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. 2012 Jan;86(1):46-51.
doi: 10.4269/ajtmh.2012.10-0497.

Etiology of acute, non-malaria, febrile illnesses in Jayapura, northeastern Papua, Indonesia

Narain H Punjabi, Walter R J Taylor, Gerald S Murphy, Sri Purwaningsih, Helena Picarima, John Sisson, James G Olson, Samuel Baso, Ferry Wangsasaputra, Murad Lesmana, Buhari A Oyofo, Cyrus H Simanjuntak, Decy Subekti, Andrew L Corwin, Thomas L Richie

Etiology of acute, non-malaria, febrile illnesses in Jayapura, northeastern Papua, Indonesia

Narain H Punjabi et al. Am J Trop Med Hyg. 2012 Jan.

Abstract

We conducted a prospective, inpatient fever study in malaria-endemic Papua, Indonesia to determine non-malaria fever etiologies. Investigations included malaria blood films, blood culture, paired serologic samples analysis for dengue, Japanese encephalitis, leptospirosis, scrub typhus, murine typhus, and spotted fever group rickettsia. During 1997-2000, 226 patients (127 males and 99 females) 1-80 years of age (median age = 25 years) were enrolled. Positive blood cultures (n = 34, 15%) were obtained for Salmonella Typhi (n = 13), Escherichia coli (n = 8), Streptococcus pneumoniae (n = 6), Staphylococcus aureus (n = 5), Streptococcus pyogenes (n = 1), and Klebsiella pneumoniae (n = 1). Twenty (8.8%) patients were positive for leptospirosis by polymerase chain reaction. Eighty (35.4%) of 226 patients had ≥ 1 positive serology, diagnostic for 15 rickettsial and 9 dengue cases. Acid-fast bacilli-positive sputum was obtained from three patients. Most common confirmed (81 of 226, 35.8%)/suspected diagnoses were typhoid fever (n = 41), pneumonia (n = 29), leptospirosis (n = 28), urinary tract infections (n = 20), rickettsioses (n = 19), dengue (n = 17), and meningitis/encephalitis (n = 15). There were 17 deaths, 7 (46.7%) were caused by meningitis/encephalitis. Multiple positive serologic results and few confirmed diagnoses indicate the need for improved diagnostics.

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Conflict of interest statement

Disclosure: Gerald S. Murphy, John Sisson, James G. Olson, Buhari A. Oyofo, Andrew L. Corwin, and Thomas L. Richie are/were military service members, and Narain H. Punjabi, Murad Lesmana, and Decy Subekti were foreign service employees of the U.S. Government. This work was prepared as part of their official duties. Title 17 U.S.C. §105 provides that ‘Copyright protection under this title is not available for any work of the United States Government.' Title 17 U.S.C. §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person's official duties. None of the authors have any conflicts of interest.

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