Febrile illness in Asia: gaps in epidemiology, diagnosis and management for informing health policy

Abstract

Many key gaps remain, and consensus guidelines for study design are needed to aid comparative understanding of the epidemiology of fevers. More investment in developing accurate and affordable diagnostic tests for rural Asia and independent evaluation of those already on the market are needed. Treatment algorithms, including simple biomarker assays, appropriate for empirical therapy of fevers in different areas of rural Asia should be a major aim of fever research. Enhanced antimicrobial resistance (AMR) surveillance and openly accessible databases of geography-specific AMR data would inform policy on empirical and specific therapy. More investment in innovative strategies facilitating infectious disease surveillance in remote rural communities would be an important component of poverty reduction and improving public health.

Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Southern Asia and South-eastern Asia, 1980–2015

“…While a global decline in malaria burden has been reported in the last 15 years, Asia has observed the sharpest decrease [ 1 , 2 ]. The most recognised cause of febrile illnesses has gradually shifted from malaria to other infectious diseases in Southern Asia (SA) and South-eastern Asia (SEA) [ 3 , 4 ]. In some endemic parts of Asia, as little as 1% of febrile illnesses among those visiting healthcare facilities has been attributed to malaria [ 5 , 6 ].…”

“…Fever is one of the commonest reasons to seek medical attention in this region [ 10 ]. However, there is a paucity of information regarding the geography of aetiological agents of fever for many countries in SA and SEA [ 4 , 11 ]. With approximately 2.5 billion inhabitants, a third of the world’s population living in SA and SEA, the scarcity of information is of upmost importance to guide public health policies and research and development investments.…”

Rickettsia felis identified in two fatal cases of acute meningoencephalitis

“…One of the positive Indonesian cases was a farmer and the other dwelt in the city; both are environments that could be conducive to fleaborne transmission. Rickettsial disease, in general, appears to be substantially underreported in Southeast Asia [21,27] and the relative importance of R. felis, specifically, is unknown. In localities where incidence is suspected to be high the possibility of rickettsial infection in acute neurological disease should be included in clinical evaluations, especially considering the benefits of early empirical treatment.…”

COVID-19 Pandemic and Endemic Febrile Illnesses: The Dilemma of Exclusion and Diagnosis with Limited Capacities in Aden, Yemen

“…[12] In endemic areas of Malaria, the importance of the study of other causes of fever has increased with the decline in the incidence of Malaria as in the case of situation in Asia. [13] Other causes of fever other than Malaria include Dengue and Chikungunya fevers. In Latin America, the most frequently reported pathogen was the Dengue virus (DENV) followed by Chikungunya virus.…”