%PDF-1.6
%
1 0 obj
<>
endobj
2 0 obj
<>stream
Carolyne N. Ngoi, Matt A. Price, Barry Fields, Juma Bonventure, Caroline Ochieng, Grace Mwashigadi, Amin S. Hassan, Alexander N. Thiong’o, Murugi Micheni, Peter Mugo, Susan Graham, Eduard J. Sanders
Dengue and Chikungunya Virus Infections among Young Febrile Adults Evaluated for Acute HIV-1 Infection in Coastal Kenya
www.plosone.org
www.plosone.org
endstream
endobj
3 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 11 0 R/Annots 12 0 R/Contents 13 0 R/TrimBox[0 0 612 792]>>
endobj
12 0 obj
[14 0 R 15 0 R 16 0 R 17 0 R 18 0 R 19 0 R 20 0 R 21 0 R 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R]
endobj
14 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref001)>>
endobj
15 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref002)>>
endobj
16 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref003)>>
endobj
17 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref004)>>
endobj
18 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref005)>>
endobj
19 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref007)>>
endobj
20 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref008)>>
endobj
21 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref009)>>
endobj
22 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref010)>>
endobj
23 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref007)>>
endobj
24 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref011)>>
endobj
25 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref013)>>
endobj
26 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref014)>>
endobj
27 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref015)>>
endobj
28 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref016)>>
endobj
13 0 obj
[29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 44 0 R]
endobj
29 0 obj
<>stream
q
0.45 0.36 0.35 0.01 k
0 w
575.9997 647.9101 m
199.9998 647.9101 l
199.9998 648.4102 l
575.9997 648.4102 l
f*
0.83 0.64 0.02 0 k
555.3071 554.8535 m
560.0693 554.8535 l
h
f*
203.4142 502.8094 m
208.1764 502.8094 l
h
f*
255.1748 463.8614 m
259.937 463.8614 l
259.937 463.8047 l
255.1748 463.8047 l
f*
389.8772 372.8126 m
394.6394 372.8126 l
h
f*
270.5386 333.8079 m
275.3008 333.8079 l
h
f*
280.4598 333.8079 m
285.222 333.8079 l
h
f*
224.6173 281.8205 m
229.3795 281.8205 l
h
f*
399.1181 281.8205 m
403.8803 281.8205 l
h
f*
378.085 268.8378 m
387.6094 268.8378 l
h
f*
279.7228 229.8331 m
284.485 229.8331 l
h
f*
281.5937 203.811 m
291.1181 203.811 l
h
f*
296.2772 203.811 m
305.8016 203.811 l
h
f*
339.0803 177.8457 m
348.6047 177.8457 l
h
f*
284.2016 164.8063 m
293.726 164.8063 l
h
f*
465.9591 125.8583 m
475.4835 125.8583 l
h
f*
0 g
1 j
1 J
11.4998 0 0 11.4998 200.0125 706.3937 cm
BT
/F2 1 Tf
1 TL
-0.0035 Tc
0 0 Td
(Conclusion)Tj
ET
Q
q
1 j
1 J
0 w
9.5 0 0 9.5 200.0125 689.3858 cm
BT
/F0 1 Tf
1 TL
-0.0042 Tc
0 0 Td
(A)Tj
0.8832 0 Td
(high)Tj
2.0827 0 Td
(prevalence)Tj
5.0486 0 Td
(of)Tj
1.0444 0 Td
(DENV)Tj
2.9778 0 Td
(infections)Tj
4.3922 0 Td
(was)Tj
1.9813 0 Td
(found)Tj
2.6914 0 Td
(in)Tj
0.9846 0 Td
(febrile)Tj
2.9063 0 Td
(young)Tj
2.9062 0 Td
(adult)Tj
2.3632 0 Td
(patients)Tj
3.6821 0 Td
(evaluated)Tj
-33.944 -1.474 Td
(for)Tj
1.3725 0 Td
(AHI.)Tj
2.1543 0 Td
(Our)Tj
1.8798 0 Td
(data)Tj
2.1424 0 Td
(suggests)Tj
4.1834 0 Td
(that)Tj
1.8678 0 Td
(DENV,)Tj
3.2584 0 Td
(along)Tj
2.6317 0 Td
(with)Tj
1.9753 0 Td
(AHI)Tj
1.8738 0 Td
(and)Tj
1.8679 0 Td
(malaria,)Tj
3.7358 0 Td
(should)Tj
3.127 0 Td
(be)Tj
1.3129 0 Td
(considered)Tj
5.0546 0 Td
(in)Tj
-38.4376 -1.468 Td
(the)Tj
1.5933 0 Td
(differential)Tj
4.7682 0 Td
(diagnosis)Tj
4.3862 0 Td
(of)Tj
1.0503 0 Td
(the)Tj
1.5934 0 Td
(adult)Tj
2.3572 0 Td
(patient)Tj
3.1867 0 Td
(seeking)Tj
3.6224 0 Td
(care)Tj
2.1424 0 Td
(for)Tj
1.3785 0 Td
(fever)Tj
2.4169 0 Td
(in)Tj
0.9847 0 Td
(coastal)Tj
3.3538 0 Td
(Kenya.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 572.8818 cm
BT
/F2 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Introduction)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 555.9307 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(Fever)Tj
2.4207 0 Td
(is)Tj
0.8447 0 Td
(a)Tj
0.6577 0 Td
(common)Tj
3.8437 0 Td
(symptom)Tj
3.9969 0 Td
(among)Tj
2.9933 0 Td
(persons)Tj
3.3109 0 Td
(seeking)Tj
3.2031 0 Td
(healthcare)Tj
4.3313 0 Td
(in)Tj
1.0375 0 Td
(developing)Tj
4.5977 0 Td
(countries)Tj
3.9515 0 Td
([)Tj
0.83 0.64 0.02 0 k
(1)Tj
0 g
(].)Tj
-35.189 -1.3039 Td
(While)Tj
2.6475 0 Td
(various)Tj
3.1464 0 Td
(illnesses)Tj
3.4583 0 Td
(may)Tj
1.9275 0 Td
(prompt)Tj
3.2485 0 Td
(individuals)Tj
4.6488 0 Td
(to)Tj
1.0261 0 Td
(seek)Tj
1.9219 0 Td
(healthcare)Tj
