Incidence of Chronic fever in Raigarh Development Block of Raigarh District, Chhattisgarh, India

Oshin Bajrang^1,*, Jitendra Kumar Premi²

¹S.O.S in Anthropology, Pt. Ravishankar Shukla University Raipur Chhattisgarh

²S.O.S in Anthropology, Pt. Ravishankar Shukla University Raipur Chhattisgarh

Abstract

The present article is an empirical investigation of the chronic fever in development block of Raigarh of Raigarh District Chhattisgarh, India. Epidemiology is a branch of medical science that deals with the incidence, distribution and control of disease in population. The study aims to find out the incidence and distribution of chronic fever. In this retrospective study, laboratory records of patients with chronic fever in hospitals were reviewed. A retrospective study was carried out in various government and private hospitals of development block of Raigarh. Purposive sampling was used for the selection of chronic fever patients in present study and for the collection of secondary data online journals and articles were reviewed. Patients with enteric fever, malaria and dengue were observed. No deaths were reported. Study concludes improved diagnosis for typhoid and vaccination for prevention with enteric fever in Raigarh is needed.

Keywords: Chronic fever, retrospective study, enteric fever, Raigarh

Introduction

Epidemiology is a branch of science which deals with the incidence, distribution and control of disease in population. Health plays fundamental role and vital in overall development of individual, Health is fundamental to all and for overall development in population and health plays vital role, epidemiological study is population based study and John M Last has defined epidemiology that states epidemiology is the study of the distribution and determinants of health related state or event in specified population and the application of this study to control of the health problem (Last, 1993). Under the epidemiological study, the distribution and determinants all over population are included which helps the researcher to identify core causes of health aliments (Gordis, 2014) , the findings of epidemiological study and preventable measures when linked will provide reducing prevalence and improving overall health outcome in study population (Merrill, 2021). Retrospective studies make use of data that has already been collected for the purposes other than research and retrospective case series describes a number of cases with novel or uncommon illness or therapies (Hess, 2004). Retrospective study is an important approach in medical research to study the past cases and develop hypothesis for more investigation because they have been helpful to determine pattern, connection and result by used existing available data (Fukuhara H et al., 1990).

Objective

The objective of the article is to explore the incidence of chronic fever among the people of Raigarh Development Block of Raigarh District, Chhattisgarh.

To know survival and mortality status of patient with chronic fever.

To know the distribution of disease according to age and gender.

Materials and methods

This study was a retrospective study which includes 89 positive patients with chronic fever from Sant Baba Guru Ghasidas Ji Memorial Hospital Government Hospital of Raigarh development block from January to December 2022 through purposive sampling. The selection criteria include all positive patients of all age groups, with a confirmed diagnosis of typhoid, malaria and dengue in the hospital, for the laboratory pathological test blood samples were used for confirming chronic fever, and for the identification of typhoid specific diagnostic test Widal test was used, malaria was identified through PV and PF diagnostic test and Dengue was identified with RD and Elisa diagnostic test. The Inclusion criterions include patients with all age group of year 2022, with typhoid, malaria and dengue fever. Data was analyzed with SPSS 16.0 and for the descriptive statistics such as mean and standard deviation were used to summarize continuous variable.

Result and discussion

The case distribution of various chronic fever is represented in the form of various tables, in which (table no.1) illustrates the distribution of three types of chronic fever – Malaria, Dengue and Typhoid among the patients admitted in Sant Baba Guru Ghasidas Ji Memorial Hospital Government Hospital of raigarh development block from January to December 2022, here malaria accounts for 16.9% , Dengue represents 24.7% and typhoid is the most prevalent , accounting for 58.4% . In the (table no.2 ) highlights the gender breakdown among chronic fever patients where males accounts for 55.1% of the cases and female makeup 44.9% of the cases, here males are slightly affected than females in study area, which might reflect exposure to risk factor or access to healthcare services. In the (table no.3) categorizes patients by age groups, range (21-40 years) are the most affected groups, accounting for 35.95%, range (41-60 years) are second highest at 23.59%, range (1-20 years) represents 21.34% of cases, range (61-80 years) accounts for 17.97% and range (81-100 years) are least affected only with 1.12%. In the (table no.4) shows the monthly distribution of cases, where in June only 1.12% of cases were reported, July shows 12.35% of cases reported, August shows 29.21% of cases reported and September was the peak with 57.30% of cases reported. This data indicates chronic fever cases rises significantly during the monsoon season in September. In the (table no.5), this table categorizes the seriousness of chronic fever based on whether patients treated as outpatients (OPD) or inpatients (IPD) here OPD males were reported 47.1% and females were reported 37.07% and only a small proportion of patients with 7.86% males and 7.86% females required hospitalization. In the (table no.6), this table breakdown the seriousness of cases into outpatient department and inpatient treatment across the age group, where younger patients(1-20 years) had highest proportion of outpatient cases, while older groups (61-80 years) had relatively higher hospitalization rates.

