Evidence map›Paper›PMID 26851948›Full record

Observational studyEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2016

A comparative hospital-based observational study of mono- and co-infections of malaria, dengue virus and scrub typhus causing acute undifferentiated fever.

S Ahmad, M Dhar, G Mittal, N K Bhat, N Shirazi, V Kalra, H C Sati, V Gupta

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 8 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 8 syntheses or guidelines pooled it, 42 citations in OpenAlex.

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  12. Scrub Typhus and Influenza A Co-Infection: A Case Report.Pathogens (Basel, Switzerland) · 2025
    Article
  13. ISCCM Position Statement on the Management of Severe Malaria in Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

S AhmadDepartment of Medicine, Himalayan Institute of Medical Sciences, SRH University, Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, 248106, India. sohadia@hotmail.com.
M DharDepartment of Medicine, Himalayan Institute of Medical Sciences, SRH University, Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, 248106, India.
G MittalDepartment of Microbiology, Himalayan Institute of Medical Sciences, Dehradun, India.
N K BhatDepartment of Pediatrics, Himalayan Institute of Medical Sciences, Dehradun, India.
N ShiraziDepartment of Pathology, Himalayan Institute of Medical Sciences, Dehradun, India.
V KalraDepartment of Medicine, Himalayan Institute of Medical Sciences, SRH University, Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, 248106, India.
H C SatiDepartment of Community Medicine, Himalayan Institute of Medical Sciences, Dehradun, India.
V GuptaDepartment of Pathology, Himalayan Institute of Medical Sciences, Dehradun, India.
Swami Rama Himalayan University · INInstitute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Positive serology for dengue and/or scrub typhus infection with/without positive malarial smear (designated as mixed or co-infection) is being increasingly observed during epidemics of acute undifferentiated febrile illnesses (AUFIs). We planned to study the clinical and biochemical spectrum of co-infections with Plasmodium sp., dengue virus and scrub typhus and compare these with mono-infection by the same organisms. During the period from December 2012 to December 2013, all cases presenting with AUFIs to a single medical unit of a referral centre in Garhwal region of the north Indian state of Uttarakhand were retrospectively selected and categorised aetiologically as co-infections, malaria, dengue or scrub typhus. The groups thus created were compared in terms of demographic, clinical, biochemical and outcome parameters. The co-infection group (n = 49) was associated with milder clinical manifestations, fewer, milder and non-progressive organ dysfunction, and lesser need for intensive care, mechanical ventilation and dialysis as compared to mono-infections. When co-infections were sub-grouped and compared with the relevant mono-infections, there were differences in certain haematological and biochemical parameters; however, this difference did not translate into differential outcomes. Scrub typhus mono-infection was associated with severe disease in terms of both morbidity and mortality. Malaria, dengue and scrub typhus should be routinely tested in all patients with AUFIs. Co-infections, whether true or due to serological cross-reactivity, appear to be a separate entity so far as presentation and morbidity is concerned. Further insight is needed into the mechanism and identification of the protective infection.

Indexed as

AdolescentAdultAgedCoinfectionDengueFemaleFever of Unknown OriginHospitalsHumansIndiaMalariaMaleMiddle AgedRetrospective StudiesScrub TyphusYoung Adult

Identifiers

PMID26851948
OpenAlexW2269152756

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.