{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:48:44Z","timestamp":1783687724586,"version":"3.55.0"},"reference-count":64,"publisher":"Scientific Scholar","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,10]]},"abstract":"\n Background & objectives:<\/jats:title>\n Although febrile illnesses are a frequent cause of consultation and hospitalization in low- and middle-income countries (LMICs), research has mainly focused on acute febrile illnesses (AFIs). In contrast, there are limited data on the causes of persistent febrile illnesses (PFIs) in LMIC. Lack of clarity on the differential diagnosis of PFIs in the rural tropics leads to the absence of diagnostic guidance tools.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n In this study, a review of the potential causes of persistent fever defined as fever of more than seven days was done in Nepal, with a focus on nine pathogen-specific conditions. The current knowledge on their burden, distribution and diagnosis was summarized.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Limited data were found on the incidence and public health burden of leptospirosis, murine typhus and brucellosis due to the absence of diagnostic tools outside reference laboratories and the overlap of signs and symptoms with other febrile conditions. The incidence of malaria and visceral leishmaniasis (VL) was found to be decreasing in Nepal, with some changes of the geographical areas at risk.<\/jats:p>\n <\/jats:sec>\n \n Interpretation & conclusions:<\/jats:title>\n This review indicates a need for more research on the causes of PFIs in Nepal and in the region and for the development of clinical guidance tailored to current local epidemiology. Guidance tools should include specific clinical features (e.g<\/jats:italic>. eschar), results of rapid diagnostic tests (e.g<\/jats:italic>. malaria, VL), appropriate indications for more sophisticated tests (e.g<\/jats:italic>. abdominal ultrasound, polymerase chain reaction) and recommendations for adequate use of empirical treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijmr.ijmr_505_18","type":"journal-article","created":{"date-parts":[[2019,1,21]],"date-time":"2019-01-21T08:58:59Z","timestamp":1548061139000},"page":"385-395","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Persistent febrile illnesses in Nepal"],"prefix":"10.25259","volume":"148","author":[{"given":"Kanika Deshpande","family":"Koirala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Chappuis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristien","family":"Verdonck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suman","family":"Rijal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marleen","family":"Boelaert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","reference":[{"key":"R1-6-20241212","doi-asserted-by":"crossref","first-page":"e0127962","DOI":"10.1371\/journal.pone.0127962","article-title":"Etiology of severe febrile illness in low- and middle-income countries: A systematic review","volume":"10","author":"Prasad","year":"2015","journal-title":"PLoS One"},{"key":"R3-6-20241212","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1056\/NEJMoa1214482","article-title":"Beyond malaria- causes of fever in outpatient Tanzanian children","volume":"370","author":"D\u2019Acremont","year":"2014","journal-title":"N Engl J Med"},{"key":"R4-6-20241212","doi-asserted-by":"crossref","first-page":"e46","DOI":"10.1016\/S2214-109X(13)70008-1","article-title":"Causes of non-malarial fever in Laos: A prospective study","volume":"1","author":"Mayxay","year":"2013","journal-title":"Lancet Glob Health"},{"key":"R5-6-20241212","doi-asserted-by":"crossref","first-page":"e95868","DOI":"10.1371\/journal.pone.0095868","article-title":"Acute undifferentiated febrile illness in rural Cambodia: A 3-year prospective observational study","volume":"9","author":"Mueller","year":"2014","journal-title":"PLoS One"},{"key":"R6-6-20241212","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00005792-196102000-00001","article-title":"Fever of unexplained origin: Report on 100 cases","volume":"40","author":"Petersdorf","year":"1961","journal-title":"Medicine (Baltimore"},{"key":"R7-6-20241212","doi-asserted-by":"crossref","first-page":"e0004853","DOI":"10.1371\/journal.pntd.0004853","article-title":"NIDIAG Consortium. 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