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
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 asymptom...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-15619-6 |
| _version_ | 1797845730668314624 |
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| author | Pablo Peñataro Yori Maribel Paredes Olórtegui Francesca Schiaffino Josh M. Colston Tackeshy Pinedo Vasquez Paul F. Garcia Bardales Valentino Shapiama Lopez Loyda Fiorella Zegarra Paredes Karin Perez Greisi Curico Thomas Flynn Jixian Zhang Cesar Ramal Asayag Graciela Meza Sanchez Hermann Silva Delgado Martin Casapia Morales Wilma Casanova Bruce Jiu Richard Oberhelman Cesar Munayco Escate Rachel Silver Olga Henao Kerry K. Cooper Jie Liu Eric R. Houpt Margaret N. Kosek |
| author_facet | Pablo Peñataro Yori Maribel Paredes Olórtegui Francesca Schiaffino Josh M. Colston Tackeshy Pinedo Vasquez Paul F. Garcia Bardales Valentino Shapiama Lopez Loyda Fiorella Zegarra Paredes Karin Perez Greisi Curico Thomas Flynn Jixian Zhang Cesar Ramal Asayag Graciela Meza Sanchez Hermann Silva Delgado Martin Casapia Morales Wilma Casanova Bruce Jiu Richard Oberhelman Cesar Munayco Escate Rachel Silver Olga Henao Kerry K. Cooper Jie Liu Eric R. Houpt Margaret N. Kosek |
| author_sort | Pablo Peñataro Yori |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-09T17:43:39Z |
| format | Article |
| id | doaj.art-33980f15b8404b5db84dd679179c1f88 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-09T17:43:39Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-33980f15b8404b5db84dd679179c1f882023-04-16T11:27:17ZengBMCBMC Public Health1471-24582023-04-012311910.1186/s12889-023-15619-6Etiology 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 studyPablo Peñataro Yori0Maribel Paredes Olórtegui1Francesca Schiaffino2Josh M. Colston3Tackeshy Pinedo Vasquez4Paul F. Garcia Bardales5Valentino Shapiama Lopez6Loyda Fiorella Zegarra Paredes7Karin Perez8Greisi Curico9Thomas Flynn10Jixian Zhang11Cesar Ramal Asayag12Graciela Meza Sanchez13Hermann Silva Delgado14Martin Casapia Morales15Wilma Casanova16Bruce Jiu17Richard Oberhelman18Cesar Munayco Escate19Rachel Silver20Olga Henao21Kerry K. Cooper22Jie Liu23Eric R. Houpt24Margaret N. Kosek25Division of Infectious Disease and International Health, School of Medicine, University of VirginiaAsociación Benefica PRISMADivision of Infectious Disease and International Health, School of Medicine, University of VirginiaDivision of Infectious Disease and International Health, School of Medicine, University of VirginiaAsociación Benefica PRISMAAsociación Benefica PRISMAAsociación Benefica PRISMAAsociación Benefica PRISMAAsociación Benefica PRISMAAsociación Benefica PRISMADivision of Infectious Disease and International Health, School of Medicine, University of VirginiaDivision of Infectious Disease and International Health, School of Medicine, University of VirginiaUniversidad Nacional de La Amazonia PeruanaUniversidad Nacional de La Amazonia PeruanaUniversidad Nacional de La Amazonia PeruanaUniversidad Nacional de La Amazonia PeruanaUniversidad Nacional de La Amazonia PeruanaLaboratorio de Referencia en Salud Publica de la Direccion Regional de Salud- DiresaTulane School of Public Health and Tropical MedicineCentro Nacional de Epidemiologia, Prevencion, y Control de Enfermedades, Ministerio de Salud de PeruCenters for Disease Control and PreventionCenters for Disease Control and PreventionSchool of Animal and Comparative Biomedical Sciences, University of ArizonaSchool of Public Health, Qingdao UniversityDivision of Infectious Disease and International Health, School of Medicine, University of VirginiaDivision of Infectious Disease and International Health, School of Medicine, University of VirginiaAbstract 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.https://doi.org/10.1186/s12889-023-15619-6LoretoAcute febrile illnessWhole bloodTaqManActive surveillanceCase-control |
| spellingShingle | Pablo Peñataro Yori Maribel Paredes Olórtegui Francesca Schiaffino Josh M. Colston Tackeshy Pinedo Vasquez Paul F. Garcia Bardales Valentino Shapiama Lopez Loyda Fiorella Zegarra Paredes Karin Perez Greisi Curico Thomas Flynn Jixian Zhang Cesar Ramal Asayag Graciela Meza Sanchez Hermann Silva Delgado Martin Casapia Morales Wilma Casanova Bruce Jiu Richard Oberhelman Cesar Munayco Escate Rachel Silver Olga Henao Kerry K. Cooper Jie Liu Eric R. Houpt Margaret N. Kosek 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 BMC Public Health Loreto Acute febrile illness Whole blood TaqMan Active surveillance Case-control |
| 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Loreto Acute febrile illness Whole blood TaqMan Active surveillance Case-control |
| url | https://doi.org/10.1186/s12889-023-15619-6 |
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