Incorporating COVID-19 into Acute Febrile Illness Surveillance Systems, Belize, Kenya, Ethiopia, Peru, and Liberia, 2020–2021

Shih, David C; Silver, Rachel; Henao, Olga; Alemu, Aynalem; Audi, Allan; Bigogo, Godfrey; Colston, Josh M.; Edu-Quansah, Elijah P; Erickson, Timothy A.; Gashu, Andargachew; Gbelee, G Burgess; Gunter, Sarah M.; Kosek, Margaret; Logan, Gorbee G; Mackey, Joy M.; Maliga, Adrianna; Manzanero, Russell; Morazán, Gerhaldine; Morey, Francis; Muñoz, Flor M.; Murray, Kristy O.; Nelson, Thelma V; Olórtegui, Maribel Paredes; Yori, Pablo Peñataro; Ronca, Shannon E.; Schiaffino, Francesca; Tayachew, Adamu; Tedasse, Musse; Wossen, Mesfin; Allen, Denise R; Angra, Pawan; Balish, Amanda; Farron, Madeline; Guerra, Marta; Herman‐Roloff, Amy; Hicks, Victoria J; Hunsperger, Elizabeth; Kazazian, Lilit; Mikoleit, Matt; Munyua, Peninah; Munywoki, Patrick K.; Namwase, Angella Sandra; Onyango, Clayton; Park, Michael; Peruski, Leonard F.; Sugerman, David; Gutiérrez, Emily Zielinski; Cohen, Adam L.

doi:10.3201/eid2813.220898

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…The aim of this study will be to implement year-round, active, etiology-specific surveillance of AFI cases and their age-matched controls in Loreto, Peru, using TaqMan array cards for the detection of bloodborne pathogens. The evaluation of respiratory testing by RT-PCR of Influenza and SARS-CoV-2 was added given the heavy burden of SARS-CoV-2 in the region [ 35 ].…”

Section: Methodsmentioning

confidence: 99%

Etiology of acute febrile illness in the peruvian amazon as determined by modular formatted quantitative PCR: a protocol for RIVERA, a health facility-based case-control study

et al. 2023

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Background The study of the etiology of acute febrile illness (AFI) has historically been designed as a prevalence of pathogens detected from a case series. This strategy has an inherent unrealistic assumption that all pathogen detection allows for causal attribution, despite known asymptomatic carriage of the principal causes of acute febrile illness in most low- and middle-income countries (LMICs). We designed a semi-quantitative PCR in a modular format to detect bloodborne agents of acute febrile illness that encompassed common etiologies of AFI in the region, etiologies of recent epidemics, etiologies that require an immediate public health response and additional pathogens of unknown endemicity. We then designed a study that would delineate background levels of transmission in the community in the absence of symptoms to provide corrected estimates of attribution for the principal determinants of AFI. Methods A case-control study of acute febrile illness in patients ten years or older seeking health care in Iquitos, Loreto, Peru, was planned. Upon enrollment, we will obtain blood, saliva, and mid-turbinate nasal swabs at enrollment with a follow-up visit on day 21–28 following enrollment to attain vital status and convalescent saliva and blood samples, as well as a questionnaire including clinical, socio-demographic, occupational, travel, and animal contact information for each participant. Whole blood samples are to be simultaneously tested for 32 pathogens using TaqMan array cards. Mid-turbinate samples will be tested for SARS-CoV-2, Influenza A and Influenza B. Conditional logistic regression models will be fitted treating case/control status as the outcome and with pathogen-specific sample positivity as predictors to attain estimates of attributable pathogen fractions for AFI. Discussion The modular PCR platforms will allow for reporting of all primary results of respiratory samples within 72 h and blood samples within one week, allowing for results to influence local medical practice and enable timely public health responses. The inclusion of controls will allow for a more accurate estimate of the importance of specific prevalent pathogens as a cause of acute illness. Study Registration Project 1791, Registro de Proyectos de Investigación en Salud Pública (PRISA), Instituto Nacional de Salud, Perú.

