defining disease heterogeneity to guide the empirical treatment of febrile illness in resource poor settings定义疾病异质性指导经验性治疗发热性疾病在缺乏资源的环境下.pdfVIP

Defining Disease Heterogeneity to Guide the Empirical Treatment of Febrile Illness in Resource Poor Settings 1,2 1,3 1,2 2 1,2 Lisa J. White *, Paul N. Newton , Richard J. Maude , Wirichada Pan-ngum , Jessica R. Fried , 1,3,4 2 1,2 Mayfong Mayxay , Rapeephan R. Maude , Nicholas P. J. Day 1 Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom, 2 Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, 3 Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic, 4 Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao People’s Democratic Republic Abstract Background: Malaria incidence is in decline in many parts of SE Asia leading to a decreasing proportion of febrile illness that is attributable to malaria. However in the absence of rapid, affordable and accurate diagnostic tests, the non-malaria causes of these illnesses cannot be reliably identified. Studies on the aetiology of febrile illness have indicated that the causes are likely to vary by geographical location within countries (i.e. be spatially heterogeneous) and that national empirical treatment policies based on the aetiology measured in a single location could lead to inappropriate treatment. Methods: Using data from Vientiane as a reference for the incidence of major febrile illnesses i