The etiology of acute infectious febrile illnesses at a tertiary care hospital: an experience from a hilly region of Uttarakhand

Sep 29, 2026

Regional distribution of prevalent diseases shapes differential diagnosis of acute febrile illness (AFI). This hospital-based study assessed AFI cases to inform clinicians and microbiologists about the serology-based percentage positivity of prevailing infections around Dehradun. Among 38,869 suspected patients, infectious etiologies including dengue, malaria, enteric fever, and scrub typhus were tested. From September 2021 to December 2022, enteric fever (12.65%) led, followed by dengue (7.37%), scrub typhus (1.44%), and malaria (0.18%). Emphasis is placed on education, hygiene, sanitation, and vector control.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Abstract

Introduction

Materials and Methods

Study design

Study participants

Study duration

Procedure

Statistical analysis

| | RIGINAL ARTICLE | | --- | --- | | | O | Volume 17 Number 6 (December 2025) 961-965 DOI: [http://doi.org/10.18502/ijm.v17i6.20364](http://doi.org/10.18502/ijm.v17i6.20364) The etiology of acute infectious febrile illnesses at a tertiary care hospital: an experience from a hilly region of Uttarakhand Yogita Rawat, Shekhar Pal, Arti Negi, Uneza Husain*, Rahul Nath, Nidhi Negi Department of Microbiology, Government Doon Medical College, Dehradun, Uttarakhand, India Received: June 2024, Accepted: November 2025 ABSTRACT Background and Objectives: The differential diagnosis of acute febrile illness (AFI) is influenced by the regional distribution of prevalent diseases. Hence, in our hospital-based data analysis, we evaluated the AFI cases presented to our center to raise awareness among clinicians and microbiologists regarding the percentage positivity of the prevailing diseases in the context of AFI based on serology, in and around the city of Dehradun. Materials and Methods: A total of 38,869 suspected AFI patients were enrolled in the study, and their specimens were analysed for infectious etiologies, including dengue, malaria, enteric fever, and scrub typhus by antigen-antibody based detection methods. Results: Data analysis conducted from September 2021 to December 2022 among patients with AFI revealed that enteric fever, dengue, scrub typhus, and malaria accounted for 12.65%, 7.37%, 1.44%, and 0.18% of cases, respectively. Conclusion: Since enteric fever followed by dengue was found to be contributing the maximum, mass education regarding safe drinking water, hygiene, sanitation, and strengthening of vector control measures is the need of the hour. Keywords: Acute febrile illness; Salmonella; Fever; Scrub typhus; Malaria INTRODUCTION Acute febrile illnesses (AFI) are responsible for the majority of outpatient visits in hospitals. Any fever of up to two weeks' duration, rapid in onset, caused by diverse pathogens, and without any evidence of organ or system-specific etiology, is defined as AFI. The various differentials of AFI in India include dengue, typhoid fever, chikungunya, malaria, leptospirosis, and rickettsial infections (1-3). Dengue, one of the most important contributors of AFI, is transmitted by the bite of infected mosquitoes such as Aedes aegypti or Aedes albopictus. The incidence of the disease has increased enormously (up to 30-fold) during the past five decades (4). Typhoidal Salmonellae such as Salmonella typhi and Salmonella paratyphi are transmitted through contaminated food or water, and hence enteric fever is a major public health concern in developing countries. The incidence rate of malaria (transmitted by being bitten by an infected female Anopheles mosquito) has subsided over the years, while scrub typhus, which is caused by chigger bites harboring Orientia tsutsugamushi, has increased in India (5-7). For dengue and scrub typhus, serology and Polymerase Chain Reaction (PCR) constitute the major investigations. For malaria, various diagnostic options include microscopy, rapid diagnostic tests, and PCR, while the commonly used tests for the detection of enteric fever in most of the laboratories are culture, the Widal test (tube/slide), and IgM/IgG rap- *Corresponding author: Uneza Husain, MD, Department of Microbiology, Government Doon Medical College, Dehradun, Uttarakhand, India. Tel: +135-2722829 [Email: uneza47@gmail.com](Email: uneza47@gmail.com) Copyright © 2025 The Authors. Published by Tehran University of Medical Sciences. This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International license ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)). Noncommercial uses of the work are permitted, provided the original work is properly cited. id point-of-care tests. Timely use of diagnostic tests supporting the presence of infection is extremely helpful and often acts as a lifesaver for

FAQs

What is the study’s main purpose for acute febrile illness (AFI)?

To evaluate suspected AFI cases using serology-based testing to determine the burden and positivity percentages of prevalent diseases in and around Dehradun.

Which infections were tested in the suspected AFI patients?

The study tested infectious etiologies including dengue, malaria, enteric fever, and scrub typhus using antigen-antibody based detection methods.

What were the key findings on disease proportions from September 2021 to December 2022?

Enteric fever accounted for 12.65% of cases, followed by dengue (7.37%), scrub typhus (1.44%), and malaria (0.18%).

Why does the study recommend public health and vector-control measures?

Because enteric fever followed by dengue contributed the highest proportions, the authors emphasize mass education on safe drinking water, hygiene and sanitation, and strengthening vector control.

Sep 29, 2026

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