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Misdiagnosis of enteric fever is a major global health problem, resulting in patient mismanagement, antimicrobial misuse and inaccurate disease burden estimates. Applying a machine learning algorithm to host gene expression profiles, we identified a diagnostic signature, which could distinguish culture-confirmed enteric fever cases from other febrile illnesses (area under receiver operating characteristic curve > 95%). Applying this signature to a culture-negative suspected enteric fever cohort in Nepal identified a further 12.6% as likely true cases. Our analysis highlights the power of data-driven approaches to identify host response patterns for the diagnosis of febrile illnesses. Expression signatures were validated using qPCR, highlighting their utility as PCR-based diagnostics for use in endemic settings.

Original publication

DOI

10.15252/emmm.201910431

Type

Journal article

Journal

EMBO Mol Med

Publication Date

10/2019

Volume

11

Keywords

biomarker, enteric fever, machine learning, transcriptomics, Diagnosis, Differential, Gene Expression Profiling, Humans, Machine Learning, Molecular Diagnostic Techniques, Nepal, Polymerase Chain Reaction, ROC Curve, Typhoid Fever