Dengue, chikungunya, and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, India.

BACKGROUND: We conducted a diagnostic surveillance study to identify Plasmodium, dengue virus, chikungunya virus, and Orientia tsutsugamushi infections among febrile patients who underwent triage for malaria in the outpatient department at Ispat General Hospital, Rourkela, Odisha, India. METHODS: Febrile patients were enrolled from January 2016-January 2017. Blood smears and small volumes or vacutainers of blood were collected from study participants to carry out diagnostic assays. Malaria was diagnosed using rapid diagnostic tests (RDT), microscopy, and PCR. Dengue, chikungunya, and scrub typhus infections were identified using rapid diagnostic test kits and ELISA. RESULTS: Nine hundred and fifty-four patients were prospectively enrolled in our study. The majority of patients were male (58.4%) and more than 15 years of age (66.4%). All 954 enrollees underwent additional testing for malaria; a subset of enrollees (293/954) that had larger volumes of plasma available was also tested for dengue, chikungunya and scrub typhus by either RDT or ELISA or both tests. Fifty-four of 954 patients (5.7%) were positive for malaria by RDT, or microscopy, or PCR. Seventy-four of 293 patients (25.3%) tested positive for dengue by either RDT or ELISA, and 17 of 293 patients (5.8%) tested positive for chikungunya-specific IgM by either ELISA or RDT. Ten of 287 patients tested (3.5%) were positive for scrub typhus by ELISA specific for scrub typhus IgM. Seventeen patients among 290 (5.9%) with results for ≥3 infections tested positive for more than one infection. Patients with scrub typhus and chikungunya had high rates of co-infection: of the 10 patients positive for scrub typhus, six were positive for dengue (p = 0.009), and five of 17 patients positive for chikungunya (by RDT or ELISA) were also diagnosed with malaria (p < 0.001). CONCLUSIONS: Dengue, chikungunya and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, and comorbidity should be considered. Routine febrile illness surveillance is required to accurately establish the prevalence of these infections in this region, to offer timely treatment, and to implement appropriate methods of control.

QT correction in atrial fibrillation - Measurement revisited.

BACKGROUND: QT interval measured in the electrocardiogram (ECG) varies with RR interval challenging the calculation of corrected QT (QTc) in Atrial fibrillation (AF). OBJECTIVES: To identify the ideal Lead, number of complexes and the formula to measure QTc that correlates best between AF and sinus rhythm (SR). PROCEDURE: We identified ECGs from patients with AF before and after conversion to SR. After excluding patients on drugs and clinical conditions that prolong QT interval, QTc was calculated from all the leads using the formulae: Bazett (BF), Fridericia (FF), Framingham(FrF), Hodges (HF), Saige (SF) and Rautaharju (RF) during AF and SR. After identifying the lead with best linear correlation, we calculated QTc following the longest RR, multiple QRS complexes and average automated RR interval during AF and compared to SR. FINDINGS: In 52 patients (male 69%, age 63 ±â€¯9 yrs), QTc measured from Lead II correlated best with SR in majority of the formulae. QTc was consistently shorter with linear formulae. While BF overestimated QTc, FF was optimal comparing AF vs SR (416 ±â€¯33 vs 411 ±â€¯38 ms, ns) calculated from single, multiple or average automated RR interval. Bland Altman analysis of the average automated QTc versus the delta of individual automated QTcs shows the least variation in the QTc calculated by FF. CONCLUSIONS: BF in commercial software is not ideal for measurement of QTc in AF, Fridericia Formula in lead II from the average RR from automated ECG measurement maybe utilized for the calculation of QTc.

Gender balance in infectious diseases and hospital epidemiology journals.

Objective: Diversity is recognized as a driver of excellence and innovation. Women represent a significant part of the infectious diseases (ID) and hospital epidemiology (HE) workforce. We aimed to assess gender representation among editors of top ID and HE journals and explore potential correlations with the gender of first and last authors in published articles. Methods: Using Scimago Journal & Country Rank, we identified 40 ID and 4 HE high-ranking journals. Editorial members were categorized by decision-making influence (levels I-III). We retrieved names of first and corresponding authors from 12 ID-focused journals' 2019 research articles. Gender assignment for editors, first authors, and last authors utilized digital galleries and manual searches. Results: Among 2,797 editors from 44 journals, 33% were women. Female representation varied across editorial levels: 26% at level I, 36% at level II, and 31% at level III. Gender balance disparities existed among journals. Female first authors accounted for 50%, and female last authors accounted for 36% of the 2,725 published articles. We found weak but significant correlations between the editors' gender and the gender of the first and last authors. Conclusion: Gender representation among ID and HE journal editors displayed unevenness, but no overt vertical segregation was observed. A generational transition among authors may be underway. Our findings suggest that a generational transition may be occurring among authors.

Are reporting guidelines used in infectious diseases publications? An analysis of more than 1,000 articles.

Objective: To assess whether 16 reporting guidelines of Enhancing the QUAlity and Transparency Of Health Research (EQUATOR) were used in infectious diseases research publications. Design: This cross-sectional, audit-type study assessed articles published in five infectious diseases journals in 2019. Methods: All articles were manually reviewed to assess if a reporting guideline was advisable and searched for the names and acronyms of 16 reporting guidelines. An "advisable use rate" was calculated. Results: We reviewed 1,251 manuscripts across five infectious diseases journals. Guideline use was advisable for 973 (75%) articles. Reporting guidelines were used in 85 articles, 6.1% of total articles, and 8% (95% CI 6%-9%) of articles for which guidelines were advised. The advisable use rate ranged from 0.06 to 0.17 for any guideline, 0-0.08 for CONSORT, 0.53-1 for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and 0-0.66 for Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) : The TRIPOD statement. No trends were observed across the five journals. Conclusions: The use of EQUATOR-related reporting guidelines is infrequent, despite journals and publishers promoting their usage. Whether this finding is attributable to knowledge, acceptance, or perceived usefulness of the guidelines still needs to be clarified.