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Section: Methodsmentioning

confidence: 99%

Etiology of acute febrile illness in the peruvian amazon as determined by modular formatted quantitative PCR: a protocol for RIVERA, a health facility-based case-control study

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Study Aim: The aim of this study will be to implement year-round, active, etiology-speci c surveillance of AFI cases and their age-matched controls in Loreto, Peru, using TaqMan array cards for the detection of bloodborne pathogens. The evaluation of respiratory testing by RT-PCR of In uenza and SARS-CoV-2 was added, given the heavy burden of SARS-CoV-2 in the region [35].…”

Section: Methodsmentioning

confidence: 99%

Etiology of Acute Febrile Illness in the Peruvian Amazon as determined by modular formatted quantitative PCR: A Protocol for RIVERA, a Health Facility-Based Case-Control Study

Yori

Olórtegui

Schiaffino

et al. 2023

Preprint

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Background: The study of the etiology of acute febrile illness (AFI) has historically been designed as a prevalence of pathogens detected from a case series. This strategy has an inherent unrealistic assumption that all pathogen detection allows for causal attribution, despite known asymptomatic carriage of the principal causes of acute febrile illness in most low- and middle-income countries (LMICs). We designed a semi-quantitative PCR in a modular format to detect bloodborne agents of acute febrile illness that encompassed common etiologies of AFI in the region, etiologies of recent epidemics, etiologies that require an immediate public health response and additional pathogens of unknown endemicity. We then designed a study that would delineate background levels of transmission in the community in the absence of symptoms to provide corrected estimates of attribution for the principal determinants of AFI. Methods: A case-control study of acute febrile illness in patients ten years or older seeking health care in Iquitos, Loreto, Peru, was planned. Upon enrollment, we will obtain blood, saliva, and mid-turbinate nasal swabs at enrollment with a follow-up visit on day 21-28 following enrollment to attain vital status and convalescent saliva and blood samples, as well as a questionnaire including clinical, socio-demographic, occupational, travel, and animal contact information for each participant. Whole blood samples are to be simultaneously tested for 32 pathogens using TaqMan array cards. Mid-turbinate samples will be tested for SARS-CoV-2, Influenza A and Influenza B. Conditional logistic regression models will be fitted treating case/control status as the outcome and with pathogen-specific sample positivity as predictors to attain estimates of attributable pathogen fractions for AFI. Discussion: The modular PCR platforms will allow for reporting of all primary results of respiratory samples within 72 hours and blood samples within one week, allowing for results to influence local medical practice and enable timely public health responses. The inclusion of controls will allow for a more accurate estimate of the importance of specific, prevalent pathogens as a cause of acute illness. Study Registration: Project 1791, Registro de Proyectos de Investigación en Salud Pública (PRISA), Instituto Nacional de Salud, Perú.

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“…The U.S. Centers for Disease Control and Prevention (CDC) has supported sentinel AFI surveillance in partner countries across Africa, Asia, Eastern Europe, and South and Central America [10,12,15]. In 2018, the CDC drafted a generic protocol as a starting point towards coordinating implementation.…”

Section: Development and Evaluation Processmentioning

confidence: 99%

A toolkit for planning and implementing acute febrile illness (AFI) surveillance

Kazazian,

Silver,

Rao

et al. 2024

PLOS Glob Public Health

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Acute febrile illness (AFI) is a broad clinical syndrome with a wide range of potential infectious etiologies. The lack of accessible, standardized approaches to conducting AFI etiologic investigations has contributed to significant global gaps in data on the epidemiology of AFI. Based on lessons learned from years of supporting AFI sentinel surveillance worldwide, the U.S. Centers for Disease Control and Prevention developed the toolkit for planning and implementing AFI surveillance, described here. This toolkit provides a comprehensive yet flexible framework to guide researchers, public health officials, and other implementers in developing a strategy to identify and/or monitor the potential causes of AFI. The toolkit comprises a cohesive set of planning aids and supporting materials, including an implementation framework, generic protocol, several generic forms (including screening, case report, specimen collection and testing, and informed consent and assent), and a generic data dictionary. These materials incorporate key elements intended to harmonize approaches for AFI surveillance, as well as setting-specific components and considerations for adaptation based on local surveillance objectives and limitations. Appropriate adaptation and implementation of this toolkit may generate data that expand the global AFI knowledge base, strengthen countries’ surveillance and laboratory capacity, and enhance outbreak detection and response efforts.

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Incorporating COVID-19 into Acute Febrile Illness Surveillance Systems, Belize, Kenya, Ethiopia, Peru, and Liberia, 2020–2021

Cited by 6 publications

References 19 publications

Etiology of acute febrile illness in the peruvian amazon as determined by modular formatted quantitative PCR: a protocol for RIVERA, a health facility-based case-control study

Etiology of acute febrile illness in the peruvian amazon as determined by modular formatted quantitative PCR: a protocol for RIVERA, a health facility-based case-control study

Etiology of Acute Febrile Illness in the Peruvian Amazon as determined by modular formatted quantitative PCR: A Protocol for RIVERA, a Health Facility-Based Case-Control Study

A toolkit for planning and implementing acute febrile illness (AFI) surveillance

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