By: Timothy Wanninger
Intro
In this article, Dr. Juan David Rodas Gonzalez, a professor at the University of Antioquía and member of the UTMB Global Infectious Disease Research Network, describes his ongoing work identifying the etiologies of acute undifferentiated febrile
syndrome in Colombia.
Although diagnostic tests exist for a number of infections, the etiologic agent is not always identifiable, impairing the delivery of focused care and treatment. A study being conducted in Colombia as part of the University of Texas Medical Branch’s
Global Infectious Disease Research Network looks to improve upon pathogen identification through novel diagnostic testing and clinical care algorithm development.
Dr. Juan David Rodas Gonzalez, a full time professor at the University of Antioquía in Colombia, is the principal investigator of this study. Dr. Rodas has worked extensively on Rickettsias, as well as other pathogens, including Ehrlichia, Hantavirus, SARS-CoV-2, Arenaviruses. He has received Fogarty funding for his work since 2016
and has been involved with the Global Infectious Disease Research Network, headed by Dr. Peter Melby at UTMB, for the past 10 years.
Dr. Rodas’ current project as part of the network received funding beginning in 2019. Patients have been recruited from three study sites, Turbo and Apartadó, both in the province of Antioquía (northwest Colombia), and one in Villeta,
in the province of Cundinamarca (near the capital, Bogotá). The goal of this project is to identify the main causes of acute undifferentiated febrile syndrome. Dr. Rodas explained that specific etiologies are only identified in 50-60% of cases
and that there are multiple barriers to identifying the pathogen causing a given illness. These difficulties include symptom overlap between pathogens, the lack of proper disease surveillance, and insufficient acute-phase diagnostics. Moreover, he
noted that, while malaria and Dengue virus are often focused on in these patients, many other pathogens must also be considered, including Rickettsias, leptospirosis, and other arboviruses.
This study looks to address the gap in pathogen identification in patients with acute fever in two ways: clinical algorithm development and the assessment of novel diagnostic tests. The new diagnostic tests include two tri-plex PCR assays, one for the
detection of Dengue virus, Chikungunya virus, and Mayaro virus, and the other for the detection of Yellow Fever virus, Oropouche virus, and Venezuelan Equine Encephalitis virus. Clinical algorithm development is being done based on a patient survey
and clinical data. Study participants were surveyed regarding their symptoms and signs of infection as well as risk factors for infection. A One Health mindset is particularly key here as human/animal interactions contribute to the infection risk
in these patients. Dr. Rodas explained that rural areas have an increased risk for tick and mosquito exposure. In addition, poverty, trash management, and hygiene can influence exposure to rodents and the pathogens they carry. Rodents can also contaminate
food and water. Moreover, Dr. Rodas also highlighted changes in the ability of mosquito species to serve as vectors for pathogens, namely the expansion of Dengue virus to Aedes albopictus, resulting in increased rural cases. With the analysis
of these risk factors, combined with patient signs/symptoms and additional clinical data, the goal is to formulate a standardized procedure to guide diagnosis and medical decision making in these patients.
Building off of this ongoing project, Dr. Rodas hopes to use the findings from this work to inform a larger study that will incorporate even more relevant factors for identifying the causative agents of acute undifferentiated febrile syndrome. He plans
to include additional diagnostic panels to expand the number of detectable pathogens and to add clinical lab tests that will be collected from all patients to enhance the clinical data available for each study participant for future work.
Dr. Rodas greatly enjoys working as part of the Global Infectious Disease Network, explaining that his colleagues are “great people and very good scientists” and that he is grateful for the opportunities he has had to “share [his] thoughts
and experiences” with his colleagues at UTMB. We look forward to seeing the results of his work as the data are analyzed and shared with the scientific community.