function,normal;influenza virus,negative;urine and stool tests,normal;and chest computed tomography(CT)findings,normal.The fever subsided after 1 week of anti-infective treatment with moxifloxacin.Subsequent tests revealed the following results:WBC,15.0×10^(9)/L;neutrophil percentage,70.0%;eosinophil percentage,16.8%;and CRP,122 mg/L.The antimicrobial treatment was then discontinued.展开更多
Typhoid fever remains a major global health challenge,particularly in regions with limited access to clean water and sanitation.The emergence of multidrug-resistant and extensively drug-resistant strains of Salmonella...Typhoid fever remains a major global health challenge,particularly in regions with limited access to clean water and sanitation.The emergence of multidrug-resistant and extensively drug-resistant strains of Salmonella enterica serovar Typhi highlights the urgent need for alternative treatment strategies.Medicinal plants represent a promising avenue for addressing this crisis,as their bioactive compounds exhibit potent antibacterial properties.According to the World Health Organization,over 20,000 medicinal plant species have been identified as valuable resources for drug discovery,with more than 1,340 demonstrating antimicrobial activity and over 30,000 antimicrobial compounds isolated.Through an extensive review,key phytochemicals with anti-typhoid properties were identified,along with their mechanisms of action and supporting evidence from in vitro and in vivo studies.This review compiles data on plants with demonstrated anti-typhoid activity,highlights challenges such as standardization,regulatory frameworks,and integration into modern healthcare,and explores the role of omics technologies in advancing the discovery of novel plant-based antimicrobial agents.By discussing potential medicinal plant targets and intervention strategies,this work lays the groundwork for future research into plant-derived anti-infective therapies and contributes to the global effort to combat the growing threat of typhoid fever,particularly in resource-limited settings.展开更多
BACKGROUND Nosocomial fever of unknown origin(nFUO)is a frequent and challenging diagnostic entity,encompassing diverse infectious and non-infectious etiologies.Timely identification is crucial,yet evidence on the dia...BACKGROUND Nosocomial fever of unknown origin(nFUO)is a frequent and challenging diagnostic entity,encompassing diverse infectious and non-infectious etiologies.Timely identification is crucial,yet evidence on the diagnostic accuracy of commonly employed sepsis screening tools and biomarkers remains sparse.We hypothesized that these tools and biomarkers measured at fever onset could distinguish infectious from non-infectious causes of nFUO in critically ill adults.AIM To evaluate the diagnostic utility of sepsis tools and biomarkers in identifying infectious causes of nFUO.METHODS This prospective observational study included patients admitted to the Acute Care Emergency Medicine Unit,Postgraduate Institute of Medical Education and Research,Chandigarh,India(July 2023 to December 2024).nFUO was defined by Durack and Street criteria.Diagnostic performance of sepsis screening tools(systemic inflammatory response syndrome,Sequential Organ Failure Assessment,quick Sequential Organ Failure Assessment,National Early Warning Score,and Modified Early Warning Score)and biomarkers[procalcitonin(PCT),C-reactive protein(CRP)]at fever onset was assessed using receiver operating characteristic curve analysis.RESULTS Of 80 cases(mean age 42.9±16.5 years;80% male),42.5% had infectious causes,38.7% non-infectious,and 18.8% remained undiagnosed.Pneumonia(26.2%)and bloodstream infections(11.2%)were the most common infectious etiologies,while central fever and thrombophlebitis(each 7.5%)were predominant among non-infectious causes.Sepsis tools showed poor diagnostic accuracy,with area under the receiver operating characteristic curve(AUC)values close to 0.5.PCT demonstrated modest performance(AUC=0.61;optimal cut-off:0.85μg/L),while CRP was paradoxically higher in non-infectious cases(AUC=0.45).Overall mortality was 20% and was highest among undiagnosed patients(33.3%).Fever duration and hospitalization length were significantly greater in infectious cases.CONCLUSION Sepsis tools,PCT,and CRP have limited utility in identifying infectious causes of nFUO in critically ill adults and should not solely guide initial decision-making.展开更多
Background:Dengue fever,an acute insect-borne infectious disease caused by the dengue virus(DENV),poses a great challenge to global public health.Hepatic involve-ment is the most common complication of severe dengue a...Background:Dengue fever,an acute insect-borne infectious disease caused by the dengue virus(DENV),poses a great challenge to global public health.Hepatic involve-ment is the most common complication of severe dengue and is closely related to the occurrence and development of disease.However,the features of adaptive immune responses associated with liver injury in severe dengue are not clear.Methods:We used single-cell sequencing to examine the liver tissues of mild or se-vere dengue mice model to analyze the changes in immune response of T cells in the liver after dengue virus infection,and the immune interaction between macrophages and T cells.Flow cytometry was used to detect T cells and macrophages in mouse liver and blood to verify the single-cell sequencing results.Results:Our result showed CTLs were significantly activated in the severe liver injury group but the immune function-related signal pathway was down-regulated.The rea-son may be that the excessive immune response in the severe group at the late stage of DENV infection induces the polarization of macrophages into M2 type,and the macrophages then inhibit T cell immunity through the TGF-βsignaling pathway.In ad-dition,the increased proportion of Treg cells suggested that Th17/Treg homeostasis was disrupted in the livers of severe liver injury mice.Conclusions:In this study,single-cell sequencing and flow cytometry revealed the characteristic changes of T cell immune response and the role of macrophages in the liver of severe dengue fever mice.Our study provides a better understanding of the pathogenesis of liver injury in dengue fever patients.展开更多
