ArticleBMC infectious diseases2017
Acute undifferentiated fever in India: a multicentre study of aetiology and diagnostic accuracy.
Article in BMC infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 8 of them syntheses that pooled 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.
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.
Who cites it
54 citing papers in PubMed, 8 syntheses or guidelines pooled it, 137 citations in OpenAlex.
- Prevalence of dengue and leptospirosis coinfection and associated mortality rates: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Unveiling the burden of scrub typhus in acute febrile illness cases across India: A systematic review & meta-analysis.The Indian journal of medical research · 2024Pooled it
- Worldwide distribution, symptoms and diagnosis of the coinfections between malaria and arboviral diseases: a systematic review.Memorias do Instituto Oswaldo Cruz · 2024Pooled it
- Prevalence of malaria and scrub typhus co-infection in febrile patients: a systematic review and meta-analysis.Parasites & vectors · 2021Pooled it
- A Systematic Review and Meta-analysis of the Prevalence of Community-Onset Bloodstream Infections among Hospitalized Patients in Africa and Asia.Antimicrobial agents and chemotherapy · 2019Pooled it
- Using hospital-based studies of community-onset bloodstream infections to make inferences about typhoid fever incidence.Tropical medicine & international health : TM & IH · 2019Pooled it
- The validity of diagnostic cut-offs for commercial and in-house scrub typhus IgM and IgG ELISAs: A review of the evidence.PLoS neglected tropical diseases · 2019Pooled it
- Global prevalence and distribution of coinfection of malaria, dengue and chikungunya: a systematic review.BMC public health · 2018Pooled it
- Trimethoprim-sulfamethoxazole Versus Azithromycin for the Treatment of Undifferentiated Febrile Illness in Nepal: A Double-blind, Randomized, Placebo-controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Trial
- Mapping Scrub Typhus Across Multiple Hosts in India.EcoHealth · 2026Review
- Laboratory-Negative Results as a Marker of Diagnostic Gap: A Retrospective Study in the One Health Context.Cureus · 2026Article
- Article
- Article
- Advancing the diagnosis of scrub typhus with targeted next-generation sequencing.Frontiers in microbiology · 2026Article
- Laboratory Diagnosis of Leptospirosis.Methods in molecular biology (Clifton, N.J.) · 2026Review
- Article
- Article
- Article
- Clinical Manifestations, Risk Factors, and Disease Burden of Rickettsiosis, Cambodia, 2007-2020.Emerging infectious diseases · 2025Review
- Bacteriological and Serological Investigation of Leptospirosis in Dogs and Pigs in Palau.The American journal of tropical medicine and hygiene · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe objectives of this study were to determine the proportion of malaria, bacteraemia, scrub typhus, leptospirosis, chikungunya and dengue among hospitalized patients with acute undifferentiated fever in India, and to describe the performance of standard diagnostic methods.
methodsDuring April 2011-November 2012, 1564 patients aged ≥5 years with febrile illness for 2-14 days were consecutively included in an observational study at seven community hospitals in six states in India. Malaria microscopy, blood culture, Dengue rapid NS1 antigen and IgM Combo test, Leptospira IgM ELISA, Scrub typhus IgM ELISA and Chikungunya IgM ELISA were routinely performed at the hospitals. Second line testing, Dengue IgM capture ELISA (MAC-ELISA), Scrub typhus immunofluorescence (IFA), Leptospira Microscopic Agglutination Test (MAT), malaria PCR and malaria immunochromatographic rapid diagnostic test (RDT) Parahit Total™ were performed at the coordinating centre. Convalescence samples were not available. Case definitions were as follows: Leptospirosis: Positive ELISA and positive MAT. Scrub typhus: Positive ELISA and positive IFA. Dengue: Positive RDT and/or positive MAC-ELISA. Chikungunya: Positive ELISA. Bacteraemia: Growth in blood culture excluding those defined as contaminants. Malaria: Positive genus-specific PCR.
resultsMalaria was diagnosed in 17% (268/1564) and among these 54% had P. falciparum. Dengue was diagnosed in 16% (244/1564). Bacteraemia was found in 8% (124/1564), and among these Salmonella typhi or S. paratyphi constituted 35%. Scrub typhus was diagnosed in 10%, leptospirosis in 7% and chikungunya in 6%. Fulfilling more than one case definition was common, most frequent in chikungunya where 26% (25/98) also had positive dengue test.
conclusionsMalaria and dengue were the most common causes of fever in this study. A high overlap between case definitions probably reflects high prevalence of prior infections, cross reactivity and subclinical infections, rather than high prevalence of coinfections. Low accuracy of routine diagnostic tests should be taken into consideration when approaching the patient with acute undifferentiated fever in India.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.