{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T19:05:40Z","timestamp":1763665540933},"reference-count":47,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Acute undifferentiated febrile illness (AUFI) is often undiagnosed in Thailand, resulting in delayed or ineffective treatment. We compared the demographic, exposure history, and clinical characteristics of AUFI patients with laboratory evidence of bacterial and nonbacterial pathogens. Patients aged 2\u201380\u2009years presenting to 12 hospitals in Nakhon Phanom and Tak provinces were enrolled from April 2017 through May 2020. Interviews were conducted and blood, urine, and sputum were collected for culture as well as rapid diagnostic and molecular testing. A total of 1,263 patients tested positive for one or more bacterial, viral, or parasitic pathogens and were included in the analysis. Multivariable logistic regression was performed to compare factors associated with bacterial infections versus nonbacterial infections. Bacterial infections were more commonly identified in participants from Nakhon Phanom than Tak. Bacterial infections were independently associated with several factors including age \u226550\u2009years (adjusted odds ratio [95% CI]): (4.18 [2.85\u20136.14]), contact with farm animals (1.82 [1.29\u20132.57]), antibiotic use within 72\u2009hours of hospital presentation (2.37 [1.50\u20133.74]), jaundice (2.31 [1.15\u20134.63]), existing comorbidities (2.77 [1.93\u20133.96]), contact with febrile individuals (0.42 [0.31\u20130.57]), muscle pain (0.44 [0.31\u20130.64]), and rash (0.45 [0.29\u20130.70]). Bacterial infections were also associated with longer hospitalization (2.75 [2.08\u20133.64]) and lower odds of recovery at the time of discharge (0.14 [0.07\u20130.31]). Consideration of patient characteristics and signs\/symptoms may help to inform targeted laboratory testing for suspected infectious etiologies. Understanding factors associated with bacterial and non-bacterial causes of AUFI may aid diagnosis and judicious use of antibiotics in resource-limited settings.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0731","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T19:24:21Z","timestamp":1721849061000},"page":"650-660","source":"Crossref","is-referenced-by-count":1,"title":["Demographic and Clinical Factors Associated with Bacterial or Nonbacterial Etiologies of Acute Undifferentiated Febrile Illness: Findings from a 3-Year Observational Study in Thailand, 2017\u20132020"],"prefix":"10.4269","volume":"111","author":[{"given":"Natalie R.","family":"Wodniak","sequence":"first","affiliation":[{"name":"Division of Global Health Protection, Thailand MOPH\u2013US CDC Collaboration, Nonthaburi, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saithip","family":"Bhengsri","sequence":"additional","affiliation":[{"name":"Division of Global Health Protection, Thailand MOPH\u2013US CDC Collaboration, Nonthaburi, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth","family":"Skaggs","sequence":"additional","affiliation":[{"name":"Division of Global Health Protection, Thailand MOPH\u2013US CDC Collaboration, Nonthaburi, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumonmal","family":"Uttayamakul","sequence":"additional","affiliation":[{"name":"Bamrasnaradura Infectious Diseases Institute, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pongpun","family":"Sawatwong","sequence":"additional","affiliation":[{"name":"Division of Global Health Protection, Thailand MOPH\u2013US CDC Collaboration, Nonthaburi, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ornuma","family":"Sangwichian","sequence":"additional","affiliation":[{"name":"Division of Global Health Protection, Thailand MOPH\u2013US CDC Collaboration, Nonthaburi, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"Gregory","sequence":"additional","affiliation":[{"name":"Division of Global Health Protection, Thailand MOPH\u2013US CDC Collaboration, Nonthaburi, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuttagarn","family":"Chuenchom","sequence":"additional","affiliation":[{"name":"Mae Sot General Hospital, Tak, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pongpot","family":"Peanumlom","sequence":"additional","affiliation":[{"name":"Mae Sot General Hospital, Tak, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Supphachoke","family":"Khemla","sequence":"additional","affiliation":[{"name":"Nakhon Phanom Hospital, Nakhon Phanom, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanaphat","family":"Lertwitayakumjorn","sequence":"additional","affiliation":[{"name":"Nakhon Phanom Hospital, Nakhon Phanom, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samkan","family":"Chaoprasert","sequence":"additional","affiliation":[{"name":"Tak Provincial Health Office, Tak, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barameht","family":"Piralam","sequence":"additional","affiliation":[{"name":"Nakhon Phanom Provincial Health Office, Nakhon Phanom, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuwan","family":"Simmali","sequence":"additional","affiliation":[{"name":"Nakhon Phanom Provincial Health Office, Nakhon Phanom, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuwattana","family":"Chara","sequence":"additional","affiliation":[{"name":"Nakhon Phanom Hospital, Nakhon Phanom, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Bloss","sequence":"additional","affiliation":[{"name":"Division of Global Health Protection, Thailand MOPH\u2013US CDC Collaboration, Nonthaburi, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John R.","family":"MacArthur","sequence":"additional","affiliation":[{"name":"Division of Global Health Protection, Thailand MOPH\u2013US CDC Collaboration, Nonthaburi, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James D.","family":"Heffelfinger","sequence":"additional","affiliation":[{"name":"Division of Global Health Protection, Thailand MOPH\u2013US CDC Collaboration, Nonthaburi, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"PLoS Negl Trop Dis","first-page":"e0007792","article-title":"Global knowledge gaps in acute febrile illness etiologic investigations: A scoping 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