4.3313 0 Td
(for)Tj
1.389 0 Td
(fever,)Tj
2.4038 0 Td
(non-malarial)Tj
-30.1491 -1.2982 Td
(febrile)Tj
2.7439 0 Td
(illnesses)Tj
3.4582 0 Td
(remain)Tj
3.0841 0 Td
(largely)Tj
2.863 0 Td
(undiagnosed)Tj
5.3574 0 Td
(at)Tj
0.9524 0 Td
(many)Tj
2.4775 0 Td
(front-line)Tj
4.0705 0 Td
(health)Tj
2.6759 0 Td
(facilities)Tj
3.498 0 Td
(due)Tj
1.6951 0 Td
(to)Tj
1.0261 0 Td
(a)Tj
0.652 0 Td
(wide)Tj
2.1259 0 Td
(a)Tj
-36.68 -1.2983 Td
(range)Tj
2.4604 0 Td
(of)Tj
1.0148 0 Td
(potential)Tj
3.7587 0 Td
(aetiologies,)Tj
4.6488 0 Td
(overlapping)Tj
4.9719 0 Td
(clinical)Tj
3.0728 0 Td
(presentation)Tj
5.2214 0 Td
(and)Tj
1.7291 0 Td
(lack)Tj
1.8198 0 Td
(of)Tj
1.0148 0 Td
(diagnostic)Tj
4.32 0 Td
(capacity)Tj
-34.0325 -1.3039 Td
([)Tj
0.83 0.64 0.02 0 k
(2)Tj
0 g
(].)Tj
1.5987 0 Td
(With)Tj
2.279 0 Td
(the)Tj
1.4684 0 Td
(World)Tj
2.8403 0 Td
(Health)Tj
2.9196 0 Td
(Organization's)Tj
6.0945 0 Td
(\(WHO\))Tj
3.3788 0 Td
(2010)Tj
2.126 0 Td
(recommendation)Tj
7.1376 0 Td
(to)Tj
1.0261 0 Td
(confirm)Tj
3.4413 0 Td
(malaria)Tj
-34.3103 -1.2983 Td
(infection)Tj
3.7927 0 Td
(by)Tj
1.1792 0 Td
(microscopy)Tj
4.8699 0 Td
(or)Tj
1.0998 0 Td
(by)Tj
1.1849 0 Td
(rapid)Tj
2.3357 0 Td
(diagnostic)Tj
4.32 0 Td
(test)Tj
1.5987 0 Td
(\(RDT\))Tj
2.8687 0 Td
(in)Tj
1.0374 0 Td
(patients)Tj
3.3676 0 Td
(presenting)Tj
4.4447 0 Td
(with)Tj
1.9956 0 Td
(a)Tj
0.6576 0 Td
(history)Tj
-34.7525 -1.2982 Td
(of)Tj
1.0034 0 Td
(fever,)Tj
2.3981 0 Td
(the)Tj
1.457 0 Td
(proportion)Tj
4.6261 0 Td
(of)Tj
1.0035 0 Td
(fevers)Tj
2.5341 0 Td
(that)Tj
1.7688 0 Td
(are)Tj
1.4344 0 Td
(recognized)Tj
4.5807 0 Td
(as)Tj
1.0091 0 Td
(likely)Tj
2.3414 0 Td
(due)Tj
1.6895 0 Td
(to)Tj
1.0148 0 Td
(diseases)Tj
3.3732 0 Td
(other)Tj
2.3357 0 Td
(than)Tj
2.0183 0 Td
(malaria)Tj
-34.5881 -1.2983 Td
(is)Tj
0.8447 0 Td
(increasing)Tj
4.3313 0 Td
([)Tj
0.83 0.64 0.02 0 k
(3)Tj
0 g
(].)Tj
-3.9798 -1.3039 Td
(There)Tj
2.5795 0 Td
(is)Tj
0.8504 0 Td
(little)Tj
1.9955 0 Td
(data)Tj
1.9162 0 Td
(on)Tj
1.2756 0 Td
(the)Tj
1.4684 0 Td
(aetiology)Tj
3.821 0 Td
(of)Tj
1.0205 0 Td
(fevers)Tj
2.5398 0 Td
(in)Tj
1.0375 0 Td
(adults)Tj
2.6135 0 Td
(presenting)Tj
4.4447 0 Td
(for)Tj
1.3833 0 Td
(care)Tj
1.8766 0 Td
(in)Tj
1.0318 0 Td
(sub-Saharan)Tj
-31.0505 -1.2983 Td
(Africa)Tj
2.6872 0 Td
(\(sSA\).)Tj
2.6475 0 Td
(In)Tj
1.1055 0 Td
(a)Tj
0.6577 0 Td
(systematic)Tj
4.3596 0 Td
(review)Tj
2.846 0 Td
(of)Tj
1.0148 0 Td
(adults)Tj
2.6135 0 Td
(seeking)Tj
3.2031 0 Td
(outpatient)Tj
4.3427 0 Td
(care)Tj
1.8708 0 Td
(from)Tj
2.2054 0 Td
(clinics)Tj
2.7552 0 Td
(in)Tj
1.0375 0 Td
(sSA)Tj
1.7405 0 Td
(in)Tj
1.0374 0 Td
(the)Tj
-36.1244 -1.2983 Td
(period)Tj
2.8346 0 Td
(20032014,)Tj
4.7678 0 Td
(34)Tj
1.1679 0 Td
(\(79%\))Tj
2.6078 0 Td
(of)Tj
1.0148 0 Td
(43)Tj
1.1736 0 Td
(studies)Tj
2.9877 0 Td
(identified)Tj
4.0592 0 Td
(focused)Tj
3.2768 0 Td
(on)Tj
1.2756 0 Td
(malaria)Tj
3.2258 0 Td
(only.)Tj
2.1997 0 Td
(The)Tj
1.7858 0 Td
(remaining)Tj
-32.3771 -1.3039 Td
(studies)Tj
2.9876 0 Td
(investigated)Tj
4.989 0 Td
(the)Tj
1.4683 0 Td
(following)Tj
3.9798 0 Td
(aetiologies:)Tj
4.6432 0 Td
(acute)Tj
2.3244 0 Td
(HIV-1)Tj
2.8516 0 Td
(infection)Tj
3.7927 0 Td
(\(AHI\))Tj
2.6873 0 Td
(and)Tj
1.7347 0 Td
(malaria)Tj
3.2259 0 Td
(\(2)Tj
-34.6845 -1.2982 Td
(studies\),)Tj
3.5489 0 Td
(human)Tj
3.0784 0 Td
(herpes)Tj
2.846 0 Td
(virus-8)Tj
3.0274 0 Td
(and)Tj
1.7291 0 Td
(hepatitis)Tj
3.617 0 Td
(B)Tj
0.7993 0 Td
(virus)Tj
2.1997 0 Td
(\(1)Tj
1.0375 0 Td
(study\),)Tj
2.9537 0 Td
(pneumococcal)Tj
6.0207 0 Td
(bacteraemia)Tj
5.057 0 Td
(\(1)Tj
-35.9147 -1.2983 Td
(study\),)Tj
2.9536 0 Td
(flaviviruses)Tj
4.6772 0 Td
(\(1)Tj
1.0374 0 Td
(study\),)Tj
2.9537 0 Td
(influenza)Tj
3.9175 0 Td
(viruses)Tj
2.982 0 Td
(\(1)Tj
1.0375 0 Td
(study\),)Tj
2.9537 0 Td
(Lassa)Tj
2.347 0 Td
(virus)Tj
2.2054 0 Td
(\(1)Tj
1.0375 0 Td
(study\),)Tj
2.9536 0 Td
(intestinal)Tj
3.9118 0 Td
(hel-)Tj
-34.9679 -1.3039 Td
(minths)Tj
3.0387 0 Td
(\(1)Tj
1.0374 0 Td
(study\))Tj
2.7326 0 Td
(and)Tj
1.7291 0 Td
(schistosomiasis)Tj
6.3439 0 Td
(\(1)Tj
1.0319 0 Td
(study\))Tj
2.7325 0 Td
([)Tj
0.83 0.64 0.02 0 k
(4)Tj
0 g
(].)Tj
-17.4499 -1.2983 Td
(Several)Tj
3.05 0 Td
(seroprevalence)Tj
6.1512 0 Td
(studies)Tj
2.9877 0 Td
(have)Tj
2.0579 0 Td
(reported)Tj
3.6623 0 Td
(exposure)Tj
3.8155 0 Td
(to)Tj
1.0261 0 Td
(arbovirus)Tj
4.0195 0 Td
(infections)Tj
4.1499 0 Td
(including)Tj
-32.1163 -1.2982 Td
(dengue)Tj
3.135 0 Td
(virus)Tj
2.1997 0 Td
(\(DENV\))Tj
3.6397 0 Td
(chikungunya)Tj
5.4425 0 Td
(virus)Tj
2.1996 0 Td
(\(CHIKV\))Tj
4.0422 0 Td
(and)Tj
1.7291 0 Td
(O'Nyong)Tj
3.8948 0 Td
(Nyong)Tj
2.931 0 Td
(\(ONNV\))Tj
3.8098 0 Td
(infection)Tj
-33.0234 -1.304 Td
(in)Tj