Objective:To observe the application effect of risk management in the nursing work of fever clinics,especially its effect on improving nursing satisfaction and the work quality of nursing staff,as well as reducing the...Objective:To observe the application effect of risk management in the nursing work of fever clinics,especially its effect on improving nursing satisfaction and the work quality of nursing staff,as well as reducing the incidence of nursing risk events,and to provide a scientific reference for future clinical research and practice.Methods:This study adopted a retrospective approach,fixing the research period from December 2024 to August 2025.A total of 110 patients admitted to the fever clinic of our hospital were selected as the research objects and divided into two groups(the control group and the experimental group)using the random number table method.Each group had 55 patients.Then,differentiated nursing strategies were implemented for the two groups.Both the control group and the experimental group received routine nursing.The difference was that the experimental group was additionally given risk management measures on the basis of routine nursing.After 7 days of intervention,the nursing satisfaction rate,nursing quality,cognitive score of fever clinic risks,nursing error rate,complaint rate,and incidence of risk events were compared and analyzed between the two groups.Results:The nursing satisfaction score,nursing complaint rate,incidence of nursing risk events,nursing error rate,nursing quality score,and cognitive score of fever clinic risks in the experimental group were significantly better than those in the control group.The differences were statistically significant(P<0.05).Conclusion:Risk management has a significant application effect in the nursing work of fever clinics,playing a positive role for both patients and nursing staff.It is an effective measure to comprehensively improve nursing quality and an important means to greatly reduce the incidence of nursing risk events,thus having high clinical promotion value.展开更多
Rationale:Dengue fever is a mosquito-borne viral infection,which commonly presents as an acute febrile illness.As the number of cases increases,rare manifestations including neurological manifestations are occasionall...Rationale:Dengue fever is a mosquito-borne viral infection,which commonly presents as an acute febrile illness.As the number of cases increases,rare manifestations including neurological manifestations are occasionally encountered.Patient concerns:A 20-year-old female presented with fever for 3 days with slurring of speech and unsteady gait,which were developed from the third day of illness.On examination,she had bilateral cerebellar signs.Dengue non-structural protein 1 antigen and dengue IgM in serum were positive.Her cerebrospinal fluid analysis and magnetic resonance image brain were normal.Diagnosis:Dengue cerebellitis.Intervention:Supportive management with fluids including oral rehydration solutions and intravenous fluids and paracetamol.Outcome:Cerebellar symptoms and signs completely resolved by the 20th day of illness.Lesson:Dengue cerebellitis is an unusual neurological manifestation of dengue infection.展开更多
Objective:Studies on the occupational health risks and experiences of healthcare waste handlers since the decline in coronavirus disease 2019(COVID-19)incidence are scarce in Nigeria.The current study aimed to examine...Objective:Studies on the occupational health risks and experiences of healthcare waste handlers since the decline in coronavirus disease 2019(COVID-19)incidence are scarce in Nigeria.The current study aimed to examine what seemed as the"hidden"and rarely researched area of practice from the standpoint of different stakeholders in a Nigerian Lassa fever treatment hospital.The primary objective was to understand the nature of waste handlers'practices and experiences and identify areas for improvement centred on supporting the development of best practices,in accordance with the World Health Organisation(WHO)guidelines.Methods:This study employed a qualitative case study design,gathering data from healthcare waste handlers(n=34)through four focus groups.Additionally,four in-depth interviews were conducted with ward managers and the infection control team to gain insight into the organisational framing of waste handling practice,the perceived challenges faced by waste handlers from their perspectives,and the provision of training and support.The qualitative data were audio-recorded and transcribed verbatim through manual processes and subjected to a reflexive thematic analysis conducted manually.Results:The findings revealed that waste handlers were subjected to various occupational health risks,including back pain,needlestick injuries,psychological distress,fatigue,anxiety,and prolonged exposure to sunlight.Concerns were raised regarding the inadequate supply of personal protective equipment and other essential tools,which suggests a need for organisational commitment to ensure the continual availability of these resources to protect the health and safety of these employees.A critical issue identified was the lack of comprehensive training for waste handlers,highlighting a form of organisational negligence.The consensual views expressed by the waste handlers indicated a sense of dissatisfaction with their working environment,largely attributable to organisational and societal stigmatisation.Furthermore,the study underscored that the hospital management faced significant financial constraints and advocated for increased funding to effectively implement best practice standards.Conclusion:To effectively manage healthcare waste and reduce hazards to waste handlers,the organisational leadership should prioritise training and support.This initiative will not only benefit the waste handlers but also the patients,other healthcare workers,and the general public.Although the findings focus on the case context of a Nigerian Lassa fever treatment hospital,the wider implications of this study are linked to the role of institutional support for waste handling practice.Moreover,it extends to the potential positions of institutions as displaying a form of"benign anomie"in not ensuring the wellbeing of waste handlers through sufficient regulation and governance focused on prioritisation,processes,and procedures.The study highlights the relevance of embedding WHO guidelines in other similar contexts as part of implementation across institutions involved with waste handling.展开更多
