Research based on traditional scientific methods, which generates numerical data and usually seeks to establish causal relationships between two or more variables, using statistical methods to test the strength and significance of the relationships.
Observations in
Observations in
A situation the researcher can observe
A
Participants are comfortable with the researcher. They are honest and forthcoming, so that the researcher can make robust observations.
Others can repeat the findings of the study
Variables are defined and correlations between them are studied
If the researcher is biased, or is expecting to find certain results, it can be difficult to make completely objective observations
Researchers may be so careful about measurement methods that they do not make connections to a greater context
Open-ended interviews
Focus groups
Observation
Participant observation
Close-ended interviews
Surveys
Clinical Trials
Laboratory Experiments
From A Dictionary of Nursing
Qualitative research includes all modes of inquiry that do not rely on numbers or statistical methods.
Naturalistic [qualitative] approaches comprise a wide array of research traditions, most often in the categories of ethnography, grounded theory, and phenomenology, but they also include ethnology, ethnomethodology, hermeneutics, oral and life histories, discourse analysis, case study methods, and critical, philosophical, and historical approaches to inquiry.
Learn more! Encyclopedia of Nursing Research
Finding qualitative studies can be slightly more challenging because this type of methodology is less commonly used in nursing research.
Try adding one of the following keywords to your search:
Look at the following qualitative article example for more search ideas:
Consider using one of the following when examining qualitative research:
Quantitative research consists of the collection, tabulation, summarization, and analysis of numerical data for the purpose of answering research questions or hypotheses.
Quantitative research uses statistical methodology at every stage in the research process. At the inception of a research project, when the research questions are formulated, thought must be given to how the research variables are to be quantified, defined, measured, and analyzed.
Learn more! Dictionary of Nursing Theory and Research
According to the Encyclopedia of Nursing Research, "The vast majority of all nursing studies can be classified as quantitative."
As a result, you'll likely find quantitative research articles when you search for your topic.
You can also try adding one of the following keywords to your search:
Look at the following quantitative article example for more search ideas.
Consider using one of the following when examining quantitative research:
If you're still wondering if the article you have is qualitative or quantitative, below you'll find a table that highlights some of the key differences in qualitative versus quantitative research methods.
Image from the Oak Ridge Institute for Science and Education .
Mixed methods research combines quantitative and qualitative research methods in a single study. The use of mixed methods research is increasingly popular in nursing and health sciences research. This growth in popularity has been driven by the increasing complexity of research problems relating to human health and wellbeing.
Mixed Methods Research for Nursing and Health Sciences
Quantitative methods emphasise on objective measurements and numerical analysis of data collected through polls, questionnaires or surveys. Quantitative research focuses on gathering numerical data and generalizing it across groups of people.
Babbie, Earl R. The Practice of Social Research . 12th ed. Belmont, CA: Wadsworth Cengage, 2010.
In quantitative research, your goal is to determine the relationship between one thing (an independent variable) and another (a dependent or outcome variable) in a population. Quantitative research designs are either descriptive (subjects usually measured once) or experimental (subjects measured before and after a treatment). A descriptive study establishes only associations between variables. An experiment establishes causality.
Quantitative research deals in numbers, logic and the objective, focusing on logic, numbers, and unchanging static data and detailed, convergent reasoning rather than divergent reasoning.
Its main characteristics are :
The overarching aim of a quantitative research study is to classify features, count them, and construct statistical models in an attempt to explain what is observed.
Things to keep in mind when reporting the results of a study using quantitative methods :
Babbie, Earl R. The Practice of Social Research . 12th ed. Belmont, CA: Wadsworth Cengage, 2010; Brians, Craig Leonard et al. Empirical Political Analysis: Quantitative and Qualitative Research Methods . 8th ed. Boston, MA: Longman, 2011; McNabb, David E. Research Methods in Public Administration and Nonprofit Management: Quantitative and Qualitative Approaches . 2nd ed. Armonk, NY: M.E. Sharpe, 2008; Quantitative Research Methods . Writing@CSU. Colorado State University; Singh, Kultar. Quantitative Social Research Methods . Los Angeles, CA: Sage, 2007.
