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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.

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dc.contributor.author Peñataro Yori, Pablo
dc.contributor.author Paredes Olórtegui, Maribel
dc.contributor.author Schiaffino Salazar, Francesca
dc.contributor.author Colston, Josh M.
dc.contributor.author Pinedo Vasquez, Tackeshy
dc.contributor.author Garcia Bardales, Paul F.
dc.contributor.author Shapiama Lopez, Valentino
dc.contributor.author Zegarra Paredes, Loyda Fiorella
dc.contributor.author Perez, Karin
dc.contributor.author Curico, Greisi
dc.contributor.author Flynn, Thomas
dc.contributor.author Zhang, Jixian
dc.contributor.author Ramal Asayag, Cesar
dc.contributor.author Meza Sanchez, Graciela
dc.contributor.author Silva Delgado, Hermann
dc.contributor.author Casapia Morales, Martin
dc.contributor.author Casanova, Wilma
dc.contributor.author Jiu, Bruce
dc.contributor.author Oberhelman, Richard
dc.contributor.author Munayco Escate, Cesar
dc.contributor.author Silver, Rachel
dc.contributor.author Henao, Olga
dc.contributor.author Cooper, Kerry K.
dc.contributor.author Liu, Jie
dc.contributor.author Houpt, Eric R.
dc.contributor.author Kosek, Margaret N.
dc.coverage.spatial Iquitos, Loreto, Perú
dc.date.accessioned 2023-04-16T04:38:13Z
dc.date.available 2023-04-16T04:38:13Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13370
dc.description.abstract 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. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartofseries BMC Public Health
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Loreto en_US
dc.subject Active surveillance en_US
dc.subject Acute febrile illness en_US
dc.subject Case-control en_US
dc.subject Population attributable fraction en_US
dc.subject TaqMan en_US
dc.subject Whole blood en_US
dc.title 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. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12889-023-15619-6
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.05
dc.relation.issn 1471-2458


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