BACKGROUND Familial Mediterranean fever(FMF)is an autosomal recessive autoinflammatory disorder marked by recurrent episodes of fever and serositis.Resistin,a proinflammatory cytokine,may play a role in FMF pathogenes...BACKGROUND Familial Mediterranean fever(FMF)is an autosomal recessive autoinflammatory disorder marked by recurrent episodes of fever and serositis.Resistin,a proinflammatory cytokine,may play a role in FMF pathogenesis by promoting the release of interleukin-1beta,tumour necrosis factor alpha,and interleukin-6.AIM To evaluate serum resistin levels in children with FMF during acute attacks and remission,and to assess its potential as a biomarker for disease activity and progression.METHODS A case-control study was conducted involving 40 pediatric patients with FMF and 40 age-and sex-matched healthy controls.Serum resistin and inflammatory markers—including total leukocyte count(TLC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),serum amyloid A(SAA),and fibrinogen—were measured using enzyme-linked immunosorbent assay and standard assays.RESULTS No significant differences were found in age or sex between FMF patients and controls.Among FMF patients,fever was the most prevalent symptom(95%),followed by abdominal pain(75%).The most frequently detected genetic mutation was M694I,followed by M694V,E148Q,M680I,and V726A.Compound heterozygous mutations,including M694I/V726A and M694I/M694V,were equally represented.During acute attacks,FMF patients exhibited significantly elevated levels of TLC,ESR,CRP,SAA,and fibrinogen compared to attack-free periods and controls.Serum resistin levels were markedly higher during acute attacks and showed a strong positive correlation with other acute inflammatory markers.Receiver operating characteristic curve analysis demonstrated high sensitivity and specificity of resistin as a potential biomarker for FMF.CONCLUSION Resistin is significantly elevated in children with FMF during acute episodes and correlates with established inflammatory markers.These findings support its potential role as a non-invasive biomarker for disease activity and severity in pediatric FMF.展开更多
文摘The dangerous Crimean-Congo hemorrhagic fever virus(CCHFV),an encapsulated negative-sense RNA virus of the family Nairoviridae,is transmitted from person to person via ticks.With a case fatality rate between 10%to 40%,the most common ways that the disease may spread to humans are via tick bites or coming into touch with infected animals'blood or tissues.Furthermore,the transfer of bodily fluids between individuals is another potential route of infection.There is a wide range of symptoms experienced by patients throughout each stage,from myalgia and fever to extreme bruising and excess bleeding.Tick management measures include minimising the spread of ticks from one species to another and from people to animals via the use of protective clothing,repellents,and proper animal handling.In order to prevent the spread of illness,healthcare workers must adhere to stringent protocols.Despite the lack of an authorised vaccine,the main components of treatment now consist of preventative measures and supportive care,which may include the antiviral medicine ribavirin.We still don't know very much about the virus's mechanisms,even though advances in molecular virology and animal models have improved our understanding of the pathogenesis of CCHFV.A critical need for vaccination that is both safe and effective,as well as for quick diagnosis and efficient treatments to lessen the disease's impact in areas where it is most prevalent.Important steps towards lowering Crimean-Congo hemorrhagic fever mortality and morbidity rates were to anticipatethe future availability of immunoglobulin products.
文摘Objective:To investigate the association between diagnosis delays and mortality in patients with haemorrhagic fever in Upper Southern Thailand.Methods:A hospital-based case control study was conducted between December 2019 and January 2020.Cases were defined as patients who had been diagnosed with haemorrhagic fever and died during hospitalization,while controls were patients with similar conditions who survived.Medical records were retrospectively reviewed,with the primary variable being a diagnosis delay of more than three days after the onset of illness.The outcome of interest was mortality during hospitalization.Data analysis involved descriptive statistics and multiple logistic regression.Results:A total of 38815 haemorrhagic fever cases were reported from 2014 to 2019.The case-to-control ratio was 1:3,comprising 66 cases and 198 controls.Among 66 cases and 198 controls,the median(IQR)time from illness onset to diagnosis was 4(4)days in cases vs.1(0)day in controls.Diagnosis delays significantly increased mortality risk[adjusted OR(aOR)5.60,95%CI 2.74-11.46].Other risk factors for mortality included age≤5 years(aOR 16.15,95%CI 3.70-70.42)and overweight status(aOR 3.43,95%CI 1.57-7.52).Conclusions:Delayed diagnosis in patients with haemorrhagic fever was strongly associated with higher mortality rates.These findings highlight the critical importance of early diagnosis to reduce mortality in haemorrhagic fever cases.
基金supported by the National Key Research and Development Program of China (2021YFD1800100)the earmarked fund for China Agriculture Research System (CARS-35)。
文摘Although African swine fever(ASF) has been prevalent for more than a century, it remains the number one swine disease that seriously endangers the global pig industry, and there is no effective means of prevention and treatment(Wang et al. 2023). Due to its enormous economic and social impact, it is listed as a notifiable animal disease by the World Organization for Animal Health(Costard et al. 2013). Although ASF has been present in Sub-Saharan Africa since its first discovery in Kenya.
基金supported in part by grants from the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB0490000 to Z.H.)National Key Research and Development Program(2021YFF0702002 to J.L.,2022YFC2303300 to Z.H.,and 2023YFC2305900 to M.W.)+3 种基金“Youth Commando”project(2023QNTJ-02 TO J.L.)Key Project(2024JZZD-02 to Z.H.)of State Key Laboratory of Virology and BiosafetyWuhan Institute of Virology,the National Natural Science Foundation of China(U22A20336 to Z.H.and Y.Z.)Wuhan Natural Science Foundation(202404071010067 to M.W.and 202404071010068 to J.L.).
文摘Dear Editor,Crimean–Congo hemorrhagic fever(CCHF),caused by the CCHF virus(CCHFV),is a severe tick-borne illness with a wide geographical distribution,posing a significant threat with case fatality rates ranging from 5%to 70%(Hawman and Feldmann,2023).Due to the lack of approved vaccines and therapeutics,the World Health Organization(WHO)has listed CCHF as one of the priority diseases(Semper et al.,2024).CCHF initially presents as a nonspecific febrile illness,characterized by fever,malaise,myalgia,and nausea,which can rapidly progress to hemorrhagic disease.The hemorrhagic stage is particularly pronounced in severe cases,with rapid progression to disseminated intravascular coagulation(DIC),overt bleeding,kidney or liver failure,and shock(Frank et al.,2024).Up to date,there is an absence of a suitable animal model that can accurately mimic the coagulopathy and bleeding associated with CCHFV infection.Consequently,our understanding of the pathogenic mechanisms underlying these conditions remains limited(Rodriguez et al.,2022).
