Background In malaria-endemic countries, febrile episodes caused by diseases other than malaria are a growing concern. However, limited knowledge of the prevalent etiologic agents and their geographic distributions restrict the ability of health services to address non-malarial morbidity and mortality through effective case management. Here, we review the etiology of fever in Latin America (LA) between 1980 and 2015 and map significant pathogens commonly implicated in febrile infectious diseases. Methods A literature search was conducted, without language restrictions, in three distinct databases in order to identify fever etiology studies that report laboratory-confirmed fever-causing pathogens that were isolated from usually sterile body sites. Data analyses and mapping was conducted with Tableau Desktop (version 2018.2.3). Results Inclusion criteria were met by 625 publications corresponding to data relative to 34 countries. Studies using serology (n = 339) predominated for viral infections, culture (n = 131) for bacteria, and microscopy (n = 62) for fungi and parasites. The pathogen groups most frequently reported were viral infections (n = 277), bacterial infections (n = 265), parasitic infections (n = 59), fungal infections (n = 47), and more than one pathogen group (n = 24). The most frequently reported virus was dengue virus (n = 171), followed by other arboviruses (n = 55), and hantavirus (n = 18). For bacteria, Staphylococcus spp. (n = 82), Rickettsia spp. (n = 70), and Leptospira spp. (n = 55) were frequently reported. Areas with biggest gaps on etiology of fever were apparent. Conclusions This review provides a landscape of pathogens causing febrile illness other than malaria in LA for over 30 years. Our findings highlight the need to standardize protocols and report guidelines for fever etiology studies for better comparability of results and improved interpretation. Lastly, we should improve existing national laboratory surveillance systems, especially from low- to middle-income countries, to inform global fever policy priorities and timely identify emerging infections threats. Study registration PROSPERO systematic review registration number: CRD42016049281

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Este artigo trata dos resultados da pesquisa: Como trabalham os comunicadores na pandemia da Covid-19? A investigação não probabilística, de carácter exploratório, aplicou questionário com questões abertas e fechadas, online, via plataforma do Google, no período de 5 a 30 de abril, e ficou disponível nas redes sociais do Centro de Pesquisa em Comunicação e Trabalho e de parceiros da pesquisa. O questionário obteve 557 respondentes comunicadores de todo o país, em diferentes atividades laborais. Os resultados, discutidos neste artigo, mostram que há aumento das jornadas de trabalho, há intensificação da atividade laboral, com uso de equipamentos próprios, cujos custos oneram o comunicador; intensificou-se o uso das plataformas e aplicativos no processo produtivo, para a organização, controle da gestão do trabalho, da rotina produtiva e, sobretudo, do fluxo de informação. As empresas, em geral, adotaram o home office e, quando a atividade não permite o distanciamento, criaram turnos mistos, presencial e a distância, nesses casos, a adoção de EPIs se apresenta como um complicador da relação trabalhador-empresa-público. No home office, os comunicadores precisam reorganizar o espaço doméstico e o acompanhamento dos filhos. Os profissionais se sentem mais cansados, inseguros com o futuro, temem o contágio, pela vida dos familiares, a situação de colapso do sistema de saúde, mas preocupam-se com o trabalho: perder o emprego, ter redução de salário, perder contratos etc. são preocupações que atormentam e tornam as jornadas mais estressantes. Mesmo com todos esses problemas, há um grande engajamento para a realização do trabalho.

Objective: Evaluate the performance of a novel antibody-based rapid diagnostic test (RDT) for detecting Chikungunya virus (CHIKV) infection in febrile patients in Rio de Janeiro, Brazil. Methods: We prospectively enrolled non-severe febrile patients aged 2-65 presenting as outpatients between October 2018 and July 2019. Serum samples were collected during acute and convalescent phases, tested for CHIKV antibodies using the DPP ZDC IgM/IgG rapid test, and compared against the reference test, CHIKV RT-PCR. We determined the seropositivity using ELISA IgM/IgG and evaluated the diagnostic performance of the WHO-endorsed CHIKV clinical definition against the reference test. Results: Of 500 participants, 226/261 (86.5%) tested ELISA IgM positive, 45/271 (16.6%) tested ELISA IgG positive, 100/294 (34%) CHIKV RT-PCR positive, and 117/495 (23.6%) RDT-antibody positive. During the acute phase [median 3 (2-4) days post illness onset], the sensitivity of IgM, IgG, and combined IgM/IgG ranged from 14.71-34.85%, while specificity ranged from 63.32-65.61%. During the convalescent phase [mean 16.5 (+5.5) days post-illness onset], sensitivity increased from 65.75% to 77.78%, and specificity ranged from 93.33 to 98.11%. The WHO's CHIKV clinical definition had a sensitivity, specificity, positive predictive value, and negative predictive value of 88 (79.9-93.6)%, 74 (68-80)%, 64.2 (58.2-69.8)%, and 92.3 (87.6-95.3)%, respectively. Conclusions: The DPP ZDC IgM/IgG accurately diagnosed CHIKV on samples collected during the convalescent phase. Field applications include investigating CHIKV in patients with sub-acute to chronic osteoarticular symptoms and conducting serosurveys to inform priority areas for CHIKV vaccine implementation. The WHO's clinical definition of CHIKV was accurate and could be deployed, especially in regions with limited diagnostic capacity.