1.0318 0 Td
(coastal)Tj
2.9253 0 Td
(Kenya)Tj
2.7552 0 Td
([)Tj
0.83 0.64 0.02 0 k
(5)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
(7)Tj
0 g
(].)Tj
2.5966 0 Td
(Due)Tj
1.9048 0 Td
(to)Tj
1.0262 0 Td
(limited)Tj
3.067 0 Td
(surveillance)Tj
4.9493 0 Td
(and)Tj
1.7291 0 Td
(lack)Tj
1.8199 0 Td
(of)Tj
1.0148 0 Td
(diagnostic)Tj
4.3199 0 Td
(capacity)Tj
3.4753 0 Td
(to)Tj
1.0261 0 Td
(screen)Tj
2.7666 0 Td
(for)Tj
-36.4079 -1.2982 Td
(arboviral)Tj
3.8097 0 Td
(infections)Tj
4.1556 0 Td
(among)Tj
2.9933 0 Td
(patients)Tj
3.3676 0 Td
(seeking)Tj
3.2031 0 Td
(care,)Tj
2.0976 0 Td
(little)Tj
2.0013 0 Td
(is)Tj
0.8503 0 Td
(known)Tj
3.0048 0 Td
(on)Tj
1.2755 0 Td
(disease)Tj
3.0161 0 Td
(burden)Tj
3.1237 0 Td
(and)Tj
1.7348 0 Td
(trans-)Tj
-34.6334 -1.2983 Td
(mission)Tj
3.3505 0 Td
(during)Tj
2.9253 0 Td
(interepidemic)Tj
5.7997 0 Td
(periods.)Tj
-10.8793 -1.2983 Td
(Dengue)Tj
3.3448 0 Td
(fever)Tj
2.1827 0 Td
(was)Tj
1.7008 0 Td
(first)Tj
1.8028 0 Td
(documented)Tj
5.2497 0 Td
(on)Tj
1.2756 0 Td
(the)Tj
1.4683 0 Td
(Kenyan)Tj
3.3052 0 Td
(coast)Tj
2.245 0 Td
(during)Tj
2.9254 0 Td
(an)Tj
1.2019 0 Td
(outbreak)Tj
3.787 0 Td
(in)Tj
1.0318 0 Td
(Malindi)Tj
3.4072 0 Td
(in)Tj
-36.1244 -1.3039 Td
(1982)Tj
2.1203 0 Td
([)Tj
0.83 0.64 0.02 0 k
(8)Tj
0 g
(],)Tj
1.6044 0 Td
(and)Tj
1.7291 0 Td
(more)Tj
2.3414 0 Td
(recently)Tj
3.4072 0 Td
(in)Tj
1.0375 0 Td
(Mombasa)Tj
4.1725 0 Td
(in)Tj
1.0375 0 Td
(2013)Tj
2.1203 0 Td
([)Tj
0.83 0.64 0.02 0 k
(9)Tj
0 g
(])Tj
1.3776 0 Td
(while)Tj
2.3698 0 Td
(chikungunya)Tj
5.4425 0 Td
(fever)Tj
2.177 0 Td
(outbreaks)Tj
4.1499 0 Td
(were)Tj
-35.087 -1.2982 Td
(reported)Tj
3.6566 0 Td
(from)Tj
2.2054 0 Td
(Lamu)Tj
2.5398 0 Td
(and)Tj
1.7348 0 Td
(Mombasa)Tj
4.1726 0 Td
(in)Tj
1.0374 0 Td
(2004)Tj
2.1203 0 Td
([)Tj
0.83 0.64 0.02 0 k
(10)Tj
0 g
(].)Tj
2.075 0 Td
(However,)Tj
4.0818 0 Td
(no)Tj
1.2756 0 Td
(assessment)Tj
4.6091 0 Td
(of)Tj
1.0148 0 Td
(DENV)Tj
2.9537 0 Td
(and)Tj
-33.4769 -1.2983 Td
(CHIKV)Tj
3.3561 0 Td
(has)Tj
1.5421 0 Td
(been)Tj
2.126 0 Td
(conducted)Tj
4.4276 0 Td
(outside)Tj
3.1295 0 Td
(of)Tj
1.0148 0 Td
(outbreaks)Tj
4.1499 0 Td
(among)Tj
2.9933 0 Td
(adult)Tj
2.2507 0 Td
(febrile)Tj
2.7496 0 Td
(patients)Tj
3.3676 0 Td
(seeking)Tj
3.2031 0 Td
(care)Tj
1.8765 0 Td
(in)Tj
-36.1868 -1.3039 Td
(coastal)Tj
2.9253 0 Td
(Kenya.)Tj
2.9763 0 Td
(A)Tj
0.9071 0 Td
(recent)Tj
2.7043 0 Td
(study)Tj
2.3924 0 Td
(documented)Tj
5.244 0 Td
(ongoing)Tj
3.532 0 Td
(CHIKV)Tj
3.3562 0 Td
(transmission)Tj
5.3688 0 Td
(in)Tj
1.0318 0 Td
(Kwale)Tj
2.6815 0 Td
(County,)Tj
-33.1197 -1.2983 Td
(south)Tj
2.4377 0 Td
(of)Tj
1.0148 0 Td
(Mombasa)Tj
4.1783 0 Td
([)Tj
0.83 0.64 0.02 0 k
(7)Tj
0 g
(].)Tj
1.5987 0 Td
(Laboratory)Tj
4.6431 0 Td
(diagnosis)Tj
3.9572 0 Td
(of)Tj
1.0148 0 Td
(CHIKV)Tj
3.3618 0 Td
(and)Tj
1.7291 0 Td
(DENV)Tj
2.9594 0 Td
(during)Tj
2.9253 0 Td
(acute)Tj
2.3301 0 Td
(phase)Tj
2.4831 0 Td
(of)Tj
1.0148 0 Td
(ill-)Tj
-35.6482 -1.2983 Td
(ness)Tj
1.9105 0 Td
(can)Tj
1.6271 0 Td
(be)Tj
1.1508 0 Td
(done)Tj
2.228 0 Td
(through)Tj
3.4469 0 Td
(virus)Tj
2.1997 0 Td
(isolation)Tj
3.6567 0 Td
(or)Tj
1.0998 0 Td
(real-time)Tj
3.8495 0 Td
(reverse-transcript)Tj
7.0752 0 Td
(ion)Tj
1.542 0 Td
(polymerase)Tj
4.7735 0 Td
(chain)Tj
-34.5597 -1.3039 Td
(reaction)Tj
3.4922 0 Td
(\(RT-PCR\))Tj
4.3257 0 Td
([)Tj
0.83 0.64 0.02 0 k
(11)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
(13)Tj
0 g
(].)Tj
3.5489 0 Td
(In)Tj
1.1055 0 Td
(a)Tj
0.6576 0 Td
(study)Tj
2.3868 0 Td
(by)Tj
1.1792 0 Td
(Riswari)Tj
3.2258 0 Td
(et)Tj
0.9468 0 Td
(al.,)Tj
1.3493 0 Td
(CHIKV)Tj
3.3562 0 Td
(viremia)Tj
3.2598 0 Td
(preceded)Tj
3.8607 0 Td
(fever)Tj
2.177 0 Td
(onset)Tj
-34.8715 -1.2982 Td
(by)Tj
1.1792 0 Td
(up)Tj
1.2642 0 Td
(to)Tj
1.0261 0 Td
(six)Tj
1.3153 0 Td
(days,)Tj
2.2223 0 Td
(and)Tj
1.7292 0 Td
(CHIKV)Tj
3.3618 0 Td
(quantitative)Tj
4.9776 0 Td
(\(qRT-PCR\))Tj
4.8359 0 Td
(testing)Tj
2.88 0 Td
(on)Tj
1.2756 0 Td
(serial)Tj
2.3244 0 Td
(specimens)Tj
4.3653 0 Td
(indicated)Tj
-32.7569 -1.2983 Td
(that)Tj
1.7744 0 Td
(viremia)Tj
3.2598 0 Td
(lasted)Tj
2.5115 0 Td
(for)Tj
1.3833 0 Td
(1113)Tj
2.6419 0 Td
(days)Tj
1.9956 0 Td
([)Tj
0.83 0.64 0.02 0 k
(14)Tj
0 g
(].)Tj
2.0806 0 Td
(DENV)Tj
2.9537 0 Td
(can)Tj
1.6271 0 Td
(be)Tj
1.1508 0 Td
(detected)Tj
3.566 0 Td
(by)Tj
1.1792 0 Td
(RT-PCR)Tj
3.651 0 Td
(two)Tj
1.7064 0 Td
(to)Tj
1.0262 0 Td
(ten)Tj
1.491 0 Td
(days)Tj
-33.9985 -1.3039 Td
(after)Tj
2.0352 0 Td
(onset)Tj
2.3584 0 Td
(of)Tj
1.0148 0 Td
(illness)Tj
2.6702 0 Td
([)Tj
0.83 0.64 0.02 0 k
(15)Tj
0 g
(].)Tj
-6.8824 -1.2983 Td
(In)Tj
1.1111 0 Td
(2013,)Tj
2.3471 0 Td
(a)Tj
0.652 0 Td
(year)Tj
1.9048 0 Td
(of)Tj
1.0148 0 Td