基金This study was supported by internal funds from Patanjali Research Foundation Trust,Haridwar,India。
文摘Background:Fever is characterized by an upregulation of the thermoregulatory set-point after the body encounters any pathological challenge.It is accompanied by uncomfortable sickness behaviors and may be harmful in patients with other comor-bidities.We have explored the impact of an Ayurvedic medicine,Fevogrit,in an endo-toxin(lipopolysaccharide)-induced fever model in Wistar rats.Methods:Active phytoconstituents of Fevogrit were identified and quantified using ultra-high-performance liquid chromatography(UHPLC)platform.For the in-vivo study,fever was induced in male Wistar rats by the intraperitoneal administration of lipopolysaccharide(LPS),obtained from Escherichia coli.The animals were allocated to normal control,disease control,Paracetamol treated and Fevogrit treated groups.The rectal temperature of animals was recorded at different time points using a digital thermometer.At the 6-h time point,levels of TNF-α,IL-1βand IL-6 cytokines were analyzed in serum.Additionally,the mRNA expression of these cytokines was deter-mined in hypothalamus,24 h post-LPS administration.Results:UHPLC analysis of Fevogrit revealed the presence of picroside I,picroside II,vanillic acid,cinnamic acid,magnoflorine and cordifolioside A,as bioactive constitu-ents with known anti-inflammatory properties.Fevogrit treatment efficiently reduces the LPS-induced rise in the rectal temperature of animals.The levels and gene ex-pression of TNF-α,IL-1βand IL-6 in serum and hypothalamus,respectively,was also significantly reduced by Fevogrit treatment.Conclusion:The findings of the study demonstrated that Fevogrit can suppress LPS-induced fever by inhibiting peripheral or central inflammatory signaling pathways and could well be a viable treatment for infection-induced increase in body temperatures.
基金supported by Public Health Talent Training and Surport Plan(National Administration of Disease Prevention and Control)Research and application of new technology for rapid monitoring and tracing of emergent infectious diseases among entry-exit population(2024YFFK0056)Monitoring,Early warning and Response of Major Infectious Diseases(2022ZDZX0017).
文摘Objective This study reports the first imported case of Lassa fever(LF)in China.Laboratory detection and molecular epidemiological analysis of the Lassa virus(LASV)from this case offer valuable insights for the prevention and control of LF.Methods Samples of cerebrospinal fluid(CSF),blood,urine,saliva,and environmental materials were collected from the patient and their close contacts for LASV nucleotide detection.Whole-genome sequencing was performed on positive samples to analyze the genetic characteristics of the virus.Results LASV was detected in the patient’s CSF,blood,and urine,while all samples from close contacts and the environment tested negative.The virus belongs to the lineage IV strain and shares the highest homology with strains from Sierra Leone.The variability in the glycoprotein complex(GPC)among different strains ranged from 3.9%to 15.1%,higher than previously reported for the seven known lineages.Amino acid mutation analysis revealed multiple mutations within the GPC immunogenic epitopes,increasing strain diversity and potentially impacting immune response.Conclusion The case was confirmed through nucleotide detection,with no evidence of secondary transmission or viral spread.The LASV strain identified belongs to lineage IV,with broader GPC variability than previously reported.Mutations in the immune-related sites of GPC may affect immune responses,necessitating heightened vigilance regarding the virus.
基金supported by the National Natural Science Foundation of China(32170144 and 32470146).
文摘Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has been proved that traditional Chinese medicine(TCM)has displayed definite therapeutic effects on viral hemorrhagic fever,indicating its potential to treat SFTS.In this study,SFTS-relative key targets were predicted via gene ontology(GO)analysis and kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis.Molecular docking was then used to select stable binders.Molecules matched TCMs were identified,and a new prescription,Qingqi Guxue decoction(QQGX),was formulated to clear heat and nourish blood,with a resulting drug composition network.We explored the optimal drug proportion for QQGX.Through an in-depth study of molecular mechanisms,we found that QQGX induces S phase arrest by promoting the degradation of cyclin A2(CCNA2)and cyclin-dependent kinase 2(CDK2),thereby inhibiting SFTSV replication.Finally,we verified the effectiveness and safety of QQGX based on the mouse liver bile duct organoid model infected with SFTSV.In summary,our study prepared a TCM decoction using the method of network pharmacology.This decoction has a significant inhibitory effect on the replication of SFTSV and provides a new treatment strategy for hemorrhagic fever with TCM.
基金Supported by The INCT-CNPq Program,No.465425/2014-3.
