Yellow Fever

Researchers are evaluating the need for antibiotic prevention in patients with chronic liver disease who have gastric varices and are treated with elective endoscopic injection of cyanoacrylate (GVO). Gastric varices can cause serious bleeding with a high chance of rebleeding and mortality. While endoscopic injection of tissue glue is effective in stopping acute bleeding, it still carries risks of rebleeding and infection, which are important concerns for patients with weakened immune systems due to liver conditions. The study compares two groups: one receiving an antibiotic called ertapenem injected intravenously before the endoscopic cyanoacrylate injection, and the other not receiving this antibiotic before the procedure. The trial is randomized and aims to clarify whether giving this antibiotic can help prevent infections and complications after GVO treatment. The treatment is delivered during an elective endoscopic procedure to manage gastric varices. Participants will be monitored for three years to evaluate key outcomes such as the prevention of sepsis, rebleeding rates, refractory bacterial infections, and mortality. Assessments will include tracking infections and bleeding events over time. The study is designed to provide long-term data on the benefits and risks of using antibiotic prophylaxis in this patient group, with ongoing safety monitoring throughout the follow-up period.

Researchers are evaluating whether AI-enabled, nurse-led treatment planning can match or improve the quality of clinical reasoning and management compared to standard physician-led care in adults aged 18 years and older. The study focuses on patients in rural and semi-urban India presenting with hypertension, diabetes mellitus, fever, breathlessness, or musculoskeletal pain. It aims to determine if nurse consultations supported by a large language model (LLM) achieve clinical quality scores that are not worse than those of physician consultations and to assess patient acceptance and satisfaction with AI-assisted nurse care. Participants receive two consultations during the same visit: one led by a nurse using an AI-based clinical decision support tool and one by a physician providing standard care. The nurse-led consultation involves routine history taking and clinical assessment, with interaction through a digital interface to the LLM for assistance in diagnosis, reasoning, and treatment planning. The physician consultation follows usual clinical practice without AI support. The study compares these two approaches in a randomized order within each participant. Throughout the study visit, both consultations are audio recorded for blinded clinical quality evaluation. After the nurse + LLM consultation, participants complete an exit survey measuring communication, trust, and satisfaction. Researchers also gather nurse-reported feedback on acceptability and feasibility through interviews after nurses complete at least 10 AI-assisted consultations. The main outcome measured is the clinical quality of the consultations immediately after both visits, with additional assessments of patient experience and nurse perspectives over up to nine months.

This research evaluates the accuracy and consistency of an AI platform called OpenGenome that analyzes free-text symptom descriptions submitted voluntarily by adults. The study collects anonymous symptom data and matches it with real biomedical literature from PubMed and ClinicalTrials.gov to generate structured biological signal reports. It aims to assess how well the extracted signals align with sources, how confidence scores correlate with dataset size and symptom specificity, and the distribution of biological signals across a large population. Adults aged 18 or older can submit free-text symptom descriptions via the OpenGenome platform, which then uses an AI-assisted method to extract primary and secondary biological signals grounded in biomedical evidence. For each submission, the system retrieves up to 16 relevant sources and provides a confidence score and signal strength. No treatment or intervention is given, and no participant contact occurs during the observational registry. Participants are involved by voluntarily submitting symptom descriptions online through the platform, with all data anonymized at collection. The study continuously monitors the internal signal-source concordance rate over 12 months. There are no in-person visits or direct assessments, ensuring privacy and minimal burden. This ongoing data collection helps researchers understand the platform's accuracy and signal calibration in a broad anonymous population.

Researchers are evaluating a telemedicine system designed for continuous monitoring of body temperature in adults who have fever. This pilot study is nonrandomized and conducted at a single center, aiming to assess both the effectiveness and safety of the device. Up to 40 adults hospitalized for infections or other conditions causing temperature changes will participate, with no randomization or stratification of participants. The investigational device will be placed in the armpit area and connected to a mobile phone to continuously record temperature readings. Study staff will also manually measure skin temperature in the opposite armpit using a gallium thermometer every 30 to 60 minutes, increasing frequency if the temperature rises or if temperature-lowering drugs are administered. The device will stay in place for up to 72 hours, followed by an additional 72-hour monitoring period after removal to observe for any side effects. Participants will be monitored closely by research staff during device placement and after removal, with temperature checks and safety evaluations continuing throughout the six-day period. The main measurement is the correlation between the telemedicine device readings and standard thermometer measurements over 72 hours. Researchers will also track any adverse events related to the device or procedures during the entire monitoring period.

This research aims to explore how intravenous vitamin C infusion affects the occurrence of fever during labor in women who receive epidural pain relief. The study focuses on reducing fever-related impacts on both mothers and infants to improve their health outcomes and offers guidance for clinical preventive treatments. It is a phase 4 randomized controlled trial involving women experiencing labor complications and fever. Participants will receive epidural labor analgesia through a catheter placed in the lower spine, with an initial test dose followed by a continuous patient-controlled epidural analgesia pump. After the epidural anesthesia is started, participants are randomly assigned to receive either 1 g, 2 g, or 3 g of vitamin C intravenously, or a placebo of normal saline, all infused at a rate of 5 ml per minute. During the study, maternal temperature and fever status are monitored every two hours until delivery. Blood tests are taken before analgesia, when fever develops, and after delivery. Researchers will also assess pain levels, total analgesic use, delivery details, and newborn health immediately after birth. The study includes safety monitoring and records infant care needs, with participation lasting through labor and delivery.