It is important to note that no deaths were reported during the study.

Discussion

Present study reports mean age was 36 years for the patients of chronic fever and majority of males patients were affected more. Study conducted in Jena Winzerela, Germany on Q fever outbreak occurred in 2005 and in this study mean age for sero-positive group were 53 years of age with confirmation of Q fever infection in 2005 and 55 years of age for sero-negative group for household members(Ankert et.al., 2022). Study conducted in Arizona on Valley Fever in 2019 its mean age was to be 50 years (Grizzle et.al., 2020). Study conducted on Fever of Unknown Origin, by systematically reviewing patients demographics, clinical symptoms, laboratory findings, imaging results and treatment outcomes were helpful to indentify common cause of Fever of Unknown Origin(FUO), and the mean age was not explicitly mentioned in this research (Petersdorf & Beeson, 1961). Study conducted on Q-fever was essential for ensuring the validity, reliability and ethical conduct of research and allowed for a systematic investigation of Chronic Q Fever and Chronic fatigue syndrome and study method help to leads to valuable insight into the long term effect of Q-fever outbreak in Jena, Germany (Ankert et.al., 2022). The retrospective method used in this study provides a comprehensive understanding of the economic burden of the disease, estimating costs, analyzing data and informing historical policy decisions and longitudinal analysis for improved healthcare resources (Grizzle et.al., 2020).Researcher used retrospective study where historical data and medical records of patients hospitalized with fever of unknown origin between 1982 and 1988 were included and as a result identification of diagnostic approaches, underlying causes, identification and studying characteristics were possible, and as findings infection, collagen disorder, neoplastic disorder, crohn,s disease and undiagnosed were found to be the cause of fever of unknown origin and mean age was not described in this research (Fukuhara H et.al., 1990). This article finds at least one typhoid fever occurrence in 42 out of 57 African countries, and outbreak of typhoid was increasing over time reported in 15 countries with both frequency and size, method used in this study was retrospective which provides comprehensive overview burden, trends and challenge of typhoid, and also for informing public health intervention and the mean age was not explicitly mentioned in this research (Kim et.al., 2019). Pattern found in present study and above mentioned studies suggest need to explore preventive measures tailored to this critical period and future studies should investigates the specific environmental factors responsible for chronic fever.

Conclusion

The incidence rate of Chronic fever in study area is 6.268, the mean age of the patients with chronic fever is 36, Males are more affected than females, patients age between 21 to 40 are more affected, patients age between 21 to 40 were admitted to Intensive care Unit, maximum patients were admitted in September, No deaths were reported hence all patients were alive and typhoid is maximum prevalent in Development Block Raigarh as compared to dengue and malaria. Chronic fever remains a significant health burden in study area and need of innovative health care solution to improve outcomes for study area.

Acknowledge

I would like to acknowledge and my warmest tahnks to my supervisor Dr. Jitendra Kumar Premi who made this work possible. His guidance and advice carried me through all the stages of writing my article. I would like to thank the committee and staff of Sant Baba Guru Ghasidas Ji Memorial Hospital Government Hospital, Raigarh for assisting me to collect data regarding chronic fever.

References

Ankert, J., Frosinki, J., Weis, S., Boden, K., & Pletz M. W. (2022). Incidence of chronic Q fever and chronic fatigue syndrome: A 6 years follow up of large Q fever outbreak. Transboundary and Emerging diseases, 69(4), 2219-2226.

Fukuhara H, Tamaki K, Nakamura H, Kanesima H, Irabu Y, Shimozi K, Shigeno Y, Kyinjou F, & Saito A. (1990). A Retrospective Study of Hospitalized patients with Fever of Unknown Origin(FUO) during six years. Kansenshōgaku Zasshii, 64(3), 335-341.

Gordis, L. (2014). Epidemiology (5^th ed.). Elsevier Health Sciences.

Grizzle, A. J., Wilson, L., Nix D. E., & Galgiani, J. N. (2020). Clinical and Economic Burden of Valley Fever in Arizona: An Incidence-Based Cost-of-Illness Analysis. Open Forum Infectious Disease, 8(2).

Hess, D. R. (2004). Retrospective studies and chart reviews. Respiratory Care, 49(10), 1171-1174.

Kim, J. H., Im, J., Parajulee, P., Holm, M., Cruz Espinoza, L. M., Poudyal, N., Mogeni, O. D., & Marks, F. (2019). A Systematic Review of Typhoid Fever Occurrence in Africa. Clinical infectious diseases: an official publication of the Infectious Disease Society of America, 69(Suppl 6), S492-S498.

Last J M. (1993). Dictionary of Epidemiology. CMAJ: Canadian Medical Association Journal, 149(4), 400.

Merrill, R. M. (2021). Introduction to Epidemiology (8^th ed.). Jones & Bartlett Learning.

Petersdorf, R. G., & Beeson, P. B. (1961). Fever of Unexplained Origin: Report on 100 Cases. Medicine, 40(1), 1-30.