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The Aetiologies and Impact of Fever in Pregnant Inpatients in Vientiane, Laos

INTRODUCTION: Laos has the highest maternal mortality ratio in mainland Southeast Asia and a high incidence of infectious diseases. Globally, malaria has been the pathogen most intensively investigated in relation to impact on pregnancy, but there has been relatively little research on the aetiology...

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Autores principales: Chansamouth, Vilada, Thammasack, Syvilay, Phetsouvanh, Rattanaphone, Keoluangkot, Valy, Moore, Catrin E., Blacksell, Stuart D., Castonguay-Vanier, Josee, Dubot-Pérès, Audrey, Tangkhabuanbutra, Jarasporn, Tongyoo, Narongchai, Souphaphonh, Phooksavanh, Sengvilaipaseuth, Onanong, Vongsouvath, Manivanh, Phommasone, Koukeo, Sengdethka, Davanh, Seurbsanith, Amphayvanh, Craig, Scott B., Hermann, Laura, Strobel, Michel, Newton, Paul N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822858/
https://www.ncbi.nlm.nih.gov/pubmed/27050192
http://dx.doi.org/10.1371/journal.pntd.0004577
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author Chansamouth, Vilada
Thammasack, Syvilay
Phetsouvanh, Rattanaphone
Keoluangkot, Valy
Moore, Catrin E.
Blacksell, Stuart D.
Castonguay-Vanier, Josee
Dubot-Pérès, Audrey
Tangkhabuanbutra, Jarasporn
Tongyoo, Narongchai
Souphaphonh, Phooksavanh
Sengvilaipaseuth, Onanong
Vongsouvath, Manivanh
Phommasone, Koukeo
Sengdethka, Davanh
Seurbsanith, Amphayvanh
Craig, Scott B.
Hermann, Laura
Strobel, Michel
Newton, Paul N.
author_facet Chansamouth, Vilada
Thammasack, Syvilay
Phetsouvanh, Rattanaphone
Keoluangkot, Valy
Moore, Catrin E.
Blacksell, Stuart D.
Castonguay-Vanier, Josee
Dubot-Pérès, Audrey
Tangkhabuanbutra, Jarasporn
Tongyoo, Narongchai
Souphaphonh, Phooksavanh
Sengvilaipaseuth, Onanong
Vongsouvath, Manivanh
Phommasone, Koukeo
Sengdethka, Davanh
Seurbsanith, Amphayvanh
Craig, Scott B.
Hermann, Laura
Strobel, Michel
Newton, Paul N.
author_sort Chansamouth, Vilada
collection PubMed
description INTRODUCTION: Laos has the highest maternal mortality ratio in mainland Southeast Asia and a high incidence of infectious diseases. Globally, malaria has been the pathogen most intensively investigated in relation to impact on pregnancy, but there has been relatively little research on the aetiology and impact of other diseases. We therefore aimed to determine the causes and impact of fever in pregnant women admitted to two central hospitals in Vientiane City, Lao PDR (Laos). MATERIALS AND METHODS: This hospital-based prospective study was conducted in Mahosot Hospital and the Mother and Child Hospital, Vientiane, between 2006 and 2010, with the aim to recruit 250 consenting pregnant women admitted with tympanic temperature ≥37.5°C. Primary outcome was the cause of fever and secondary outcomes were pregnancy outcomes. Specific investigations (culture, antigen, molecular and serological tests) were performed to investigate causes of fever. After discharge, all pregnant women were asked to return for review and convalescence serum on day 10–14 and were monitored until delivery. PRINCIPLE FINDINGS: 250 pregnant women were recruited to this study between February 2006 and November 2010. Fifty percent were pregnant for the first time. Their median (range) gestational age on admission was 24 (4–43) weeks. The median (range) tympanic admission temperature was 38.5°C (37.5–40.5°C). Fifteen percent of patients stated that they had taken antibiotics before admission. Headache, myalgia, back pain and arthralgia were described by >60% of patients and 149 (60%) were given a laboratory diagnosis. Of those with confirmed diagnoses, 132 (53%) had a single disease and 17 (7%) had apparent mixed diseases. Among those who had a single disease, dengue fever was the most common diagnosis, followed by pyelonephritis, scrub typhus, murine typhus and typhoid. Patients were also diagnosed with tuberculosis, appendicitis, Staphylococcus aureus septicemia, leptospirosis, Japanese encephalitis virus infection and Plasmodium falciparum malaria. Severe consequences, including maternal death, miscarriage, stillbirth, low birth weight and preterm birth, were found among 28 (78%) mothers with dengue fever, rickettsioses and typhoid. CONCLUSION: Fevers other than malaria, such as dengue, pyelonephritis, rickettsioses and typhoid are common causes of fever during pregnancy in the Asian tropics. Further investigations of their impact in the community on maternal death, fetal loss, vertical transmission, low birth weight and preterm birth are needed.
