Evidence map›Paper›PMID 39838275›Full record

ArticleBMC infectious diseases2025

Beyond the fever: shotgun metagenomic sequencing of stool unveils pathogenic players in HIV-infected children with non-malarial febrile illness.

Patricia Nabisubi, Stephen Kanyerezi, Grace Kebirungi, Ivan Sserwadda, Mike Nsubuga, Grace Kisitu, Patricia Ntege Nahirya, Bonny Mulindwa, George P Akabwai, Sylvia Nantongo and 8 more

Abstract read
In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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. Review
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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

18 authors.

Patricia NabisubiThe African Centre of Excellence in Bioinformatics and Data-Intensive Sciences, Kampala, Uganda.
Stephen KanyereziThe African Centre of Excellence in Bioinformatics and Data-Intensive Sciences, Kampala, Uganda.
Grace KebirungiThe African Centre of Excellence in Bioinformatics and Data-Intensive Sciences, Kampala, Uganda.
Ivan SserwaddaThe African Centre of Excellence in Bioinformatics and Data-Intensive Sciences, Kampala, Uganda.
Mike NsubugaThe African Centre of Excellence in Bioinformatics and Data-Intensive Sciences, Kampala, Uganda.
Grace KisituBaylor College of Medicine Children's Foundation, Mulago Hospital, Kampala, Uganda.
Patricia Ntege NahiryaBaylor College of Medicine Children's Foundation, Mulago Hospital, Kampala, Uganda.
Bonny MulindwaBaylor College of Medicine Children's Foundation, Mulago Hospital, Kampala, Uganda.
George P AkabwaiBaylor College of Medicine Children's Foundation, Mulago Hospital, Kampala, Uganda.
Sylvia NantongoThe African Centre of Excellence in Bioinformatics and Data-Intensive Sciences, Kampala, Uganda.
Adeodata KekitiinwaBaylor College of Medicine Children's Foundation, Mulago Hospital, Kampala, Uganda.
Edgar KigoziDepartment of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
Nsubuga Moses LuutuDepartment of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
Fred Ashaba KatabaziDepartment of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
Leymon KalemaDepartment of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
Andrew KatabalwaDepartment of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
Daudi JjingoThe African Centre of Excellence in Bioinformatics and Data-Intensive Sciences, Kampala, Uganda.
Gerald MboowaThe African Centre of Excellence in Bioinformatics and Data-Intensive Sciences, Kampala, Uganda. gmboowa@gmail.com.

Funding

NURTURING GENOMICS AND BIOINFORMATICS RESEARCH CAPACITY IN AFRICA (BRecA)U2RTW010672 · FIC · MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES · PI JJINGO, DAUDI, KATEETE, DAVID PATRICK · 2017 to 2022
$1.3M
European and Developing Countries Clinical Trials Partnership TMA2020CDF-3159FIC NIH HHS U2R TW010672
6 · The paper itself

Abstract

backgroundNon-malarial febrile illnesses (NMFI) pose significant challenges in HIV-infected children, often leading to severe complications and increased morbidity. While traditional diagnostic approaches focus on specific pathogens, shotgun metagenomic sequencing offers a comprehensive tool to explore the microbial landscape underlying NMFI in this vulnerable population ensuring effective management.

methodsIn this study, we employed shotgun metagenomics to analyse stool samples from HIV-infected children at the Baylor Children's Clinic Uganda presenting with non-malarial febrile illness. Samples were collected and subjected to DNA extraction at the Molecular and Genomics Laboratory, Makerere University followed by shotgun metagenomics sequencing at the Chan Zuckerberg Biohub San Francisco. Bioinformatics analysis was conducted to identify and characterise the microbial composition and potential pathogenic taxa associated with NMFI using the CZID pipeline.

resultsOur findings reveal a diverse array of microbial taxa in the stool samples of HIV-infected children with NMFI. Importantly, shotgun metagenomics revealed potentially pathogenic players including Trichomonas vaginalis, Candida albicans, Giardia, and Bacteroides in stool from this patient population. This sheds light on the complexities of microbial interactions that potentially underpin non-malarial febrile illness in this group. Taxonomic profiling identified recognised pathogens and comorbidities and revealed possible new correlations with NMFI, shedding light on the pathophysiology of fever in HIV-infected children.

conclusionShotgun metagenomics is a valuable method for understanding the gut microbial landscape of NMFI in HIV-infected children, providing a comprehensive approach to pathogen identification and characterisation. By revealing potential pathogenic actors beyond the fever, this work demonstrates how metagenomic sequencing may improve our knowledge of infectious illnesses in vulnerable groups and inspire targeted therapies for better clinical care and outcomes.

Indexed as

FecesFeverHIV InfectionsMetagenomicsBacteriaChildChild, PreschoolFemaleHumansInfantMaleUgandaChildrenHIV-InfectedNon-malarial febrile illnessShotgun metagenomic sequencingUganda

Identifiers

PMID39838275
PMCPMC11752807

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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.