文摘BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment.Yellow fever(YF)is an infectious disease that primarily affects the liver and has a high mortality rate.However,LT can be a viable option for treating rare cases with extensive liver involvement.However,the criteria for assessing the severity of ALF and determining the indications for transplantation have not been specifically validated for cases caused by YF.AIM To present necessary adjustments to established scoring systems for ALF secondary to YF.METHODS This was an observational,retrospective,single-center study.Fourteen consecutive patients with confirmed ALF due to YF were monitored in the intensive care unit by a specialized liver transplant team during a three-month epidemic outbreak in Brazil.During hospitalization,general supportive therapeutic measures were implemented,and the patients were regularly assessed using the King's College criteria and the Clichy-Villejuif criteria to determine the severity of liver failure.LT is considered a viable measure for patients with signs of end-stage liver failure.RESULTS Eight of 14(57%)patients developed severe neurological alterations within the first 96 hours after hospital admission.Four patients underwent emergency LT,and despite a moderate viral infection of the graft after transplantation,the 5-year survival rate was 50%.Although the King's College criteria and the Clichy-Villejuif criteria are the main scoring systems for ALF,they are insufficient for predicting the risk of mortality in this context,primarily because of low serum bilirubin levels in the final stage of the disease and significant disparities between coagulation abnormalities and patient severity.CONCLUSION To ensure good applicability in cases of YF-induced ALF,the authors suggest adaptations to the King's College and Clichy-Villejuif criteria.
文摘Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 - 15 years. Patients and Methods: This was a prospective cross-sectional study from April 1, 2021 to March 31, 2022 and affected all children aged 0 to 15 years old with a temperature of 39˚C or higher (≥), having less than five days and hospitalized in the pediatric department of the Gabriel Touré University Hospital. Results: During the study period, 150 children were included, the sex-ratio was 0.85. Children aged 0 - 5 years represented 71.4% of the sample. References represented more than half of the sample, or 58% of cases. Body temperature was above 40˚C in 18.7% of cases. Functional signs were dominated by respiratory signs in 28% and digestive signs in 18%. Clinical pallor was found in 55.3% of children associated with signs of respiratory struggle in 70% of cases and tachycardia in 40% of patients. Anemia was present in 65.3% of patients. Hyperleucocytosis and leukopenia were found in 45.3% and 43.3% of patients respectively. The C-reactive protein was positive in 44.7% of patients and Cytobacteriological Examination and Chemistry of Cerebrospinal Fluid was positive in 8.7% of cases. The thick drop was positive in 44.7% of patients and blood cultures grew in 6 patients. Etiology was dominated by severe malaria 54 cases (36%), pneumonia (19.3%), meningitis (12.6%), and in those under one month it was bacterial neonatal infection (8.6%). In our study, slightly more than one patient out of three died during hospitalization, 36% (54 cases/150) and among these 70% (38 cases/54) were under 5 years old. The most lethal pathologies were severe malaria (36%), bacterial pneumonia (19.3%), meningitis (12.6%), bacterial neonatal infections (8.6%) and measles complicated by pneumonia (5.3%). Mortality during hospitalization was 36% of deaths (54 out of 150 patients) and 70.3% (38/54) of the deceased patients were under 5 years old. Conclusion: This study shows that fever is a frequent symptom and a sign of serious and very lethal pathologies. The cause of fever can be a diagnostic challenge for health workers. However, early identification of children at risk for serious illness could allow for prompt and appropriate management in appropriate settings.
文摘Still common in developing countries, acute rheumatic fever (ARF) is not only a disease of children and adolescents, but can also occur in adults. At this age, the diagnosis of rheumatic flare-ups can be difficult due to the frequency of other types of joint diseases and the existence of degenerative and dystrophic valve disease. In adults, the initial rheumatic attack is marked by the predominance of joint damage over cardiac damage. However, it is often at this age that rheumatic valve disease is discovered. The revised Jones criteria also find their place in the diagnosis of AAR in adults. Objective: To study the demographic, clinical, and biological characteristics of acute rheumatic fever (ARF) in the General Medicine Department of the Siguiri Prefectural Hospital. Materials and Methods: This descriptive observational study examined the demographic, clinical and biological characteristics of acute rheumatic fever (ARF) at the Siguiri Prefectural Hospital, Guinea, between April 1 and September 31, 2021 according to Jones criteria. The data were collected on a form containing sociodemographic variables (age, sex, profession), rheumatological, cardiac, pulmonary and neurological clinical signs, biological variables and treatment. Results: Figure 1 shows the flow of the hospital frequency of the RAA in the General Medicine Department of the Prefectural Hospital of Siguiri. During the study period, 420 patients were hospitalized, of whom 161 patients had AAR, a frequency of 38.33%. Table 1 shows the distribution of patients diagnosed with ARB, by sociodemographic characteristics. The average age was 44.7 ± 19.78 years and the extremes of 14 and 90 years, the female sex dominated with a ratio of 0.75. The informal sector was in the majority in 45.34% of cases and most were illiterate, i.e. 53.42%. In our study, the incidence was lower during the dry season than during the rainy season, a hot season with high rainfall and humidity, the rainy period was a provider with a peak in August and September. The lifestyle was characterized by overcrowding in 87.58% of patients. The main complaint was fever, i.e. 88.82%. Rheumatological manifestations such as arthritis were 98.14%, chest pain was 37.89% (61 cases). The diagnosis was confirmed by ASLO titration in 85.71% of patients and 98.55% (136 cases) had a titration greater than 400 U/ml. Conclusion: The results obtained from our study show a high prevalence of acute rheumatic fever, which makes it a worrying health problem in the Siguiri health district. Young female adult patients, married with an informal profession and not in school residing in Siguiri were the most encountered in our study. The main functional signs mentioned by the patients were fever, cough and abdominal pain;osteoarticular pain and chest pain dominated the clinical picture. Almost all of our patients had an ASLO titer greater than 400 U/ml and a positive C-reactive protein. Our results show a high risk of spread of acute rheumatic fever within the population of Siguiri. Due to the serious complications caused by acute rheumatic fever, particular attention must be paid to it by carrying out other, much larger studies in order to identify the problem of RAA.
