AFIRE
AFIRE (INA-101) : The Etiology of Acute Febrile Illness Requiring Hospitalization
ClinicalTrials.gov: NCT02763462
Collaborator: NIAID -HIH
Status: Completed
https://clinicaltrials.gov/study/NCT02763462
The AFIRE prospective observational cohort study enrolled 1,492 acute febrile patients (864 adults, 628 children) requiring hospitalization from July 2013 to June 2016. Inclusion criteria consisted of axillary body temperature ≥38˚C, ≥1 year of age, and hospitalization within the past 24 hours. Demographic, clinical, and laboratory data, including hematology results, were collected at enrollment, once during days 14-28, and three months after enrollment. Blood and other biological specimens were collected at each study visit, and each participant had aerobic blood cultures performed at enrollment. Microbial etiologies were identified in 1,003 (67.5%) participants and included dengue virus (467, 46.6%), Salmonella spp. (103, 10.3%), Rickettsia spp. (103, 10.3%), influenza virus (68, 6.8%), Leptospira spp. (44, 4.4%), chikungunya virus (37, 3.7%), and others.
Associated Publications:
- An observational prospective cohort study of the epidemiology of hospitalized patients with acute febrile illness in Indonesia. PLoS Negl Trop Dis. 2020 Jan 10;14(1):e0007927. doi: 10.1371/journal.pntd.0007927. PMID: 31923174.
- The characteristics of bacteremia among patients with acute febrile illness requiring hospitalization in Indonesia. PLoS One. 2022 Sep 8;17(9):e0273414. doi: 10.1371/journal.pone.0273414. PMID: 36074783.
- Underdiagnoses of Rickettsia in patients hospitalized with acute fever in Indonesia: observational study results. BMC Infect Dis. 2020 May 24;20(1):364. doi: 10.1186/s12879-020-05057-9. PMID: 32448167.
- Dengue viral infection in Indonesia: Epidemiology, diagnostic challenges, and mutations from an observational cohort study. PLoS Negl Trop Dis. 2019 Oct 21;13(10):e0007785. doi: 10.1371/journal.pntd.0007785. PMID: 31634352.
- Comparison of Commercial Enzyme-Linked Immunosorbent Assay and Immunofluorescence Assay for Diagnosis of Acute Rickettsia typhi Infections. Vector-Borne, and Zoonotic Diseases. doi:
- Leptospirosis in Indonesia: Diagnostic challenges associated with atypical manifestations and limited laboratory capacity. BMC.
- “Chikungunya in Indonesia: Epidemiology and diagnostic challenges” PLOS NTDs
- Etiologies of severe acute respiratory infection (SARI) and misdiagnosis of influenza in Indonesia, 2013-2016. Influenza and Other Respiratory Viruses
- Case report: two confirmed cases of human Seoul virus infections in Indonesia BMC Infect Dis.
- Prevalence of HIV Infection and Resistance Mutations in Patients Hospitalized for Febrile Illness in Indonesia. Am J Trop Med Hyg.