(low)Tj
1.6611 0 Td
(malaria)Tj
3.2258 0 Td
(transmission)Tj
5.3632 0 Td
(in)Tj
1.0374 0 Td
(coastal)Tj
2.9197 0 Td
(Kenya,)Tj
2.982 0 Td
(we)Tj
1.3266 0 Td
(conducted)Tj
4.4277 0 Td
(a)Tj
0.652 0 Td
(pilot)Tj
2.0579 0 Td
(study)Tj
2.3924 0 Td
(on)Tj
-36.2718 -1.2982 Td
(acute)Tj
2.3243 0 Td
(febrile)Tj
2.7496 0 Td
(illness)Tj
2.6703 0 Td
(and)Tj
1.7291 0 Td
(reported)Tj
3.6623 0 Td
(that)Tj
1.7802 0 Td
(1.7%)Tj
2.1543 0 Td
(of)Tj
1.0148 0 Td
(young)Tj
2.7212 0 Td
(febrile)Tj
2.7439 0 Td
(adults)Tj
2.6192 0 Td
(who)Tj
1.9389 0 Td
(were)Tj
2.1203 0 Td
(seronegative)Tj
5.1987 0 Td
(or)Tj
-35.4271 -1.2983 Td
(serodiscordant)Tj
6.1454 0 Td
(for)Tj
1.389 0 Td
(HIV-1)Tj
2.846 0 Td
(had)Tj
1.7121 0 Td
(AHI)Tj
2.0126 0 Td
(and)Tj
1.7291 0 Td
(another)Tj
3.3278 0 Td
(1.7%)Tj
2.1544 0 Td
(had)Tj
1.7121 0 Td
(malaria)Tj
3.2258 0 Td
([)Tj
0.83 0.64 0.02 0 k
(16)Tj
0 g
(].)Tj
2.0749 0 Td
(As)Tj
1.2643 0 Td
(less)Tj
1.6157 0 Td
(than)Tj
2.0239 0 Td
(4%)Tj
1.457 0 Td
(of)Tj
-34.6901 -1.3039 Td
(fevers)Tj
2.5398 0 Td
(in)Tj
1.0375 0 Td
(pilot)Tj
2.0522 0 Td
(study)Tj
2.3924 0 Td
(participants)Tj
4.955 0 Td
(enrolled)Tj
3.5149 0 Td
(in)Tj
1.0375 0 Td
(2013)Tj
2.1203 0 Td
(could)Tj
2.4548 0 Td
(be)Tj
1.1508 0 Td
(explained)Tj
4.0706 0 Td
(we)Tj
1.3266 0 Td
(set)Tj
1.3039 0 Td
(out)Tj
1.5534 0 Td
(to)Tj
1.0261 0 Td
(assess)Tj
-32.5358 -1.2983 Td
(whether)Tj
3.4752 0 Td
(CHIKV)Tj
3.3619 0 Td
(or)Tj
1.0941 0 Td
(DENV)Tj
2.9594 0 Td
(were)Tj
2.1203 0 Td
(other)Tj
2.3471 0 Td
(causes)Tj
2.7496 0 Td
(of)Tj
1.0147 0 Td
(febrile)Tj
2.7496 0 Td
(illness)Tj
2.6703 0 Td
(in)Tj
1.0374 0 Td
(patients)Tj
3.3676 0 Td
(enrolled)Tj
3.5149 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4683 0 Td
(ongo-)Tj
-34.9679 -1.2983 Td
(ing)Tj
1.5023 0 Td
(study.)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 107.1496 23.6976 re
W* n
q
107.0929 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 295.4834 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Dengue)Tj
3.6567 0 Td
(and)Tj
1.8567 0 Td
(Chikunguny)Tj
5.1803 0 Td
(a)Tj
0.7654 0 Td
(Virus)Tj
2.4591 0 Td
(Infections)Tj
4.4291 0 Td
(among)Tj
3.2245 0 Td
(Febrile)Tj
3.2173 0 Td
(Adults)Tj
2.9552 0 Td
(in)Tj
0.9779 0 Td
(Coastal)Tj
3.5504 0 Td
(Kenya)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(ONE)Tj
2.3669 0 Td
(|)Tj
0.4748 0 Td
(DOI:10.137)Tj
5.0387 0 Td
(1/journal.po)Tj
5.1236 0 Td
(ne.0167)Tj
3.5434 0 Td
(508)Tj
2.6362 0 Td
(December)Tj
4.7622 0 Td
(12,)Tj
1.5874 0 Td
(2016)Tj
36.7515 0 Td
(2)Tj
0.7654 0 Td
(/)Tj
0.496 0 Td
(12)Tj
/F8 1 Tf
-0.025 Tc
-66.402 84.0904 Td
(by)Tj
1.1126 0 Td
(the)Tj
1.3748 0 Td
(generous)Tj
3.685 0 Td
(support)Tj
3.0969 0 Td
(of)Tj
0.9496 0 Td
(the)Tj
1.3678 0 Td
(American)Tj
3.7346 0 Td
(people)Tj
-15.3213 -1.3748 Td
(through)Tj
3.1464 0 Td
(the)Tj
1.3748 0 Td
(United)Tj
2.6221 0 Td
(States)Tj
2.5229 0 Td
(Agency)Tj
2.9551 0 Td
(for)Tj
1.2543 0 Td
(International)Tj
-13.8756 -1.3749 Td
(Developmen)Tj
4.6417 0 Td
(t)Tj
0.4748 0 Td
(\(USAID\).)Tj
3.5363 0 Td
(The)Tj
1.5945 0 Td
(contents)Tj
3.4157 0 Td
(are)Tj
1.3678 0 Td
(the)Tj
-15.0308 -1.3748 Td
(responsibi)Tj
3.848 0 Td
(lity)Tj
1.2898 0 Td
(of)Tj
0.9425 0 Td
(the)Tj
1.3748 0 Td
(authors)Tj
3.0473 0 Td
(and)Tj
1.5874 0 Td
(do)Tj
1.1622 0 Td
(not)Tj
1.4244 0 Td
(necessaril)Tj
3.6922 0 Td
(y)Tj
-18.3686 -1.3748 Td
(reflect)Tj
2.4945 0 Td
(the)Tj
1.3677 0 Td
(views)Tj
2.3173 0 Td
(of)Tj
0.9496 0 Td
(USAID)Tj
2.7001 0 Td
(or)Tj
1.0063 0 Td
(the)Tj
1.3677 0 Td
(United)Tj
2.6221 0 Td
(States)Tj
-14.8253 -1.3748 Td
(Governmen)Tj
4.3299 0 Td
(t.)Tj
0.7016 0 Td
(This)Tj
1.7858 0 Td
(manus)Tj
2.5371 0 Td
(cript)Tj
1.8708 0 Td
(was)Tj
1.7079 0 Td
(submitt)Tj
2.8205 0 Td
(ed)Tj
1.1197 0 Td
(for)Tj
-16.8733 -1.3748 Td
(publication)Tj
4.2661 0 Td
(with)Tj
1.7788 0 Td
(permission)Tj
4.3512 0 Td
(from)Tj
2.0126 0 Td
(the)Tj
1.3677 0 Td
(Director)Tj
3.189 0 Td
(of)Tj
-16.9654 -1.3748 Td
(the)Tj
1.3677 0 Td
(Kenya)Tj
2.4874 0 Td
(Medical)Tj
3.0969 0 Td
(Research)Tj
3.6921 0 Td
(Institute)Tj
3.2245 0 Td
(\(KEMRI\).)Tj
3.6567 0 Td
(The)Tj
-17.5253 -1.3748 Td
(funders)Tj
3.0472 0 Td
(had)Tj
1.5874 0 Td
(no)Tj
1.1693 0 Td
(role)Tj
1.6087 0 Td
(in)Tj
0.8929 0 Td
(study)Tj
2.2607 0 Td
(design,)Tj
2.8984 0 Td
(data)Tj
1.793 0 Td
(collection)Tj
-15.2576 -1.3748 Td
(and)Tj
1.5874 0 Td
(analysis,)Tj
3.4087 0 Td
(decision)Tj
3.2953 0 Td
(to)Tj
0.9496 0 Td
(publish,)Tj
3.1464 0 Td
(or)Tj
0.9993 0 Td
(preparation)Tj
4.4362 0 Td
(of)Tj
-17.8229 -1.3749 Td
(the)Tj
1.3677 0 Td
(manuscript.)Tj
/F7 1 Tf
-1.3677 -2.126 Td
(Competing)Tj
4.3795 0 Td
(Interests)Tj
3.3307 0 Td
(:)Tj
/F8 1 Tf
0.4819 0 Td
(The)Tj
1.5875 0 Td
(authors)Tj
3.0401 0 Td
(have)Tj
1.963 0 Td