文摘BACKGROUND There is a need to synthesize the different patterns of fever treatment and phobias in Nigeria and to document these behavioral issues among caregivers.Although,fever is commonly seen in children and this make the mothers to seek medical care when all effort of theirs have failed.Yet,this behavioral and anxiety disorders among mothers still persists several years after the word“Fever phobia”was coined.AIM To document the knowledge of fever among Nigerian mothers and to determine heterogeneity in these practices across the nation.METHODS A search of articles on fever phobias among mothers or caregivers in Nigeria was performed via the Cochrane Database of Systematic Reviews,PubMed,Google Scholar,and MEDLINE.Articles published between 2008,and 2023 were included in the study.The keywords used in the literature search included fever,phobias,perceptions,mothers,caregivers,perceptions,drugs,knowledge,and practices.Boolean operators were also used in the search for items,such as“fever AND phobia”,“fever AND perception”,“fever AND mothers”,“fevers AND/OR phobia”,“AND OR mothers/caregivers”,to help narrow parameters in the search engine and enhance reproducibility.Studies that fulfilled the inclusion criteria were presented via the PRISMA model.I2 statistics were used to assess heterogeneity.RESULTS The studies show wide variation in the reported levels of knowledge about fever,with proportions ranging from as low as 35%to as high as 94%.The pooled proportion estimate using the common effect model is 65%(95%CI:64%-67%),assuming that all studies reflect a single underlying value.However,the random effects model,which accounts for differences among studies,yields a higher estimate of 70%(95%CI:56%-82%).This divergence reflects significant heterogeneity in the data,with a Tau^(2)of 0.7007,I²of 95.7%,and,an H statistic of 4.80,all indicating that most of the variability is due to actual differences among studies rather than random chance.The Q test further confirms this,with a P value less than 0.0001,reinforcing that the variability across studies is statistically significant.The subgroup analysis revealed that studies in Group A(six studies)reported a pooled knowledge proportion of 75%,with a confidence interval ranging from 56%to 88%,and relatively lower heterogeneity(Tau^(2)=0.5709,Tau=0.7556),indicating greater consistency in their findings.In contrast,Group B(four studies)had a lower pooled estimate of 62%,but with a much wider confidence interval(27%to 88%)and greater heterogeneity(Tau^(2)=0.8380,Tau=0.9154),suggesting greater variation across studies in that group.Fear of brain damage,convulsions,witches/wizards,and death was high in many of the studies.Herbal concoctions,and prayers were the mostly used measures to cure fever by mothers.CONCLUSION Mothers’knowledge of fever detection in children is low.There was heterogeneity in the sample size of the studies,which may have affected the knowledge of fever.
基金the Military Program for Clinical Cultivation Specialty and Chinese Preventive Medicine Association.
文摘Objective:Children below 14 years of age are highly vulnerable to dengue infection and are at a greater risk of developing severe dengue illness.This study aimed to investigate the trends in the burden of dengue fever among children below 14 years of age in China from 1990 to 2021 and to project the disease burden from 2022 to 2035.Methods:Based on the datasets derived from the Global Burden of Disease Study 2021,the following data were collected from dengue-affected children aged ≤14 years in China from 1990 to 2021:number and rate of incident dengue cases,number of prevalent dengue cases,number of deaths due to dengue,and disability-adjusted life years(DALYs) lost due to dengue.The trends in disease burden were examined based on average annual percent change(AAPC) and annual percent change,and the burdens were proj ected from 2022 to 2035 by using a Bayesian age-period-cohort model.Results:The incidence and prevalence of dengue fever were increased in children aged ≤ 14 years in China from1990 to 2021(AAPC=5.42 % and 5.44 %,respectively,P <0.001),while the mortality and DALYs rates were reduced(AAPC=-8.21 % and-7.55 %,respectively,P <0.001).The burden was comparable between genders,with numerically lower incidence and prevalence in boys than in girls.The lowest incidence and prevalence and the highest mortality and DALYs rates were observed in children aged <5 years.The incidence and prevalence rates were projected to increase from 2022 to 2035;in contrast,the mortality and DALYs rates were projected to decrease during this period.Conclusions:Although the mortality and DALYs rates of dengue fever decreased significantly in children aged0-14 years in China from 1990 to 2021,the incidence and prevalence increased remarkably.Enhanced surveillance and ample health education programs and preventive interventions are recommended for targeting this high-risk population.
文摘Fever of unknown origin(FUO)is recognized as fever with uncertain diagnosis despite three days of hospital admission or three or more outpatient visits.[1]Acute liver fluke infection is characterized by fever,right upper quadrant pain,hepatomegaly,jaundice,and peripheral blood eosinophilia.By contrast,chronic liver fluke infection is asymptomatic in its early stage,but can easily progress to cirrhosis,cancer,or bile duct cancer initslaterstages.The diagnosis of clonorchiasis is particularly challenging in non-endemic areas.We herein report an unusual case of liver fluke infection in a patient who presented with FUO and eosinophilia.A 38-year-old male was admitted to our hospital with a history of intermittent and recurrent fever for over 10 d and a history of sudden abdominal pain for1 h.He had no other medical history.More than 10d ago,he visited our emergency department because of FUO,with his body temperature reaching 39.7℃,and he had no other symptoms at that time.Laboratory and radiological examinations revealed:white blood cell(WBC)counts,10.9×10^(9)/L;neutrophil percentage,84.5%;eosinophil percentage,3.1%;C-reactive protein(CRP),141 mg/L;liver and kidney function,normal;influenza virus,negative;urine and stool tests,normal;and chest computed tomography(CT)findings,normal.The fever subsided after 1 week of anti-infective treatment with moxifloxacin.Subsequent tests revealed the following results:WBC,15.0×10^(9)/L;neutrophil percentage,70.0%;eosinophil percentage,16.8%;and CRP,122 mg/L.The antimicrobial treatment was then discontinued.
