ArticleRevista do Instituto de Medicina Tropical de Sao Paulo2026
Sentinel surveillance of acute febrile illness in a Brazilian Amazon region: laboratory findings and epidemiological implications.
Article in Revista do Instituto de Medicina Tropical de Sao Paulo, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Amapa State, Brazil, in the Amazon region and bordering French Guiana, is a strategic sentinel location for infectious disease surveillance. Ecological pressures such as deforestation, artisanal gold mining, and high human mobility contribute to complex transmission dynamics of arboviruses, bacterial infections, and other pathogens. This study aims to characterize the etiologies of acute febrile illness (AFI) reported in Amapa State in 2018-2020, focusing on arbovirus circulation, bacterial contributions, and emerging pathogens. A retrospective analysis was carried out with 727 AFI cases. Laboratory diagnoses were established using molecular and serological assays, with systematic testing for different pathogens. Definitive diagnoses were obtained in 185 individuals (25.4%), yielding 209 positive results and including 23 cases of co-infection. Dengue virus was the predominant etiological agent (n=109, 52%), followed by leptospirosis (n=20, 9.5%), chikungunya virus (n=16, 7.6%), parvovirus B19 (n=16, 7.6%), measles (n=15, 7.1%), zika virus (n=10, 4.8%), mayaro virus (n=1,0.5%), and other bacterial infections (n=5, 2.4%). Isolated cases of hepatitis A and B, malaria, SARS-CoV-2, enterovirus, and acute Chagas disease were also identified. No hepatitis E virus or oropouche cases were detected. Dengue virus was the leading cause of AFI. Leptospirosis, chikungunya virus, and parvovirus B19 were other prevalent and often underrecognized contributors. The detection of additional viruses highlights Amapa State as a potential zone of "silent expansion" for emerging arboviruses. Co-detection of multiple pathogens underscores diagnostic complexity in regions with overlapping transmission. Strengthening surveillance, expanding laboratory capacity, and prioritizing differential diagnostics are essential to capture epidemiological dynamics and guide public health interventions.
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.