(declared)Tj
-14.7827 -1.3748 Td
(that)Tj
1.6228 0 Td
(no)Tj
1.1693 0 Td
(competing)Tj
4.1599 0 Td
(interests)Tj
ET
endstream
endobj
30 0 obj
<>stream
endstream
endobj
31 0 obj
<>stream
endstream
endobj
32 0 obj
<>stream
endstream
endobj
33 0 obj
<>stream
endstream
endobj
34 0 obj
<>stream
endstream
endobj
35 0 obj
<>stream
endstream
endobj
36 0 obj
<>stream
endstream
endobj
37 0 obj
<>stream
endstream
endobj
38 0 obj
<>stream
endstream
endobj
39 0 obj
<>stream
endstream
endobj
40 0 obj
<>stream
endstream
endobj
41 0 obj
<>stream
endstream
endobj
42 0 obj
<>stream
endstream
endobj
43 0 obj
<>stream
endstream
endobj
44 0 obj
<>stream
BT
10.3394 66.8414 Td
(exist.)Tj
ET
Q
endstream
endobj
45 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 11 0 R/Annots 49 0 R/Contents 50 0 R/TrimBox[0 0 612 792]>>
endobj
49 0 obj
[51 0 R 52 0 R 53 0 R]
endobj
51 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref017)>>
endobj
52 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref016)>>
endobj
53 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167508.ref016)>>
endobj
50 0 obj
[54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R]
endobj
54 0 obj
<>stream
q
0.83 0.64 0.02 0 k
238.9606 605.0268 m
248.315 605.0268 l
h
f*
362.3244 391.6346 m
371.8488 391.6346 l
h
f*
478.4882 339.6472 m
488.0126 339.6472 l
h
f*
0 g
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 706.0535 cm
BT
/F2 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Methods)Tj
/F0 1 Tf
0 -1.4976 Td
(Study)Tj
2.7543 0 Td
(setting)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 671.074 cm
BT
/F5 1 Tf
1 TL
-0.012 Tc
0 0 Td
(The)Tj
1.7517 0 Td
(study)Tj
2.3471 0 Td
(was)Tj
1.6725 0 Td
(conducted)Tj
4.3539 0 Td
(in)Tj
1.0148 0 Td
(two)Tj
1.6838 0 Td
(nearby)Tj
2.9083 0 Td
(towns)Tj
2.5739 0 Td
(in)Tj
1.0148 0 Td
(Kilifi)Tj
2.177 0 Td
(County)Tj
3.1691 0 Td
(along)Tj
2.3811 0 Td
(the)Tj
1.44 0 Td
(Kenyan)Tj
3.2484 0 Td
(coast:)Tj
2.4208 0 Td
(Mtwapa,)Tj
-34.1572 -1.2982 Td
(which)Tj
2.6078 0 Td
(is)Tj
0.8334 0 Td
(situated)Tj
3.2938 0 Td
(16)Tj
1.1566 0 Td
(km)Tj
1.5193 0 Td
(north-east)Tj
4.2576 0 Td
(of)Tj
1.0035 0 Td
(Mombasa,)Tj
4.3313 0 Td
(and)Tj
1.7064 0 Td
(Kilifi,)Tj
2.3981 0 Td
(which)Tj
2.6136 0 Td
(is)Tj
0.8333 0 Td
(situated)Tj
3.2939 0 Td
(42)Tj
1.1508 0 Td
(km)Tj
1.5251 0 Td
(further)Tj
-32.5245 -1.3039 Td
(north)Tj
2.4321 0 Td
(along)Tj
2.381 0 Td
(the)Tj
1.4457 0 Td
(Mombasa-Malindi)Tj
7.5911 0 Td
(Road.)Tj
2.4945 0 Td
(The)Tj
1.7575 0 Td
(region)Tj
2.7552 0 Td
(experiences)Tj
4.7792 0 Td
(warm)Tj
2.4945 0 Td
(weather)Tj
3.3278 0 Td
(throughout)Tj
4.6999 0 Td
(the)Tj
-36.1585 -1.2983 Td
(year)Tj
1.8708 0 Td
(with)Tj
1.9672 0 Td
(two)Tj
1.6838 0 Td
(rainy)Tj
2.2564 0 Td
(seasons,)Tj
3.3732 0 Td
(the)Tj
1.4456 0 Td
(long)Tj
1.9559 0 Td
(rainy)Tj
2.2564 0 Td
(season)Tj
2.8063 0 Td
(starting)Tj
3.2031 0 Td
(in)Tj
1.0205 0 Td
(March)Tj
2.8289 0 Td
(and)Tj
1.7065 0 Td
(lasting)Tj
2.7836 0 Td
(through)Tj
3.3902 0 Td
(June)Tj
2.0126 0 Td
(\(4)Tj
-36.561 -1.2983 Td
(months\),)Tj
3.7813 0 Td
(and)Tj
1.7065 0 Td
(a)Tj
0.6463 0 Td
(shorter)Tj
3.0274 0 Td
(rainy)Tj
2.2507 0 Td
(period)Tj
2.7892 0 Td
(starting)Tj
3.1975 0 Td
(in)Tj
1.0205 0 Td
(October)Tj
3.4412 0 Td
(and)Tj
1.7064 0 Td
(continuing)Tj
4.5411 0 Td
(through)Tj
3.3902 0 Td
(December)Tj
4.286 0 Td
(\(3)Tj
-35.7843 -1.2982 Td
(months\))Tj
3.5659 0 Td
([)Tj
0.83 0.64 0.02 0 k
(17)Tj
0 g
(].)Tj
2.0353 0 Td
(The)Tj
1.7574 0 Td
(annual)Tj
2.914 0 Td
(average)Tj
3.1692 0 Td
(temperature)Tj
5.0399 0 Td
(ranges)Tj
2.778 0 Td
(between)Tj
3.4695 0 Td
(26.5C)Tj
2.88 0 Td
(and)Tj
1.7065 0 Td
(34.0C)Tj
2.88 0 Td
(\(high\))Tj
2.6418 0 Td
(and)Tj
-34.8375 -1.3039 Td
(22.5C)Tj
2.8799 0 Td
(and)Tj
1.7065 0 Td
(24.5C)Tj
2.88 0 Td
(\(low\).)Tj
2.5114 0 Td
(The)Tj
1.7575 0 Td
(region)Tj
2.7553 0 Td
(has)Tj
1.5193 0 Td
(an)Tj
1.1906 0 Td
(average)Tj
3.1691 0 Td
(relative)Tj
3.0727 0 Td
(humidity)Tj
3.8438 0 Td
(of)Tj
1.0034 0 Td
(60%.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 565.7385 cm
BT
/F0 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Study)Tj
2.7543 0 Td
(design)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 548.7307 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(This)Tj
1.9842 0 Td
(was)Tj
1.7008 0 Td
(a)Tj
0.6519 0 Td
(cross-sectional)Tj
6.1058 0 Td
(study)Tj
2.3868 0 Td
(nested)Tj
2.8063 0 Td
(within)Tj
2.8119 0 Td
(an)Tj
1.2019 0 Td
(ongoing)Tj
3.5263 0 Td
(AHI)Tj
2.0126 0 Td
(study)Tj
2.3924 0 Td
(conducted)Tj
4.4277 0 Td
(between)Tj
3.5262 0 Td
(Feb-)Tj
-35.5348 -1.2982 Td
(ruary)Tj
2.3754 0 Td
(2014)Tj
2.1259 0 Td
(and)Tj
1.7292 0 Td
(January)Tj
3.3221 0 Td
(2015.)Tj
2.3471 0 Td
(Study)Tj