- Clinical characteristics of enteric fever and performance of TUBEX TF IgM test in Indonesian hospitals PLOS NTDs
Associated Biorepository
|
Pathogen (Cellular & Coinfection) |
Baseline | Day 14-28 | Month 3 | |||||
| Buffy coat | Plasma | Urine | NS swab | Plasma | Urine | Plasma | Urine | |
| Acinetobacter baumanii | 7 | 7 | N/A | 1 | 6 | N/A | 5 | 1 |
| Amoeba | 12 | 10 | 1 | N/A | 11 | N/A | 10 | N/A |
|
Ascaris lumbricoides & Trichiuris trichiura |
2 | 2 | 2 | N/A | 1 | N/A | 1 | N/A |
|
Bordetella pertusis & Streptococcus pneumoniae |
1 | 1 | N/A | 1 | 1 | N/A | 1 | N/A |
| Escherichia coli | 14 | 19 | 7 | 1 | 15 | 1 | 16 | 1 |
| Klebsiella pneumoniae | 13 | 12 | 1 | 2 | 10 | N/A | 9 | N/A |
| Leptospira spp. | 35 | 41 | 6 | 1 | 35 | N/A | 35 | 1 |
|
Moraxella catharrhalis & Influenza B virus |
1 | 1 | N/A | N/A | 1 | N/A | N/A | N/A |
| Mycobacterium leprae | 2 | 2 | N/A | N/A | 2 | N/A | 1 | N/A |
| Mycobacterium tuberculosis | 18 | 19 | 2 | N/A | 11 | N/A | 11 | N/A |
| Mycoplasma pneumoniae | 1 | 1 | N/A | N/A | 1 | N/A | 1 | N/A |
| Plasmodium spp. | 2 | 2 | N/A | N/A | 1 | N/A | 1 | N/A |
| Pseudomonas aeruginosa | 7 | 8 | 1 | NA | 4 | NA | 5 | NA |
| Rickettsia felis | 1 | 1 | N/A | N/A | 1 | N/A | 1 | N/A |
| Rickettsia typhi | 87 | 96 | 5 | 1 | 76 | N/A | 71 | N/A |
| Salmonella spp. | 54 | 91 | 9 | 2 | 78 | 2 | 67 | N/A |
| Streptococcus pneumoniae | 16 | 18 | 4 | N/A | 16 | N/A | 13 | N/A |
| Toxoplasma gondii | 1 | 1 | N/A | N/A | 1 | N/A | 1 | N/A |
| Other Bacteria | 7 | 9 | 1 | N/A | 7 | N/A | 6 | N/A |
| Pathogen (Viral) | Baseline | Day 14-28 | Month 3 | |||||
| Buffy coat | Plasma | Urine | NS swab | Plasma | Urine | Plasma | Urine | |
| Adenovirus | 1 | 1 | N/A | 1 | 1 | N/A | 1 | N/A |
| Chikungunya virus | 31 | 37 | 4 | 1 | 39 | N/A | 35 | N/A |
| Coronavirus OC43 | 1 | 1 | N/A | 1 | 1 | N/A | 1 | N/A |
| Dengue virus | 375 | 415 | 19 | 11 | 318 | N/A | 294 | N/A |
| Enterovirus | 1 | 1 | N/A | 1 | 1 | N/A | 1 | N/A |
| Hepatitis A Virus | 3 | 4 | N/A | N/A | 4 | N/A | 4 | N/A |
| Human Herpes Virus 6 | 5 | 8 | 1 | 1 | 5 | N/A | 6 | N/A |
| Human Metapneumovirus | N/A | 1 | N/A | 1 | 1 | N/A | 1 | N/A |
| Influenza A virus | 32 | 36 | N/A | 5 | 32 | N/A | 36 | N/A |
| Influenza B virus | 18 | 19 | 1 | 3 | 18 | N/A | 17 | N/A |
| Measles virus | 8 | 10 | N/A | 1 | 10 | N/A | 9 | N/A |
| Respiratory Syncytial Virus | 8 | 10 | N/A | 3 | 10 | N/A | 9 | N/A |
| Seoul virus | 2 | 2 | N/A | N/A | 2 | N/A | 2 | N/A |
| Unidentified | 376 | 442 | 38 | 13 | 331 | 13 | 270 | 6 |
| Other Categories | Baseline | Day 14-28 | Month 3 | |||||
| Buffy coat | Plas ma | Urine | NS swab | Plas ma | Urine | Plas ma | Urine | |
| Adult | 761 | 831 | 73 | 22 | 643 | 14 | 582 | 7 |
| Paediatric | 368 | 494 | 35 | 30 | 397 | 5 | 356 | 3 |
| Comorbidities* | 327 | 383 | 40 | 22 | 302 | 12 | 261 | 7 |
| Fatal cases | 73 | 81 | 10 | 3 | 28 | 1 | 6 | 0 |