文摘Typhoid fever remains a major global health challenge,particularly in regions with limited access to clean water and sanitation.The emergence of multidrug-resistant and extensively drug-resistant strains of Salmonella enterica serovar Typhi highlights the urgent need for alternative treatment strategies.Medicinal plants represent a promising avenue for addressing this crisis,as their bioactive compounds exhibit potent antibacterial properties.According to the World Health Organization,over 20,000 medicinal plant species have been identified as valuable resources for drug discovery,with more than 1,340 demonstrating antimicrobial activity and over 30,000 antimicrobial compounds isolated.Through an extensive review,key phytochemicals with anti-typhoid properties were identified,along with their mechanisms of action and supporting evidence from in vitro and in vivo studies.This review compiles data on plants with demonstrated anti-typhoid activity,highlights challenges such as standardization,regulatory frameworks,and integration into modern healthcare,and explores the role of omics technologies in advancing the discovery of novel plant-based antimicrobial agents.By discussing potential medicinal plant targets and intervention strategies,this work lays the groundwork for future research into plant-derived anti-infective therapies and contributes to the global effort to combat the growing threat of typhoid fever,particularly in resource-limited settings.
文摘BACKGROUND Nosocomial fever of unknown origin(nFUO)is a frequent and challenging diagnostic entity,encompassing diverse infectious and non-infectious etiologies.Timely identification is crucial,yet evidence on the diagnostic accuracy of commonly employed sepsis screening tools and biomarkers remains sparse.We hypothesized that these tools and biomarkers measured at fever onset could distinguish infectious from non-infectious causes of nFUO in critically ill adults.AIM To evaluate the diagnostic utility of sepsis tools and biomarkers in identifying infectious causes of nFUO.METHODS This prospective observational study included patients admitted to the Acute Care Emergency Medicine Unit,Postgraduate Institute of Medical Education and Research,Chandigarh,India(July 2023 to December 2024).nFUO was defined by Durack and Street criteria.Diagnostic performance of sepsis screening tools(systemic inflammatory response syndrome,Sequential Organ Failure Assessment,quick Sequential Organ Failure Assessment,National Early Warning Score,and Modified Early Warning Score)and biomarkers[procalcitonin(PCT),C-reactive protein(CRP)]at fever onset was assessed using receiver operating characteristic curve analysis.RESULTS Of 80 cases(mean age 42.9±16.5 years;80% male),42.5% had infectious causes,38.7% non-infectious,and 18.8% remained undiagnosed.Pneumonia(26.2%)and bloodstream infections(11.2%)were the most common infectious etiologies,while central fever and thrombophlebitis(each 7.5%)were predominant among non-infectious causes.Sepsis tools showed poor diagnostic accuracy,with area under the receiver operating characteristic curve(AUC)values close to 0.5.PCT demonstrated modest performance(AUC=0.61;optimal cut-off:0.85μg/L),while CRP was paradoxically higher in non-infectious cases(AUC=0.45).Overall mortality was 20% and was highest among undiagnosed patients(33.3%).Fever duration and hospitalization length were significantly greater in infectious cases.CONCLUSION Sepsis tools,PCT,and CRP have limited utility in identifying infectious causes of nFUO in critically ill adults and should not solely guide initial decision-making.
基金Chinese Academy of Medical Sciences Initiative for Innovative Medicine,Grant/Award Number:2021-I2M-1-035 and 2022-I2M-1-011。
文摘Background:Dengue fever,an acute insect-borne infectious disease caused by the dengue virus(DENV),poses a great challenge to global public health.Hepatic involve-ment is the most common complication of severe dengue and is closely related to the occurrence and development of disease.However,the features of adaptive immune responses associated with liver injury in severe dengue are not clear.Methods:We used single-cell sequencing to examine the liver tissues of mild or se-vere dengue mice model to analyze the changes in immune response of T cells in the liver after dengue virus infection,and the immune interaction between macrophages and T cells.Flow cytometry was used to detect T cells and macrophages in mouse liver and blood to verify the single-cell sequencing results.Results:Our result showed CTLs were significantly activated in the severe liver injury group but the immune function-related signal pathway was down-regulated.The rea-son may be that the excessive immune response in the severe group at the late stage of DENV infection induces the polarization of macrophages into M2 type,and the macrophages then inhibit T cell immunity through the TGF-βsignaling pathway.In ad-dition,the increased proportion of Treg cells suggested that Th17/Treg homeostasis was disrupted in the livers of severe liver injury mice.Conclusions:In this study,single-cell sequencing and flow cytometry revealed the characteristic changes of T cell immune response and the role of macrophages in the liver of severe dengue fever mice.Our study provides a better understanding of the pathogenesis of liver injury in dengue fever patients.
