Etiologies of tropical acute febrile illness in West Pahang, Malaysia: A prospective observational study

Alif Thabit; Wan Mohd Kamil; Mohd Mutalip; Eida Muhammad; Nor Muhamad; Mohd Din; Mohan Arumugam; Siti Azman; Rafidah Abdullah; Roslinda Jaafar; Sathvinder Singh

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Etiologies of tropical acute febrile illness in West Pahang, Malaysia: A prospective observational study

Author: Alif THABIT ¹ ; Wan Mohd KAMIL ¹ ; Mohd MUTALIP ² ; Eida MUHAMMAD ² ; Nor MUHAMAD ² ; Mohd DIN ³ ; Mohan ARUMUGAM ³ ; Siti AZMAN ³ ; Rafidah ABDULLAH ³ ; Roslinda JAAFAR ⁴ ; Sathvinder SINGH ⁵
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1. Department of Medicine Hospital Bentong
2. Institute for Public Health, National Institute of Health, Ministry of Health Malaysia
3. Department of Medicine Hospital Sultan Haji Ahmad Shah
4. Department of Pathology Hospital Sultan Haji Ahmad Shah
5. Department of Medicine Hospital Kuala Lipis
Publication Type:Journal Article
Keywords: Comorbidities; Mortality; Tropical acute febrile illness
From: Asian Pacific Journal of Tropical Medicine 2020;13(3):115-122
CountryChina
Language:Chinese
Abstract: Objective: To determine the etiologies of tropical acute febrile illness (TAFI) in West Pahang, Malaysia and to investigate morbidity and mortality factors in relation to TAFI. Methods: A multicenter prospective cohort study was conducted between January and June 2016 in six district hospitals throughout the western part of Pahang State in Peninsular Malaysia. A total of 336 patients answered a standardized questionnaire and blood samples were collected for laboratory confirmation of infectious etiology. Descriptive analysis and logistic regression were performed to identify factors associated with TAFI. Results: A total of 336 patients were included. The patients were mainly Malays (70.2%), males (61.3%), aged (44.6±17.4) years, with more than half (58.9%) presenting with gastrointestinal symptoms. The majority were diagnosed with dengue (35.7%) while malaria (4.5%) was the least frequent. The in-hospital mortality due to TAFI was 9.2%. Patients with meliodosis had five times higher mortality [Adjusted OR: 5.002, 95% CI: (1.233, 20.286)]. Patients with comorbidities such as cardiovascular symptoms (P <0.001) and renal replacement therapy initiation (P <0.001) were significantly associated with in-hospital mortality in all TAFI. Conclusions: The etiology of TAFI in the western Pahang includes dengue, leptospirosis, malaria and melioidosis, which carry the highest risk of in-hospital mortality. The presence of cardiovascular symptoms may be used to assess the disease severity in TAFI, but more studies are needed in the future.