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Infectious Etiologies of Febrile Illnesses in Cameron.

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Title:Infectious Etiologies of Febrile Illnesses in Cameron.
Authors:Kenji, Obadia Mfuh
Contributors:Biomedical Sciences (Tropical Medicine) (department)
Date Issued:May 2017
Publisher:University of Hawaiʻi at Mānoa
Abstract:Background: Diagnosis of febrile illnesses in malaria-endemic countries focuses primarily on
confirming or ruling out malaria, since malaria is considered a major health threat. But because
of the high rate of malaria over-diagnosis, other febrile illnesses are often misdiagnosed or
overlooked. Thus, there remains a large gap in our understanding of pathogen profiling in most
malaria-endemic countries. Because knowing the cause of fever is the first step in deciding
appropriate treatment and improving disease outcomes, the overall objective of this dissertation
research was to identify infectious causes of febrile illnesses in Cameroon.
Methods: We recruited 550 febrile patients seeking care at selected hospitals in Cameroon.
Blood samples were collected from patients and used to conduct malaria tests by thick film
microscopy, rapid diagnostic testing and PCR. Plasma samples were tested for antibodies
against dengue, West Nile, chikungunya and respiratory viruses, Leptospira interrogans and
Salmonella typhi, using RDT, microsphere immunoassay (MIA) and ELISA. Collected stool
samples were cultured for the isolation of Salmonella and Shigella sp. Recombinant proteins of
Ebola, Sudan, Marburg and Lassa viruses were expressed using Drosophila S2 cells and used
to develop a MIA for viral hemorrhagic fevers (VHF). MIA was pre-validated using human or
humanized monoclonal antibodies, and 408 previously collected plasma samples were
screened for the presence of IgG antibodies for hemorrhagic fever viruses.
Results: Although malaria was the main cause of febrile illnesses in Cameroon, the accuracy of
clinical diagnosis of malaria was poor. That is, 38% of the patients clinically diagnosed as
having malaria had fever caused by other pathogens, including acute respiratory tract infections,
typhoid fever, amebiasis, toxoplasmosis, shigellosis, dengue fever, West Nile fever, and
chikungunya virus infection. We developed and pre-validated a multiplex MIA for the diagnosis
of VHF, and identified samples (5/408) suspected to be positive for Ebola, Lassa and Marburg
viruses.
Conclusion: Collectively, our data provide the first evidence of several pathogens causing
febrile illnesses in Cameroon and may provide the basis for developing an algorithm for the
management of febrile illnesses. This study also reports for the first time the development of a
MIA for the diagnosis of VHF.
Description:Ph.D. Thesis. University of Hawaiʻi at Mānoa 2017.
URI:http://hdl.handle.net/10125/62203
Rights:All UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.
Appears in Collections: Ph.D. - Biomedical Sciences (Tropical Medicine)


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