Evidence map›Paper›PMID 33681986›Full record

Observational studyTransactions of the Royal Society of Tropical Medicine and Hygiene2021

Observational study of adult respiratory infections in primary care clinics in Myanmar: understanding the burden of melioidosis, tuberculosis and other infections not covered by empirical treatment regimes.

Clare E Warrell, Aung Pyae Phyo, Mo Mo Win, Alistair R D McLean, Wanitda Watthanaworawit, Myo Maung Maung Swe, Kyaw Soe, Htet Naing Lin, Yee Yee Aung, Chitmin Ko Ko and 8 more

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Transactions of the Royal Society of Tropical Medicine and Hygiene, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 29% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Burden and Risk Factors of Melioidosis in Southeast Asia: A Scoping Review.International journal of environmental research and public health · 2022
    Article
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

18 authors at 5 institutions in 4 countries.

Clare E WarrellMyanmar Oxford Clinical Research Unit, Yangon, Myanmar.ORCID 0000-0003-0633-0986
Aung Pyae PhyoMyanmar Oxford Clinical Research Unit, Yangon, Myanmar.
Mo Mo WinDepartment of Medical Research, Myanmar.
Alistair R D McLeanMyanmar Oxford Clinical Research Unit, Yangon, Myanmar.
Wanitda WatthanaworawitShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
Myo Maung Maung SweMyanmar Oxford Clinical Research Unit, Yangon, Myanmar.
Kyaw SoeMyanmar Oxford Clinical Research Unit, Yangon, Myanmar.
Htet Naing LinMyanmar Oxford Clinical Research Unit, Yangon, Myanmar.
Yee Yee AungDepartment of Medical Research, Myanmar.
Chitmin Ko KoMedical Action Myanmar, Yangon, Myanmar.
Cho Zin WaingMedical Action Myanmar, Yangon, Myanmar.
Kaung San LinnMedical Action Myanmar, Yangon, Myanmar.
Yadanar Phoo Wai AungMedical Action Myanmar, Yangon, Myanmar.
Ne Myo AungDepartment of Medicine, Insein General Hospital, Min Gyi Road, Insein Township, Yangon, Myanmar.
Ni Ni TunMyanmar Oxford Clinical Research Unit, Yangon, Myanmar.
David A B DanceCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Frank M SmithuisMyanmar Oxford Clinical Research Unit, Yangon, Myanmar.
Elizabeth A AshleyMyanmar Oxford Clinical Research Unit, Yangon, Myanmar.
Myanmar Oxford Clinical Research Unit · MMMahosot Hospital · LAEast Yangon General Hospital · MMMahidol University · THUniversity of Oxford · GB

Funding

Medical Action MyanmarPlanet Wheeler fundRoyal Society of Tropical Medicine and HygieneWellcome TrustWellcome Trust 106698/Z/14/Z
6 · The paper itself

Abstract

backgroundLower respiratory infections constitute a major disease burden worldwide. Treatment is usually empiric and targeted towards typical bacterial pathogens. Understanding the prevalence of pathogens not covered by empirical treatment is important to improve diagnostic and treatment algorithms.

methodsA prospective observational study in peri-urban communities of Yangon, Myanmar was conducted between July 2018 and April 2019. Sputum specimens of 299 adults presenting with fever and productive cough were tested for Mycobacterium tuberculosis (microscopy and GeneXpert MTB/RIF [Mycobacterium tuberculosis/resistance to rifampicin]) and Burkholderia pseudomallei (Active Melioidosis Detect Lateral Flow Assay and culture). Nasopharyngeal swabs underwent respiratory virus (influenza A, B, respiratory syncytial virus) polymerase chain reaction testing.

resultsAmong 299 patients, 32% (95% confidence interval [CI] 26 to 37) were diagnosed with tuberculosis (TB), including 9 rifampicin-resistant cases. TB patients presented with a longer duration of fever (median 14 d) and productive cough (median 30 d) than non-TB patients (median fever duration 6 d, cough 7 d). One case of melioidosis pneumonia was detected by rapid test and confirmed by culture. Respiratory viruses were detected in 16% (95% CI 12 to 21) of patients.

conclusionsTB was very common in this population, suggesting that microscopy and GeneXpert MTB/RIF on all sputum samples should be routinely included in diagnostic algorithms for fever and cough. Melioidosis was uncommon in this population.

Indexed as

MelioidosisMycobacterium tuberculosisRespiratory Tract InfectionsTuberculosisTuberculosis, PulmonaryAdultDrug Resistance, BacterialHumansMyanmarPrimary Health CareSensitivity and SpecificitySputumBurkholderia pseudomalleiinfluenzamelioidosisMyanmarrespiratory infectiontuberculosis

Identifiers

PMID33681986
PMCPMC8326957
OpenAlexW3133962269

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.