2.5058 0 Td
(volunteers)Tj
4.3767 0 Td
(were)Tj
2.126 0 Td
(recruited)Tj
3.8551 0 Td
(from)Tj
2.2053 0 Td
(six)Tj
1.3096 0 Td
(health)Tj
2.6816 0 Td
(facilities)Tj
3.4922 0 Td
(in)Tj
-34.452 -1.3039 Td
(Mtwapa,)Tj
3.702 0 Td
(including)Tj
4.0422 0 Td
(four)Tj
1.9162 0 Td
(private)Tj
2.9877 0 Td
(clinics,)Tj
2.982 0 Td
(one)Tj
1.6951 0 Td
(research)Tj
3.5603 0 Td
(clinic)Tj
2.3924 0 Td
(operated)Tj
3.7247 0 Td
(by)Tj
1.1792 0 Td
(the)Tj
1.474 0 Td
(Kenya)Tj
2.7496 0 Td
(Medical)Tj
-32.4054 -1.2983 Td
(Research)Tj
3.804 0 Td
(Institute,)Tj
3.8098 0 Td
(and)Tj
1.7291 0 Td
(one)Tj
1.7008 0 Td
(government)Tj
5.0796 0 Td
(health)Tj
2.6759 0 Td
(centre.)Tj
2.9367 0 Td
(In)Tj
1.1055 0 Td
(Kilifi,)Tj
2.4548 0 Td
(the)Tj
1.474 0 Td
(Kilifi)Tj
2.228 0 Td
(County)Tj
3.2201 0 Td
(Hospital)Tj
3.617 0 Td
(was)Tj
-35.8353 -1.2983 Td
(the)Tj
1.4683 0 Td
(only)Tj
1.9786 0 Td
(participating)Tj
5.3291 0 Td
(health)Tj
2.6758 0 Td
(facility.)Tj
3.1238 0 Td
(Study)Tj
2.5058 0 Td
(enrolments)Tj
4.7679 0 Td
(in)Tj
1.0318 0 Td
(Kilifi)Tj
2.2337 0 Td
(County)Tj
3.2201 0 Td
(hospital)Tj
3.3732 0 Td
(started)Tj
2.9367 0 Td
(mid-)Tj
-34.6448 -1.3039 Td
(June)Tj
2.0466 0 Td
(2014,)Tj
2.347 0 Td
(at)Tj
0.9525 0 Td
(the)Tj
1.474 0 Td
(end)Tj
1.7177 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4684 0 Td
(long)Tj
1.9899 0 Td
(rainy)Tj
2.296 0 Td
(season.)Tj
-14.1107 -1.2982 Td
(As)Tj
1.2699 0 Td
(part)Tj
1.8368 0 Td
(of)Tj
1.0148 0 Td
(a)Tj
0.6576 0 Td
(standardized)Tj
5.3518 0 Td
(protocol,)Tj
3.8211 0 Td
(patients)Tj
3.3675 0 Td
(aged)Tj
2.075 0 Td
(between)Tj
3.5263 0 Td
(18)Tj
1.1735 0 Td
(and)Tj
1.7291 0 Td
(35)Tj
1.1679 0 Td
(years)Tj
2.2677 0 Td
(who)Tj
1.9389 0 Td
(sought)Tj
-32.3941 -1.2983 Td
(urgent)Tj
2.8516 0 Td
(health)Tj
2.6815 0 Td
(care)Tj
1.8709 0 Td
(at)Tj
0.9524 0 Td
(these)Tj
2.2507 0 Td
(facilities)Tj
3.498 0 Td
(were)Tj
2.1203 0 Td
(screened)Tj
3.7247 0 Td
(for)Tj
1.3889 0 Td
(eligibility.)Tj
4.1499 0 Td
(Potentially)Tj
4.5071 0 Td
(eligible)Tj
3.0614 0 Td
(partici-)Tj
-33.0574 -1.3039 Td
(pants)Tj
2.3754 0 Td
(were)Tj
2.1259 0 Td
(assigned)Tj
3.6057 0 Td
(a)Tj
0.6576 0 Td
(risk)Tj
1.7121 0 Td
(score)Tj
2.3074 0 Td
(by)Tj
1.1792 0 Td
(summing)Tj
4.0309 0 Td
(points)Tj
2.7212 0 Td
(based)Tj
2.4718 0 Td
(on)Tj
1.2756 0 Td
(the)Tj
1.4683 0 Td
(following)Tj
3.9798 0 Td
(signs)Tj
2.2224 0 Td
(and)Tj
1.7291 0 Td
(symp-)Tj
-33.8624 -1.2983 Td
(toms)Tj
2.2053 0 Td
(and)Tj
1.7291 0 Td
(reported)Tj
3.6624 0 Td
(risk)Tj
1.7121 0 Td
(behaviour:)Tj
4.4673 0 Td
(one)Tj
1.7008 0 Td
(point)Tj
2.3584 0 Td
(each)Tj
2.024 0 Td
(for)Tj
1.3889 0 Td
(generalized)Tj
4.7622 0 Td
(body)Tj
2.2167 0 Td
(pains)Tj
2.347 0 Td
(or)Tj
1.0999 0 Td
(multiple)Tj
-31.6741 -1.2983 Td
(partners)Tj
3.5432 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4683 0 Td
(past)Tj
1.8312 0 Td
(two)Tj
1.7065 0 Td
(months)Tj
3.2825 0 Td
(and)Tj
1.7348 0 Td
(two)Tj
1.7064 0 Td
(points)Tj
2.7212 0 Td
(each)Tj
2.0296 0 Td
(for)Tj
1.3833 0 Td
(documented)Tj
5.2498 0 Td
(fever)Tj
2.177 0 Td
(\()Tj
/F9 1 Tf
0 Tc
()Tj
/F5 1 Tf
-0.004 Tc
(37.5C)Tj
4.0421 0 Td
(axillary\),)Tj
-33.9134 -1.3039 Td
(reported)Tj
3.6566 0 Td
(diarrhoea,)Tj
4.3087 0 Td
(or)Tj
1.0998 0 Td
(symptoms)Tj
4.3596 0 Td
(compatible)Tj
4.6658 0 Td
(with)Tj
1.9956 0 Td
(a)Tj
0.652 0 Td
(sexually)Tj
3.3789 0 Td
(transmitted)Tj
4.8699 0 Td
(infection)Tj
3.7927 0 Td
(including)Tj
-32.7796 -1.2982 Td
(signs)Tj
2.2223 0 Td
(such)Tj
2.0579 0 Td
(as)Tj
1.0148 0 Td
(discharge)Tj
4.0195 0 Td
(or)Tj
1.0999 0 Td
(genital)Tj
2.9026 0 Td
(ulcers)Tj
2.5739 0 Td
([)Tj
0.83 0.64 0.02 0 k
(16)Tj
0 g
(].)Tj
2.0749 0 Td
(Inclusion)Tj
3.9912 0 Td
(criteria)Tj
3.0784 0 Td
(included)Tj
3.7133 0 Td
(age)Tj
1.5421 0 Td
(1835)Tj
2.6362 0 Td
(years,)Tj
2.4945 0 Td
(a)Tj
0.6519 0 Td
(risk)Tj
-36.0734 -1.2983 Td
(score)Tj
2.3073 0 Td
(of)Tj
1.0148 0 Td
(at)Tj
0.9525 0 Td
(least)Tj
1.9785 0 Td
(two,)Tj
1.9389 0 Td
(and)Tj
1.7291 0 Td
(willingness)Tj
4.6375 0 Td
(to)Tj
1.0261 0 Td
(be)Tj
1.1509 0 Td
(evaluated)Tj
3.9855 0 Td
(for)Tj
1.3889 0 Td
(acute)Tj
2.3244 0 Td
(or)Tj
1.0999 0 Td
(prevalent)Tj
3.9401 0 Td
(HIV-1)Tj
2.846 0 Td
(infection)Tj
-32.3204 -1.2983 Td
(and,)Tj
1.9558 0 Td
(if)Tj
0.7711 0 Td
(febrile,)Tj
2.9763 0 Td
(for)Tj
1.3833 0 Td
(malaria.)Tj
3.4526 0 Td
(Patients)Tj
3.4072 0 Td
(with)Tj
2.0013 0 Td
(known)Tj
3.0047 0 Td
(HIV-1-seropositive)Tj
7.9539 0 Td
(status)Tj
2.5002 0 Td
(were)Tj
2.1259 0 Td
(excluded.)Tj
4.0082 0 Td
(Par-)Tj
-35.5405 -1.3039 Td
(ticipants)Tj
3.6339 0 Td
(were)Tj
2.1203 0 Td
(also)Tj
1.7689 0 Td
(recruited)Tj
3.855 0 Td
(for)Tj
1.389 0 Td
(this)Tj
1.6724 0 Td
(study)Tj
2.3868 0 Td
(at)Tj
0.9524 0 Td
(five)Tj
1.6555 0 Td