文摘Objective:To observe the application effect of risk management in the nursing work of fever clinics,especially its effect on improving nursing satisfaction and the work quality of nursing staff,as well as reducing the incidence of nursing risk events,and to provide a scientific reference for future clinical research and practice.Methods:This study adopted a retrospective approach,fixing the research period from December 2024 to August 2025.A total of 110 patients admitted to the fever clinic of our hospital were selected as the research objects and divided into two groups(the control group and the experimental group)using the random number table method.Each group had 55 patients.Then,differentiated nursing strategies were implemented for the two groups.Both the control group and the experimental group received routine nursing.The difference was that the experimental group was additionally given risk management measures on the basis of routine nursing.After 7 days of intervention,the nursing satisfaction rate,nursing quality,cognitive score of fever clinic risks,nursing error rate,complaint rate,and incidence of risk events were compared and analyzed between the two groups.Results:The nursing satisfaction score,nursing complaint rate,incidence of nursing risk events,nursing error rate,nursing quality score,and cognitive score of fever clinic risks in the experimental group were significantly better than those in the control group.The differences were statistically significant(P<0.05).Conclusion:Risk management has a significant application effect in the nursing work of fever clinics,playing a positive role for both patients and nursing staff.It is an effective measure to comprehensively improve nursing quality and an important means to greatly reduce the incidence of nursing risk events,thus having high clinical promotion value.
文摘Rationale:Dengue fever is a mosquito-borne viral infection,which commonly presents as an acute febrile illness.As the number of cases increases,rare manifestations including neurological manifestations are occasionally encountered.Patient concerns:A 20-year-old female presented with fever for 3 days with slurring of speech and unsteady gait,which were developed from the third day of illness.On examination,she had bilateral cerebellar signs.Dengue non-structural protein 1 antigen and dengue IgM in serum were positive.Her cerebrospinal fluid analysis and magnetic resonance image brain were normal.Diagnosis:Dengue cerebellitis.Intervention:Supportive management with fluids including oral rehydration solutions and intravenous fluids and paracetamol.Outcome:Cerebellar symptoms and signs completely resolved by the 20th day of illness.Lesson:Dengue cerebellitis is an unusual neurological manifestation of dengue infection.
基金Bangor University,UK supported this study through the International Science Partnerships Fund(ISPF)。
文摘Objective:Studies on the occupational health risks and experiences of healthcare waste handlers since the decline in coronavirus disease 2019(COVID-19)incidence are scarce in Nigeria.The current study aimed to examine what seemed as the"hidden"and rarely researched area of practice from the standpoint of different stakeholders in a Nigerian Lassa fever treatment hospital.The primary objective was to understand the nature of waste handlers'practices and experiences and identify areas for improvement centred on supporting the development of best practices,in accordance with the World Health Organisation(WHO)guidelines.Methods:This study employed a qualitative case study design,gathering data from healthcare waste handlers(n=34)through four focus groups.Additionally,four in-depth interviews were conducted with ward managers and the infection control team to gain insight into the organisational framing of waste handling practice,the perceived challenges faced by waste handlers from their perspectives,and the provision of training and support.The qualitative data were audio-recorded and transcribed verbatim through manual processes and subjected to a reflexive thematic analysis conducted manually.Results:The findings revealed that waste handlers were subjected to various occupational health risks,including back pain,needlestick injuries,psychological distress,fatigue,anxiety,and prolonged exposure to sunlight.Concerns were raised regarding the inadequate supply of personal protective equipment and other essential tools,which suggests a need for organisational commitment to ensure the continual availability of these resources to protect the health and safety of these employees.A critical issue identified was the lack of comprehensive training for waste handlers,highlighting a form of organisational negligence.The consensual views expressed by the waste handlers indicated a sense of dissatisfaction with their working environment,largely attributable to organisational and societal stigmatisation.Furthermore,the study underscored that the hospital management faced significant financial constraints and advocated for increased funding to effectively implement best practice standards.Conclusion:To effectively manage healthcare waste and reduce hazards to waste handlers,the organisational leadership should prioritise training and support.This initiative will not only benefit the waste handlers but also the patients,other healthcare workers,and the general public.Although the findings focus on the case context of a Nigerian Lassa fever treatment hospital,the wider implications of this study are linked to the role of institutional support for waste handling practice.Moreover,it extends to the potential positions of institutions as displaying a form of"benign anomie"in not ensuring the wellbeing of waste handlers through sufficient regulation and governance focused on prioritisation,processes,and procedures.The study highlights the relevance of embedding WHO guidelines in other similar contexts as part of implementation across institutions involved with waste handling.
文摘BACKGROUND Familial Mediterranean fever(FMF)is an autosomal recessive autoinflammatory disorder marked by recurrent episodes of fever and serositis.Resistin,a proinflammatory cytokine,may play a role in FMF pathogenesis by promoting the release of interleukin-1beta,tumour necrosis factor alpha,and interleukin-6.AIM To evaluate serum resistin levels in children with FMF during acute attacks and remission,and to assess its potential as a biomarker for disease activity and progression.METHODS A case-control study was conducted involving 40 pediatric patients with FMF and 40 age-and sex-matched healthy controls.Serum resistin and inflammatory markers—including total leukocyte count(TLC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),serum amyloid A(SAA),and fibrinogen—were measured using enzyme-linked immunosorbent assay and standard assays.RESULTS No significant differences were found in age or sex between FMF patients and controls.Among FMF patients,fever was the most prevalent symptom(95%),followed by abdominal pain(75%).The most frequently detected genetic mutation was M694I,followed by M694V,E148Q,M680I,and V726A.Compound heterozygous mutations,including M694I/V726A and M694I/M694V,were equally represented.During acute attacks,FMF patients exhibited significantly elevated levels of TLC,ESR,CRP,SAA,and fibrinogen compared to attack-free periods and controls.Serum resistin levels were markedly higher during acute attacks and showed a strong positive correlation with other acute inflammatory markers.Receiver operating characteristic curve analysis demonstrated high sensitivity and specificity of resistin as a potential biomarker for FMF.CONCLUSION Resistin is significantly elevated in children with FMF during acute episodes and correlates with established inflammatory markers.These findings support its potential role as a non-invasive biomarker for disease activity and severity in pediatric FMF.
