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.

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 platforms 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.

Researchers are investigating the genetics and underlying causes of diseases characterized by intermittent fever, such as familial Mediterranean fever, TRAPS, hyper-IgD syndrome, and related inflammatory disorders. This exploratory natural history study aims to discover genetic variants linked to these conditions and to describe their immunologic and clinical features. The research also includes retrospective analysis of clinical data from standard medical follow-up for some participants. Participants include patients with known or suspected autoinflammatory diseases, their family members, and healthy volunteers aged one year or older. The study involves collecting blood, saliva, or buccal samples for genetic and functional analysis, with some undergoing additional procedures like skin biopsies, leukapheresis, or bone marrow aspiration. Patients may receive standard medical care follow-up, and relatives with the diseases receive similar monitoring and counseling. During the study, participants undergo medical and family history reviews, physical exams, blood and urine tests, specialist consultations, and imaging like X-rays. Genetic counseling is provided on inheritance risks and treatment options. Follow-up visits occur approximately every six months to monitor symptoms and adjust treatments. The main outcome measured is genetic linkage related to autoinflammatory diseases, with ongoing monitoring and sample collection as needed.

Vector-borne diseases, caused by bites from infected mosquitoes, flies, fleas, ticks, or other blood-feeding insects, result in nearly one million deaths annually and are increasing, especially in Southeast Asia. In Cambodia, these diseases may account for about 10 percent of fevers, but many cases go undiagnosed. This research aims to better understand the range of febrile illnesses by using advanced metagenomic sequencing to identify pathogens in affected individuals. Participants include people aged 2 months and older who have a fever of at least 38 degrees Celsius or are diagnosed with a concerning pathogen. Close contacts of infected individuals may also join. The study collects blood samples, and for those with respiratory symptoms, nasal swabs. Participants share information on their age, sex, health history, and recent travel. If a highly transmissible or virulent pathogen is found, follow-up samples and testing of close contacts are performed to deepen understanding of disease spread. During the study, participants undergo screening with medical history review and physical assessments such as weight for children. They complete questionnaires and provide biological samples for pathogen identification. Optional follow-up samples may be collected within 1 to 2 weeks and again at 3 months after enrollment. Researchers measure pathogen sequences and immune responses to vector saliva proteins. The study continues through July 2027, aiming to improve knowledge of febrile diseases in Cambodia.

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 childs 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.

Researchers are investigating the effects of measles vaccine MV and Bacille Calmette-Gurin vaccine BCG given to women of fertile age before pregnancy, and the impact of providing early measles vaccination to their children. The study aims to understand both measles-specific and general immune benefits in mothers and children, focusing on antibody responses, viral loads after yellow fever vaccination, and overall health outcomes. This is a phase 4 randomized, triple-blind trial conducted in Guinea-Bissau, exploring the novel concept that vaccinating mothers with live vaccines may enhance protection for their children. In this trial, 2400 non-pregnant, HIV-negative women aged 15 to 35 will be randomly assigned to receive either the measles vaccine, BCG vaccine, or a saline placebo. Their children, all receiving BCG at birth as per local recommendations, will be further randomized at 20 weeks of age to receive either an early measles vaccine or placebo. All children will then receive the standard measles and yellow fever vaccines at 9 months. The study will create six groups combining maternal and child vaccination schedules to compare outcomes. Participants will be followed through regular home visits and health center monitoring. Women will have blood samples taken before and after vaccination to measure antibody levels. Children will be closely monitored monthly and have blood samples taken at specified ages to assess immune responses and viral loads. The study tracks morbidity and mortality data for both mothers and children over time, using interviews, hospital records, and vaccination documentation. The trial will continue until 2027, assessing which vaccination schedules best support health and immunity.

Researchers are conducting a national observational study to understand bacterial meningitis in children and newborns. This study focuses on the bacteria that cause meningitis, how vaccination has influenced its occurrence, and the treatment outcomes in children under 18 who are hospitalized with this condition. The goal is to describe the changing epidemiology of bacterial meningitis, especially in the context of vaccine use. The study collects detailed data on hospitalized children including risk factors, vaccination status, symptoms, and treatments given during hospital stays. Laboratory analyses such as cerebrospinal fluid cultures, antigen tests, blood cultures, and PCR are used to identify the bacteria involved. The study also tracks cases of purpura fulminans, a serious complication related to bacterial infections. Participants will be monitored during their hospital stay with focus on mortality before discharge, treatment failures 48 hours after antibiotics and repeat lumbar puncture, and the impact of vaccines. Data on clinical signs and laboratory results are collected to support the study. The study began in 2001 and continues to gather information to improve understanding of bacterial meningitis in this population.

Fever is a common reason for children aged 3 months to 15 years to visit healthcare providers. It can be hard to tell if the fever is caused by a viral or bacterial infection just by examining the child, which sometimes requires additional tests like measuring C-reactive protein CRP. This study looks at using a capillary medical device to measure CRP directly in primary care to help reduce unnecessary referrals to emergency rooms and labs, improving care for febrile children and easing healthcare system burdens. The study compares two groups one using capillary CRP measurement with the ACTIM-CRP device and a control group without this intervention. Children are randomly assigned to these groups during their primary care visit when they have a fever that meets specific duration and severity conditions. The study runs from September 2025 to June 2027 and focuses on referral rates and other outcomes related to care pathways for febrile children. Participants will be involved in the study during their initial consultation and followed up for up to seven days to monitor referrals, antibiotic prescriptions, satisfaction of both general practitioners and parents, fever duration, and cost impacts. Data on complementary tests and healthcare usage will also be collected to understand the effects of using capillary CRP testing in primary care. The study aims to improve the efficiency and quality of care for children with fever.