(selected)Tj
3.3448 0 Td
(pharmacies)Tj
4.8019 0 Td
(in)Tj
1.0375 0 Td
(Mtwapa,)Tj
3.702 0 Td
(and)Tj
1.7291 0 Td
(referred)Tj
-34.0495 -1.2982 Td
(to)Tj
1.0261 0 Td
(any)Tj
1.6554 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(six)Tj
1.3153 0 Td
(health)Tj
2.6759 0 Td
(facilities)Tj
3.4979 0 Td
(for)Tj
1.3833 0 Td
(screening)Tj
4.0535 0 Td
(as)Tj
1.0148 0 Td
(described)Tj
4.0536 0 Td
(previously)Tj
4.3483 0 Td
([)Tj
0.83 0.64 0.02 0 k
(16)Tj
0 g
(].)Tj
2.0749 0 Td
(The)Tj
1.7858 0 Td
(Kiswahili)Tj
3.9458 0 Td
(name)Tj
-35.3137 -1.2983 Td
(of)Tj
1.0147 0 Td
(the)Tj
1.4684 0 Td
(study)Tj
2.3924 0 Td
(was)Tj
1.6951 0 Td
(`)Tj
/F10 1 Tf
[()97()16()17()11()4()]TJ
3.7927 0 Td
[()28()12()4()2()6()73( )]TJ
/F5 1 Tf
(,)Tj
4.1386 0 Td
(which)Tj
2.6475 0 Td
(means)Tj
2.8063 0 Td
(test)Tj
1.9956 0 Td
(early.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 300.359 cm
BT
/F0 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Study)Tj
2.7543 0 Td
(procedures)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 283.3511 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(After)Tj
2.2847 0 Td
(obtaining)Tj
4.0591 0 Td
(written)Tj
3.1125 0 Td
(informed)Tj
3.9741 0 Td
(consent)Tj
3.3335 0 Td
(from)Tj
2.2054 0 Td
(eligible)Tj
3.0614 0 Td
(volunteers,)Tj
4.6091 0 Td
(a)Tj
0.6519 0 Td
(trained)Tj
3.0955 0 Td
(clinician)Tj
3.6453 0 Td
(from)Tj
-34.0325 -1.2982 Td
(each)Tj
2.0295 0 Td
(respective)Tj
4.184 0 Td
(facility)Tj
2.8969 0 Td
(collected)Tj
3.7418 0 Td
(demographic)Tj
5.4991 0 Td
(information,)Tj
5.3065 0 Td
(obtained)Tj
3.7303 0 Td
(a)Tj
0.652 0 Td
(standardised)Tj
5.3064 0 Td
(clinical)Tj
-33.3465 -1.2983 Td
(history)Tj
3.0047 0 Td
(including)Tj
4.0421 0 Td
(onset)Tj
2.3584 0 Td
(of)Tj
1.0148 0 Td
(illness,)Tj
2.897 0 Td
(symptoms)Tj
4.3597 0 Td
(and)Tj
1.7291 0 Td
(signs)Tj
2.228 0 Td
(present)Tj
3.1635 0 Td
(at)Tj
0.9524 0 Td
(health)Tj
2.6759 0 Td
(care)Tj
1.8709 0 Td
(seeking,)Tj
3.4299 0 Td
(and)Tj
1.7291 0 Td
(per-)Tj
-35.4555 -1.3039 Td
(formed)Tj
3.1577 0 Td
(a)Tj
0.652 0 Td
(targeted)Tj
3.4639 0 Td
(physical)Tj
3.4469 0 Td
(exam.)Tj
-9.5243 -1.2983 Td
(A)Tj
0.907 0 Td
(5-ml)Tj
2.109 0 Td
(sample)Tj
3.0217 0 Td
(of)Tj
1.0148 0 Td
(venous)Tj
3.0444 0 Td
(blood)Tj
2.5172 0 Td
(was)Tj
1.6951 0 Td
(collected)Tj
3.7417 0 Td
(into)Tj
1.8425 0 Td
(EDTA.)Tj
3.0444 0 Td
(Onsite)Tj
2.8629 0 Td
(HIV-1)Tj
2.8517 0 Td
(testing)Tj
2.88 0 Td
(using)Tj
2.3924 0 Td
(two)Tj
-35.121 -1.2982 Td
(rapid)Tj
2.3357 0 Td
(diagnostic)Tj
4.32 0 Td
(tests)Tj
1.9615 0 Td
(\(RDT\))Tj
2.8687 0 Td
(Alere)Tj
2.3697 0 Td
(Determine)Tj
/F11 1 Tf
[()]TJ
/F5 1 Tf
4.989 0 Td
(HIV-1/2,)Tj
3.8777 0 Td
(\(Alere)Tj
2.7099 0 Td
(Medical,)Tj
3.6567 0 Td
(Tokyo,)Tj
3.0217 0 Td
(Japan\))Tj
2.8233 0 Td
(and)Tj
-34.9339 -1.3039 Td
(Uni-Gold)Tj
/F11 1 Tf
[()]TJ
/F5 1 Tf
4.575 0 Td
(\(Trinity)Tj
3.3732 0 Td
(Biotech)Tj
3.2485 0 Td
(plc,)Tj
1.6328 0 Td
(Bray,)Tj
2.2847 0 Td
(Ireland\))Tj
3.4526 0 Td
(was)Tj
1.7007 0 Td
(done)Tj
2.2224 0 Td
(in)Tj
1.0375 0 Td
(parallel.)Tj
3.3675 0 Td
(Participants)Tj
4.9946 0 Td
(with)Tj
2.0013 0 Td
(docu-)Tj
-33.8908 -1.2983 Td
(mented)Tj
3.2598 0 Td
(fever)Tj
2.1826 0 Td
(were)Tj
2.1203 0 Td
(also)Tj
1.7688 0 Td
(tested)Tj
2.5512 0 Td
(for)Tj
1.389 0 Td
(malaria)Tj
3.2258 0 Td
(using)Tj
2.3867 0 Td
(an)Tj
1.2019 0 Td
(RDT)Tj
2.194 0 Td
(\(Optimal,)Tj
4.1102 0 Td
(Flow)Tj
2.1884 0 Td
(Inc.,)Tj
1.9842 0 Td
(Portland,)Tj
3.9345 0 Td
(Ore-)Tj
-34.4974 -1.2983 Td
(gon,)Tj
1.9672 0 Td
(USA\).)Tj
2.6815 0 Td
(All)Tj
1.3947 0 Td
(malaria-positive)Tj
6.6727 0 Td
(results)Tj
2.8063 0 Td
(were)Tj
2.1259 0 Td
(confirmed)Tj
4.3937 0 Td
(at)Tj
0.9525 0 Td
(the)Tj
1.4683 0 Td
(KEMRI-Wellcome)Tj
7.7272 0 Td
(Trust)Tj
-32.19 -1.3039 Td
(laboratories)Tj
4.9435 0 Td
(in)Tj
1.0375 0 Td
(Mtwapa)Tj
3.4809 0 Td
(and)Tj
1.7292 0 Td
(Kilifi)Tj
2.228 0 Td
(using)Tj
2.3924 0 Td
(the)Tj
1.4683 0 Td
(same)Tj
2.2564 0 Td
(RDT)Tj
2.194 0 Td
(test)Tj
1.5987 0 Td
(kit.)Tj
1.5081 0 Td
(Plasma)Tj
3.0727 0 Td
(was)Tj
1.7008 0 Td
(then)Tj
2.0182 0 Td
(separated)Tj
4.0082 0 Td
(and)Tj
-35.6369 -1.2983 Td
(stored)Tj
2.7099 0 Td
(at)Tj
0.9524 0 Td
(-80C)Tj
2.5738 0 Td
(in)Tj
1.0375 0 Td
(Kilifi,)Tj
2.4548 0 Td
(until)Tj
2.109 0 Td
(further)Tj
3.0273 0 Td
(testing)Tj
2.88 0 Td
(at)Tj
0.9525 0 Td
(the)Tj
1.4683 0 Td
(KEMRI-Centers)Tj
6.7577 0 Td
(for)Tj
1.389 0 Td
(Disease)Tj
3.2258 0 Td
(Control)Tj
3.3619 0 Td
(and)Tj
-34.8999 -1.2982 Td
(Prevention.)Tj
4.8472 0 Td
(Plasma)Tj
3.0727 0 Td
(was)Tj
1.7008 0 Td
(initially)Tj
3.2485 0 Td
(stored)Tj
2.7099 0 Td
(at)Tj
0.9524 0 Td
(a)Tj
0.652 0 Td
(-20C)Tj
2.5738 0 Td
(at)Tj
0.9524 0 Td
(the)Tj
1.474 0 Td
(satellite)Tj
3.2145 0 Td
(laboratory)Tj
4.354 0 Td
