Andrews Mekkattukunnel A, Ittyachen Abraham M
1 Professor of Medicine, Government Medical College & Hospital, M. G. Kavu, Thrissur, Kerala, India.
2 Professor of Medicine, M.O.S.C Medical College & Hospital, Kolenchery, Kerala, India.
Trop Doct. 2018 Oct;48(4):322-325. doi: 10.1177/0049475518794572. Epub 2018 Aug 20.
Acute febrile illness with varied aetiology but similar symptoms is common in tropical countries. This prospective, multicentre study was conducted in selected centres in the province of Kerala in India principally to analyse the aetiology of acute febrile illnesses in adult patients over the course of one year. Overall, 1324 patients were included in the study. The most common cause was dengue in 576 patients (43.5%). In 396 (29.9%), the exact aetiology could not be identified. Other causes, in order, were leptospirosis, enteric fever, malaria, respiratory tract infection, urinary tract infection and typhus. When such a wide variation with a significant number of 'indeterminate' cases exists, especially in such a small area and with limited resources, the onus is on public health authorities to draw up an 'easy-to-use algorithm' to tackle epidemics of febrile illness, particularly in the monsoon season.
病因各异但症状相似的急性发热性疾病在热带国家很常见。这项前瞻性多中心研究在印度喀拉拉邦的选定中心进行，主要目的是分析成年患者在一年时间里急性发热性疾病的病因。该研究共纳入1324例患者。最常见的病因是登革热，有576例患者（43.5%）。396例（29.9%）患者的确切病因无法确定。其他病因依次为钩端螺旋体病、伤寒、疟疾、呼吸道感染、尿路感染和斑疹伤寒。当存在如此广泛的差异且有大量“不确定”病例时，尤其是在如此小的区域且资源有限的情况下，公共卫生当局有责任制定一种“易于使用的算法”来应对发热性疾病的流行，特别是在季风季节。