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spelling pubmed-48228582016-04-22 The Aetiologies and Impact of Fever in Pregnant Inpatients in Vientiane, Laos Chansamouth, Vilada Thammasack, Syvilay Phetsouvanh, Rattanaphone Keoluangkot, Valy Moore, Catrin E. Blacksell, Stuart D. Castonguay-Vanier, Josee Dubot-Pérès, Audrey Tangkhabuanbutra, Jarasporn Tongyoo, Narongchai Souphaphonh, Phooksavanh Sengvilaipaseuth, Onanong Vongsouvath, Manivanh Phommasone, Koukeo Sengdethka, Davanh Seurbsanith, Amphayvanh Craig, Scott B. Hermann, Laura Strobel, Michel Newton, Paul N. PLoS Negl Trop Dis Research Article INTRODUCTION: Laos has the highest maternal mortality ratio in mainland Southeast Asia and a high incidence of infectious diseases. Globally, malaria has been the pathogen most intensively investigated in relation to impact on pregnancy, but there has been relatively little research on the aetiology and impact of other diseases. We therefore aimed to determine the causes and impact of fever in pregnant women admitted to two central hospitals in Vientiane City, Lao PDR (Laos). MATERIALS AND METHODS: This hospital-based prospective study was conducted in Mahosot Hospital and the Mother and Child Hospital, Vientiane, between 2006 and 2010, with the aim to recruit 250 consenting pregnant women admitted with tympanic temperature ≥37.5°C. Primary outcome was the cause of fever and secondary outcomes were pregnancy outcomes. Specific investigations (culture, antigen, molecular and serological tests) were performed to investigate causes of fever. After discharge, all pregnant women were asked to return for review and convalescence serum on day 10–14 and were monitored until delivery. PRINCIPLE FINDINGS: 250 pregnant women were recruited to this study between February 2006 and November 2010. Fifty percent were pregnant for the first time. Their median (range) gestational age on admission was 24 (4–43) weeks. The median (range) tympanic admission temperature was 38.5°C (37.5–40.5°C). Fifteen percent of patients stated that they had taken antibiotics before admission. Headache, myalgia, back pain and arthralgia were described by >60% of patients and 149 (60%) were given a laboratory diagnosis. Of those with confirmed diagnoses, 132 (53%) had a single disease and 17 (7%) had apparent mixed diseases. Among those who had a single disease, dengue fever was the most common diagnosis, followed by pyelonephritis, scrub typhus, murine typhus and typhoid. Patients were also diagnosed with tuberculosis, appendicitis, Staphylococcus aureus septicemia, leptospirosis, Japanese encephalitis virus infection and Plasmodium falciparum malaria. Severe consequences, including maternal death, miscarriage, stillbirth, low birth weight and preterm birth, were found among 28 (78%) mothers with dengue fever, rickettsioses and typhoid. CONCLUSION: Fevers other than malaria, such as dengue, pyelonephritis, rickettsioses and typhoid are common causes of fever during pregnancy in the Asian tropics. Further investigations of their impact in the community on maternal death, fetal loss, vertical transmission, low birth weight and preterm birth are needed. Public Library of Science 2016-04-06 /pmc/articles/PMC4822858/ /pubmed/27050192 http://dx.doi.org/10.1371/journal.pntd.0004577 Text en © 2016 Chansamouth et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chansamouth, Vilada
Thammasack, Syvilay
Phetsouvanh, Rattanaphone
Keoluangkot, Valy
Moore, Catrin E.
Blacksell, Stuart D.
Castonguay-Vanier, Josee
Dubot-Pérès, Audrey
Tangkhabuanbutra, Jarasporn
Tongyoo, Narongchai
Souphaphonh, Phooksavanh
Sengvilaipaseuth, Onanong
Vongsouvath, Manivanh
Phommasone, Koukeo
Sengdethka, Davanh
Seurbsanith, Amphayvanh
Craig, Scott B.
Hermann, Laura
Strobel, Michel
Newton, Paul N.
The Aetiologies and Impact of Fever in Pregnant Inpatients in Vientiane, Laos
title The Aetiologies and Impact of Fever in Pregnant Inpatients in Vientiane, Laos
title_full The Aetiologies and Impact of Fever in Pregnant Inpatients in Vientiane, Laos
title_fullStr The Aetiologies and Impact of Fever in Pregnant Inpatients in Vientiane, Laos
title_full_unstemmed The Aetiologies and Impact of Fever in Pregnant Inpatients in Vientiane, Laos
title_short The Aetiologies and Impact of Fever in Pregnant Inpatients in Vientiane, Laos
title_sort aetiologies and impact of fever in pregnant inpatients in vientiane, laos
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822858/
https://www.ncbi.nlm.nih.gov/pubmed/27050192
http://dx.doi.org/10.1371/journal.pntd.0004577
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