@article{fdi:010062067,
  title = {{C}auses of non-malarial fever in {L}aos : a prospective study},
  author = {{M}ayxay, {M}. and {C}astonguay-{V}anier, {J}. and {C}hansamouth, {V}. and {D}ubot {P}{\'e}r{\`e}s, {A}udrey and {P}aris, {D}. {H}. and {P}hetsouvanh, {R}. and {T}angkhabuanbutra, {J}. and {D}ouangdala, {P}. and {I}nthalath, {S}. and {S}ouvannasing, {P}. and {S}lesak, {G}. and {T}ongyoo, {N}. and {C}hanthongthip, {A}. and {P}anyanouvong, {P}. and {S}ibounheuang, {B}. and {P}hommasone, {K}. and {D}ohnt, {M}. and {P}honekeo, {D}. and {H}ongvanthong, {B}. and {X}ayadeth, {S}. and {K}etmayoon, {P}. and {B}lacksell, {S}. {D}. and {M}oore, {C}. {E}. and {C}raig, {S}. {B}. and {B}urns, {M}. {A}. and von {S}onnenburg, {F}. and {C}orwin, {A}. and de {L}amballerie, {X}avier and {G}onzalez, {I}. {J}. and {C}hristophel, {E}. {M}. and {C}awthorne, {A}. and {B}ell, {D}. and {N}ewton, {P}. {N}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {B}ecause of reductions in the incidence of {P}lasmodium falciparum malaria in {L}aos, identification of the causes of fever in people without malaria, and discussion of the best empirical treatment options, are urgently needed. {W}e aimed to identify the causes of non-malarial acute fever in patients in rural {L}aos. {M}ethods {F}or this prospective study, we recruited 1938 febrile patients, between {M}ay, 2008, and {D}ecember, 2010, at {L}uang {N}amtha provincial hospital in northwest {L}aos (n=1390), and between {S}eptember, 2008, and {D}ecember, 2010, at {S}alavan provincial hospital in southern {L}aos (n=548). {E}ligible participants were aged 5-49 years with fever (>= 38 degrees {C}) lasting 8 days or less and were eligible for malaria testing by national guidelines. {F}indings {W}ith conservative definitions of cause, we assigned 799 (41%) patients a diagnosis. {W}ith exclusion of influenza, the top five diagnoses when only one aetiological agent per patient was identified were dengue (156 [8%] of 1927 patients), scrub typhus (122 [7%] of 1871), {J}apanese encephalitis virus (112 [6%] of 1924), leptospirosis (109 [6%] of 1934), and bacteraemia (43 [2%] of 1938). 115 (32%) of 358 patients at {L}uang {N}amtha hospital tested influenza {PCR}-positive between {J}une and {D}ecember, 2010, of which influenza {B} was the most frequently detected strain (n=121 [87%]). {D}isease frequency differed significantly between the two sites: {J}apanese encephalitis virus infection (p=0.04), typhoid (p=0.006), and leptospirosis (p=0.001) were more common at {L}uang {N}amtha, whereas dengue and malaria were more common at {S}alavan (all p<0.0001). {W}ith use of evidence from southeast {A}sia when possible, we estimated that azithromycin, doxycycline, ceftriaxone, and ofloxacin would have had significant efficacy for 258 (13%), 240 (12%), 154 (8%), and 41 (2%) of patients, respectively. {I}nterpretation {O}ur findings suggest that a wide range of treatable or preventable pathogens are implicated in non-malarial febrile illness in {L}aos. {E}mpirical treatment with doxycycline for patients with undifferentiated fever and negative rapid diagnostic tests for malaria and dengue could be an appropriate strategy for rural health workers in {L}aos.},
  keywords = {{LAOS}},
  booktitle = {},
  journal = {{L}ancet {G}lobal {H}ealth},
  volume = {1},
  numero = {1},
  pages = {{E}46--{E}54},
  ISSN = {2214-109{X}},
  year = {2013},
  URL = {https://www.documentation.ird.fr/hor/fdi:010062067},
}