{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:10:26Z","timestamp":1790791826883,"version":"4.1.0"},"reference-count":77,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["GH002259"],"award-info":[{"award-number":["GH002259"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>\n                    Understanding the distribution of pathogens causing acute febrile illness (AFI) is important for clinical management of patients in resource-poor settings. We evaluated the proportion of AFI caused by specific pathogens among outpatients in Bangladesh. During May 2019-March 2020, physicians screened patients aged \u22652 years in outpatient departments of four tertiary level public hospitals. We randomly enrolled patients having measured fever (\u2265100.4\u00b0F) during assessment with onset within the past 14 days. Blood and urine samples were tested at icddr,b through rapid diagnostic tests, bacterial culture, and polymerase chain reaction (PCR). Acute and convalescent samples were sent to the Centers for Disease Control and Prevention (USA) for\n                    <jats:italic>Rickettsia<\/jats:italic>\n                    and\n                    <jats:italic>Orientia<\/jats:italic>\n                    (\n                    <jats:italic>R\/O<\/jats:italic>\n                    ) and\n                    <jats:italic>Leptospira<\/jats:italic>\n                    tests. Among 690 patients, 69 (10%) had enteric fever (\n                    <jats:italic>Salmonella enterica<\/jats:italic>\n                    serotype Typhi or\n                    <jats:italic>Salmonella enterica<\/jats:italic>\n                    serotype Paratyphi), 51 (7.4%)\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    , and 28 (4.1%) dengue detected. Of the 441 patients tested for\n                    <jats:italic>R\/O<\/jats:italic>\n                    , 39 (8.8%) had rickettsioses. We found 7 (2%)\n                    <jats:italic>Leptospira<\/jats:italic>\n                    cases among the 403 AFI patients tested. Nine patients (1%) were hospitalized, and none died. The highest proportion of enteric fever (15%, 36\/231) and rickettsioses (14%, 25\/182) was in Rajshahi. Dhaka had the most dengue cases (68%, 19\/28).\n                    <jats:italic>R\/O<\/jats:italic>\n                    affected older children and young adults (IQR 8\u201323 years) and was detected more frequently in the 21\u201325 years age-group (17%, 12\/70).\n                    <jats:italic>R\/O<\/jats:italic>\n                    was more likely to be found in patients in Rajshahi region than in Sylhet (aOR 2.49, 95% CI 0.85\u20137.32) between July and December (aOR 2.01, 1.01\u20135.23), and who had a history of recent animal entry inside their house than not (aOR 2.0, 0.93\u20134.3). Gram-negative Enterobacteriaceae were the most common bacterial infections, and dengue was the most common viral infection among AFI patients in Bangladeshi hospitals, though there was geographic variability. These results can help guide empiric outpatient AFI management.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0273902","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T13:38:53Z","timestamp":1662039533000},"page":"e0273902","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":14,"title":["Acute febrile illness among outpatients seeking health care in Bangladeshi hospitals prior to the COVID-19 pandemic"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8353-120X","authenticated-orcid":true,"given":"Pritimoy","family":"Das","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Ziaur","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayera","family":"Banu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmudur","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9958-3071","authenticated-orcid":true,"given":"Mohammod Jobayer","family":"Chisti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahmida","family":"Chowdhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5054-9243","authenticated-orcid":true,"given":"Zubair","family":"Akhtar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1868-4538","authenticated-orcid":true,"given":"Anik","family":"Palit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9915-1666","authenticated-orcid":true,"given":"Daniel W.","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahabub Ul","family":"Anwar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angella Sandra","family":"Namwase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawan","family":"Angra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6963-6849","authenticated-orcid":true,"given":"Cecilia Y.","family":"Kato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen J.","family":"Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Singleton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeri","family":"Stewart-Juba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7084-4952","authenticated-orcid":true,"given":"Marah","family":"Condit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida 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