Researchers are evaluating the protective efficacy of Mossie-GO, an active spatial repellent device that releases transfluthrin, to reduce malaria prevalence in children 5 years old and younger in Uganda. This cluster-randomized, double-blinded control trial aims to measure how well the device lowers malaria cases confirmed by rapid diagnostic tests and microscopy, while also assessing its impact on mosquito behavior, resistance, and diversion effects on nearby unprotected individuals. The study includes surveys and safety monitoring. The Mossie-GO device is a small solar-powered fan unit that holds repellent discs treated with transfluthrin, designed to prevent mosquito bites and reduce mosquito populations when used overnight for 8 to 12 hours. Households in the intervention group receive devices with treated discs and monthly refills, while control households receive devices with untreated blank discs and refills to maintain blinding. The device is placed in the room where the enrolled child sleeps. Participants continue standard malaria prevention such as bed nets. Participants are monitored at baseline and followed for up to 18 months, covering two malaria transmission seasons. Assessments include malaria testing in children using blood tests, household surveys, mosquito collection with light traps and human landing catches, air sampling to measure repellent concentration, and acceptability surveys. Data on adverse events and intervention safety are collected. The trial involves 56 clusters with about 100 households sampled for detailed evaluation in core zones, plus additional monitoring in buffer zones.

Researchers are exploring the genetics and biological processes behind diseases that cause intermittent fever, such as familial Mediterranean fever, TRAPS, hyper-IgD syndrome, and related disorders. This observational study aims to discover genetic variants linked to these inflammatory diseases and to understand immune system features and the clinical characteristics of these conditions through detailed genetic and medical data analysis. Participants include patients with known or suspected autoinflammatory diseases, their family members, and healthy volunteers. Patients may undergo a variety of tests and procedures, including physical exams, blood and urine tests, X-rays, specialist consultations, and genetic sampling via blood or saliva. Some may undergo leukapheresis to collect white blood cells, while relatives and healthy volunteers may also provide samples for genetic and functional studies. Follow-up visits occur approximately every six months to monitor symptoms and adjust care as needed. During the study, participants will provide medical and family histories, undergo physical exams, and complete various laboratory tests. Genetic counseling is offered to discuss risks and treatment options. Researchers will measure genetic linkages annually to identify variants related to inflammatory diseases. The study involves ongoing monitoring to collect clinical data and biological samples, supporting a comprehensive understanding of these rare inflammatory conditions.

Researchers are investigating vector-borne diseases, which are infections caused by bites from mosquitoes, flies, fleas, ticks, or other blood-feeding insects. These diseases contribute to nearly one million deaths annually and are increasing, especially in Southeast Asia. This study aims to better understand these illnesses in Cambodia, where they may account for about 10% of fevers, by identifying pathogens using advanced metagenomic sequencing techniques. Participants include people aged 2 months to 65 years who have a fever of at least 38 degrees Celsius or have been diagnosed with important infectious pathogens. Close contacts of infected individuals may also join. Participants provide information about their health, travel, sex, age, and residence. Blood samples are collected, and nasal swabs are taken if respiratory symptoms are present. Optional follow-up blood samples and nasal swabs may be taken within 1-2 weeks and/or up to 3 months after enrollment. During the study, participants complete questionnaires and undergo medical history screening. Children are weighed to ensure suitability for blood sampling. The researchers will analyze pathogen sequences from samples collected between day 0 and 2 of enrollment and assess immune reactions to insect saliva. This study includes long-term tracking through optional follow-up samples to better understand disease spread and impact in the region.

Fever is a common symptom in young children, especially those between one and five years old, and is a frequent reason for emergency room visits. This study focuses on evaluating how educating parents of children presenting with fever affects their anxiety levels and how they manage their child's fever. It aims to reduce parental anxiety and improve fever management practices by providing targeted education to parents. The study is a randomized controlled trial with two groups: an experimental group and a control group. Parents in the experimental group will receive fever management education through home visits using specially developed training materials. The control group will not receive any intervention but will participate in the same measurement schedule. The study includes pre-tests, post-tests one month after training, and follow-up assessments three months after the training to evaluate the lasting effects of the education. Participants will be assessed using various tools including the Parent-Child Introductory Information Form, State Anxiety Scale, Parent Fever Management Scale, Visual Analogue Scale for satisfaction with the education, and the Parent-Education Satisfaction Form. Data collection will occur before education, one month after, and three months after, with analysis focusing on anxiety levels and fever management. The total study period runs from April 2024 to April 2025, aiming to help reduce unnecessary emergency visits and improve health system efficiency.

Researchers are investigating how adults who have previously received the yellow fever vaccine 17D respond to receiving the vaccine again. The study aims to understand how prior vaccination affects antibody levels and immune cell responses after re-vaccination. This research will help identify the antibody levels needed for effective protection and support future studies to improve yellow fever vaccination strategies. Participants will receive a single standard dose (0.5 mL) of the yellow fever vaccine 17D given under the skin. The study involves one vaccination arm where all participants are re-vaccinated with the vaccine. This live-virus challenge approach allows researchers to measure immune responses over time and evaluate how well the vaccine boosts immunity. During the study, participants will provide medical and travel histories, blood samples before vaccination, and blood samples approximately every other day for 14 days after vaccination. They will also give a blood sample around 28 days post-vaccination. Participants will complete daily symptom diaries for 14 days and report any symptoms afterward. Researchers will monitor antibody levels, vaccine virus presence in the blood, and immune cell responses to assess vaccine effects and safety over the study period.