Evidence map›Paper›PMID 28644847›Full record

ArticlePloS one2017

Role of classic signs as diagnostic predictors for enteric fever among returned travellers: Relative bradycardia and eosinopenia.

Takashi Matono, Satoshi Kutsuna, Yasuyuki Kato, Yuichi Katanami, Kei Yamamoto, Nozomi Takeshita, Kayoko Hayakawa, Shuzo Kanagawa, Mitsuo Kaku, Norio Ohmagari

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.2field-weighted citation impact, top 12% 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

8 citing papers in PubMed, 22 citations in OpenAlex.

  1. Article
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  8. Travel-Related Typhoid Fever: Narrative Review of the Scientific Literature.International journal of environmental research and public health · 2020
    Review
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

10 authors at 2 institutions in 1 country.

Takashi MatonoDisease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Satoshi KutsunaDisease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Yasuyuki KatoDisease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Yuichi KatanamiDisease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Kei YamamotoDisease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Nozomi TakeshitaDisease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Kayoko HayakawaDisease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Shuzo KanagawaDisease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Mitsuo KakuDepartment of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Norio OhmagariDisease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
National Center for Global Health and Medicine · JPTohoku University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe lack of characteristic clinical findings and accurate diagnostic tools has made the diagnosis of enteric fever difficult. We evaluated the classic signs of relative bradycardia and eosinopenia as diagnostic predictors for enteric fever among travellers who had returned from the tropics or subtropics.

methodsThis matched case-control study used data from 2006 to 2015 for culture-proven enteric fever patients as cases. Febrile patients (>38.3°C) with non-enteric fever, who had returned from the tropics or subtropics, were matched to the cases in a 1:3 ratio by age (±3 years), sex, and year of diagnosis as controls. Cunha's criteria were used for relative bradycardia. Absolute eosinopenia was defined as an eosinophilic count of 0/μL.

resultsData from 160 patients (40 cases and 120 controls) were analysed. Cases predominantly returned from South Asia (70% versus 18%, p <0.001). Relative bradycardia (88% versus 51%, p <0.001) and absolute eosinopenia (63% versus 38%, p = 0.008) were more frequent in cases than controls. In multivariate logistic regression analysis, return from South Asia (aOR: 21.6; 95% CI: 7.17-64.9) and relative bradycardia (aOR: 11.7; 95% CI: 3.21-42.5) were independent predictors for a diagnosis of enteric fever. The positive likelihood ratio was 4.00 (95% CI: 2.58-6.20) for return from South Asia, 1.72 (95% CI: 1.39-2.13) for relative bradycardia, and 1.63 (95%CI: 1.17-2.27) for absolute eosinopenia. The negative predictive values of the three variables were notably high (83-92%);. however, positive predictive values were 35-57%.

conclusionsThe classic signs of relative bradycardia and eosinopenia were not specific for enteric fever; however both met the criteria for being diagnostic predictors for enteric fever. Among febrile returned travellers, relative bradycardia and eosinopenia should be re-evaluated for predicting a diagnosis of enteric fever in non-endemic areas prior to obtaining blood cultures.

Indexed as

TravelAdolescentAdultAsia, SoutheasternBlood Cell CountBradycardiaCase-Control StudiesChildChild, PreschoolDiagnosis, DifferentialEosinophilsFemaleHumansInfantLikelihood FunctionsLogistic Models

Identifiers

PMID28644847
PMCPMC5482448
OpenAlexW2713299975

What OpenQuestion holds

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LicenceCC BY
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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.