A Combined Syndromic Approach to Examine Viral, Bacterial, and Parasitic Agents among Febrile Patients: A Pilot Study in Kilombero, Tanzania

Hercik, Christine; Cosmas, Leonard; Mogeni, Ondari D.; Wamola, Newton; Kohi, Wanze; Houpt, Eric; Liu, Jie; Ochieng, Caroline; Onyango, Clayton; Fields, Barry; Mfinanga, Sayoki; Montgomery, Joel M.

To better interpret which agents may in fact be contributing to fever syndrome, we further investigated cycle threshold (Ct) values, which serve as proxies for microbial concentration. We examined distributions of Ct values by agent using box plots and, based upon these distributions, we calculated the overall median Ct observed among all detected agents, for comparison to agent-specific Ct median values. Furthermore, to explore potential correlation between parasite load (Ct), as determined by quantitative PCR (qPCR), and the intensity of infection, as determined by blood smear, we conducted an analysis of variance (ANOVA) test to examine mean Ct values for patients grouped within each level of parasite intensity (1+, 2+, 3+, or 4+).