(in)Tj
1.0318 0 Td
(Mtwapa.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 112.9889 cm
BT
/F0 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Laboratory)Tj
4.9417 0 Td
(methods)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 95.9811 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(In)Tj
1.1055 0 Td
(our)Tj
1.627 0 Td
(study)Tj
2.3925 0 Td
(we)Tj
1.3266 0 Td
(used)Tj
2.0579 0 Td
(qRT-PCR)Tj
4.1556 0 Td
(to)Tj
1.0261 0 Td
(diagnose)Tj
3.753 0 Td
(DENV)Tj
2.9537 0 Td
(or)Tj
1.0999 0 Td
(CHIKV)Tj
3.3618 0 Td
(infection.)Tj
4.0139 0 Td
(Automated)Tj
4.7395 0 Td
(Viral)Tj
-33.613 -1.2982 Td
(RNA)Tj
2.262 0 Td
(extraction)Tj
4.2576 0 Td
(was)Tj
1.6951 0 Td
(done)Tj
2.228 0 Td
(from)Tj
2.2054 0 Td
(200)Tj
/F11 1 Tf
1.6497 0 Td
[()]TJ
/F5 1 Tf
(L)Tj
1.2643 0 Td
(of)Tj
1.0148 0 Td
(plasma)Tj
3.033 0 Td
(samples)Tj
3.3789 0 Td
(using)Tj
2.3924 0 Td
(the)Tj
1.4683 0 Td
(NucliSens)Tj
4.2293 0 Td
(easyMAG)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 107.1496 23.6976 re
W* n
q
107.0929 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 295.4834 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Dengue)Tj
3.6567 0 Td
(and)Tj
1.8567 0 Td
(Chikunguny)Tj
5.1803 0 Td
(a)Tj
0.7654 0 Td
(Virus)Tj
2.4591 0 Td
(Infections)Tj
4.4291 0 Td
(among)Tj
3.2245 0 Td
(Febrile)Tj
3.2173 0 Td
(Adults)Tj
2.9552 0 Td
(in)Tj
0.9779 0 Td
(Coastal)Tj
3.5504 0 Td
(Kenya)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(ONE)Tj
2.3669 0 Td
(|)Tj
0.4748 0 Td
(DOI:10.137)Tj
5.0387 0 Td
(1/journal.po)Tj
5.1236 0 Td
(ne.0167)Tj
3.5434 0 Td
(508)Tj
2.6362 0 Td
(December)Tj
4.7622 0 Td
(12,)Tj
1.5874 0 Td
(2016)Tj
36.7515 0 Td
(3)Tj
0.7654 0 Td
(/)Tj
ET
endstream
endobj
55 0 obj
<>stream
endstream
endobj
56 0 obj
<>stream
endstream
endobj
57 0 obj
<>stream
endstream
endobj
58 0 obj
<>stream
endstream
endobj
59 0 obj
<>stream
endstream
endobj
60 0 obj
<>stream
endstream
endobj
61 0 obj
<>stream
BT
66.402 0 Td
(12)Tj
ET
Q
endstream
endobj
62 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 11 0 R/Annots 64 0 R/Contents 65 0 R/TrimBox[0 0 612 792]>>
endobj
63 0 obj
<>
endobj
66 0 obj
<>
endobj
67 0 obj
<>stream
%!PS-AdobeFont-1.0
11 dict begin
/FontName /PI_chars_3 def
/FontType 1 def
/FontBBox {-11 -345 1373 718} readonly def
/FontMatrix [0.001 0 0 0.001 0 0] readonly def
/PaintType 0 def
/FontInfo 8 dict dup begin
/FullName (PI_chars_3) readonly def
/BaseFontName (PI_chars_3) def
end def
/Encoding 256 array
0 1 255 {1 index exch /.notdef put} for
dup 33 /exclam put
dup 34 /quotedbl put
dup 35 /numbersign put
dup 36 /dollar put
dup 37 /percent put
dup 38 /ampersand put
dup 39 /quoteright put
dup 40 /parenleft put
dup 41 /parenright put
dup 42 /asterisk put
dup 43 /plus put
dup 44 /comma put
dup 45 /hyphen put
dup 46 /period put
dup 47 /slash put
dup 49 /one put
dup 50 /two put
dup 51 /three put
dup 52 /four put
dup 53 /five put
dup 54 /six put
dup 55 /seven put
dup 56 /eight put
dup 58 /colon put
dup 60 /less put
dup 61 /equal put
dup 62 /greater put
dup 63 /question put
dup 64 /at put
dup 65 /A put
dup 66 /B put
dup 67 /C put
dup 68 /D put
dup 69 /E put
dup 70 /F put
dup 71 /G put
dup 72 /H put
dup 73 /I put
dup 74 /J put
dup 75 /K put
dup 76 /L put
dup 77 /M put
dup 78 /N put
dup 79 /O put
dup 80 /P put
dup 81 /Q put
dup 82 /R put
dup 83 /S put
dup 84 /T put
dup 85 /U put
dup 86 /V put
dup 87 /W put
dup 88 /X put
dup 89 /Y put
dup 90 /Z put
dup 91 /bracketleft put
dup 92 /backslash put
dup 93 /bracketright put
dup 94 /asciicircum put
dup 97 /a put
dup 98 /b put
dup 99 /c put
dup 100 /d put
dup 101 /e put
dup 102 /f put
dup 103 /g put
dup 104 /h put
dup 105 /i put
dup 106 /j put
dup 107 /k put
dup 108 /l put
dup 109 /m put
dup 110 /n put
dup 111 /o put
dup 112 /p put
dup 113 /q put
dup 114 /r put
dup 115 /s put
dup 116 /t put
dup 117 /u put
dup 118 /v put
dup 119 /w put
dup 120 /x put
dup 121 /y put
dup 122 /z put
dup 123 /braceleft put
dup 124 /bar put
dup 125 /braceright put
dup 126 /asciitilde put
readonly def
currentdict end
currentfile eexec
M#1H5 J6o\&rtS(#v\0\V7Fe༙OYx5-cY9^%Y6
(efIOldN"wȰ;)UƽoFg/rvV$JS8_oc@
o9-eGJp}[Do]mN=4*{ܯq=eU^t6¤/{zM4aܪ
Q:д'B-r^ܦ6y?rRnu S\U{Oλrs(Βƚ
#d29%s'ƈT1F8&\0Xd&&Zug'VPd]:>u=Q,?#(CV4'..|ӱ5 h
sȀg)fɘ`UXK^>] q\l#5pE"JO}rquáQBr/E7
QW5\GSlu{7ZH(PSf/O;̟w{ɴ}-K hA8!b!U>`#u?Vlnǝ19V+mg'QmA}S Y$í8n uJ ڒx3>[x0Z]
ͩw4M&1+pkC,sr"%q&OjbH{:5$65*S`cr;%s4Oӆe>T+6~pBOD!$c]"~r#nh6$38i˞[~Z}}rHmte9(1½=j{<\ ;? RA?c{Rf1'VԞ_-Lwo]`.l|zjf"![G1BYro˓9[-+z g!}RN+pX!M~HcFh@g%J6B)6!Lq>TX\ݪGF
PiQݓX~Fs;Ölo4/(C?+,ɖxۼ:xU^)
fd,`*>-:}=q$:\Xzcw1Nf(
ZkEeJXfэi@zXc\{a5qKg\5ݩv\Qe%1>OY̗$Y#P[)."^+{"bP]Bt&zeN6
іijDE% 0;̅
~~lfB>u'i4znym%tfԟ^נBTDS6-ghiWk/(r!!˶fc>趕%U