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Analysis of institutional authors

Camprubí-Ferrer DCorresponding AuthorRodriguez-Valero NAuthorAlmuedo-Riera AAuthorBalerdi-Sarasola LAuthorFernandez-Pardos MAuthorMartinez MjAuthorNavero-Castillejos JAuthorMuñoz JAuthor

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March 25, 2022
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Causes of fever in returning travelers: a European multicenter prospective cohort study

Publicated to:Journal Of Travel Medicine. 29 (2): taac002- - 2022-03-21 29(2), DOI: 10.1093/jtm/taac002

Authors: Camprubí-Ferrer, D; Cobuccio, L; Van den Broucke, S; Genton, B; Bottieau, E; D'Acremont, V; Rodriguez-Valero, N; Almuedo-Riera, A; Balerdi-Sarasola, L; Subirà, C; Fernandez-Pardos, M; Martinez, MJ; Navero-Castillejos, J; Vera, I; Llenas-Garcia, J; Rothe, C; Cadar, D; Van Esbroeck, M; Foque, N; Muñoz, J

Affiliations

Hosp Clin Barcelona, Microbiol Dept, Barcelona, Spain - Author
Inst Trop Med, Dept Clin Sci, Antwerp, Belgium - Author
Natl Reference Ctr Trop Pathogens, Bernhard Nocht Inst Trop Med, Hamburg, Germany - Author
Swiss Trop & Publ Hlth Inst, Basel, Switzerland - Author
Univ Barcelona, ISGlobal, Hosp Clin, Barcelona, Spain - Author
Univ Hosp LMU, Div Infect Dis & Trop Med, Munich, Germany - Author
Univ Lausanne, Ctr Primary Care & Publ Hlth, Lausanne, Switzerland - Author
Univ Miguel Hernandez, Clin Med Dept, Alicante, Spain - Author
Vega Baja Hosp, Internal Med Infect Dis, Alicante, Spain - Author
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Abstract

Background Etiological diagnosis of febrile illnesses in returning travelers is a great challenge, particularly when presenting with no focal symptoms [acute undifferentiated febrile illnesses (AUFI)], but is crucial to guide clinical decisions and public health policies. In this study, we describe the frequencies and predictors of the main causes of fever in travelers. Methods Prospective European multicenter cohort study of febrile international travelers (November 2017-November 2019). A predefined diagnostic algorithm was used ensuring a systematic evaluation of all participants. After ruling out malaria, PCRs and serologies for dengue, chikungunya and Zika viruses were performed in all patients presenting with AUFI <= 14 days after return. Clinical suspicion guided further microbiological investigations. Results Among 765 enrolled participants, 310/765 (40.5%) had a clear source of infection (mainly traveler's diarrhea or respiratory infections), and 455/765 (59.5%) were categorized as AUFI. AUFI presented longer duration of fever (p < 0.001), higher hospitalization (p < 0.001) and ICU admission rates (p < 0.001). Among travelers with AUFI, 132/455 (29.0%) had viral infections, including 108 arboviruses, 96/455 (21.1%) malaria and 82/455 (18.0%) bacterial infections. The majority of arboviral cases (80/108, 74.1%) was diagnosed between May and November. Dengue was the most frequent arbovirosis (92/108, 85.2%). After 1 month of follow-up, 136/455 (29.9%) patients with AUFI remained undiagnosed using standard diagnostic methods. No relevant differences in laboratory presentation were observed between undiagnosed and bacterial AUFI. Conclusions Over 40% of returning travelers with AUFI were diagnosed with malaria or dengue, infections that can be easily diagnosed by rapid diagnostic tests. Arboviruses were the most common cause of AUFI (above malaria) and most cases were diagnosed during Aedes spp. high season. This is particularly relevant for those areas at risk of introduction of these pathogens. Empirical antibiotic regimens including doxycycline or azithromycin should be considered in patients with AUFI, after ruling out malaria and arboviruses.

Keywords

arbovirusesdoxycyclinefebrilemalariapredictorpredictorsstaytravel-related illnessArbovirusesClinical trialCohort analysisCohort studiesComplicationDengueDiagnosisDiarrheaDoxycyclineFebrileFeverHumanHumansMalariaMulticenter studyPredictorProspective studiesProspective studyTravelTravel-related illnessZika feverZika virusZika virus infection

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Journal Of Travel Medicine due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 5/207, thus managing to position itself as a Q1 (Primer Cuartil), in the category Public, Environmental & Occupational Health. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 4.85. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 4.95 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 23.5 (source consulted: Dimensions Aug 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-08-02, the following number of citations:

  • WoS: 44
  • Scopus: 47
  • Europe PMC: 8

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-08-02:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 90.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 104 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 6.
  • The number of mentions on the social network X (formerly Twitter): 8 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Belgium; Germany; Switzerland; United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (CAMPRUBI FERRER, DANIEL) and Last Author (MUÑOZ GUTIERREZ, JOSE).

the author responsible for correspondence tasks has been CAMPRUBI FERRER, DANIEL.