Before designing a quantitative research study, you must decide whether it will be descriptive or experimental because this will dictate how you gather, analyze, and interpret the results. A descriptive study is governed by the following rules: subjects are generally measured once; the intention is to only establish associations between variables; and, the study may include a sample population of hundreds or thousands of subjects to ensure that a valid estimate of a generalized relationship between variables has been obtained. An experimental design includes subjects measured before and after a particular treatment, the sample population may be very small and purposefully chosen, and it is intended to establish causality between variables. Introduction The introduction to a quantitative study is usually written from the third person point of view and covers the following information:
Methodology The methods section of a quantitative study should describe how each objective of your study will be achieved. Be sure to provide enough detail to enable that the reader can make an informed assessment of the method being used to obtain results associated with the research problem.
Results The finding of your study should be written objectively and in a succinct and precise format. In quantitative studies, it is common to use graphs, tables, charts and other non-textual elements to help the reader understand the data. Make sure that non-textual elements do not stand in isolation from the text but are used to supplement the overall description of the results and to help clarify key points being made. Further information about how to effectively present data using charts and graphs can be found here .
Discussion Discussions should be analytic, logical and comprehensive. The discussion should meld together your findings in relation to those identified in the literature review, and placed within the context of the theoretical framework underpinning the study.
Conclusion End your study by to summarizing the topic and provide a final comment and assessment of the study.
Black, Thomas R. Doing Quantitative Research in the Social Sciences: An Integrated Approach to Research Design, Measurement and Statistics . London: Sage, 1999; Gay,L. R. and Peter Airasain. Educational Research: Competencies for Analysis and Applications . 7th edition. Upper Saddle River, NJ: Merril Prentice Hall, 2003; Hector, Anestine. An Overview of Quantitative Research in Compostion and TESOL. Department of English, Indiana University of Pennsylvania; Hopkins, Will G. “Quantitative Research Design.” Sportscience 4, 1 (2000); A Strategy for Writing Up Research Results . The Structure, Format, Content, and Style of a Journal-Style Scientific Paper. Department of Biology. Bates College; Nenty, H. Johnson. "Writing a Quantitative Research Thesis." International Journal of Educational Science 1 (2009): 19-32; Ouyang, Ronghua (John). Basic Inquiry of Quantitative Research. Kennesaw State University.
Quantitative researchers try to recognize and isolate specific variables contained within the study framework, seek correlation, relationships and causality, and attempt to control the environment in which the data is collected to avoid the risk of variables, other than the one being study, accounting for the relationships identified.
Among the specific strengths of using quantitative methods to study social science research problems:
Babbie, Earl R. The Practice of Social Research . 12th ed. Belmont, CA: Wadsworth Cengage, 2010; Brians, Craig Leonard et al. Empirical Political Analysis: Quantitative and Qualitative Research Methods . 8th ed. Boston, MA: Longman, 2011; McNabb, David E. Research Methods in Public Administration and Nonprofit Management: Quantitative and Qualitative Approaches . 2nd ed. Armonk, NY: M.E. Sharpe, 2008; Singh, Kultar. Quantitative Social Research Methods . Los Angeles, CA: Sage, 2007.
Quantitative methods presume to have an objective approach to studying research problems, where data is controlled and measured, to address the accumulation of facts, and to determine the causes of behavior. As a consequence, the results of quantitative research may be statistically significant but are often humanly insignificant.
Some specific limitations associated with using quantitative methods to study research problems in the social sciences include:
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Hannah Dostal, Jessica Scott, Ana Gediel, Shirley Vilhalva, Literacy and signing deaf students: a multi-national scoping review, The Journal of Deaf Studies and Deaf Education , 2024;, enae023, https://doi.org/10.1093/jdsade/enae023
Many literature reviews or other types of reviews (e.g., meta-analyses, scoping reviews) in deaf education research are focused upon primarily or exclusively research that is performed in U.S. contexts or English-speaking contexts only. However, research that is conducted in non-English-speaking, non-U.S. settings that may be more likely to be multilingual, has value for our understanding of how deaf students using multiple languages may develop literacy skills. The objective of this review was to explore the literature on literacy development with deaf learners conducted outside of English-speaking contexts that has been published in English, Portuguese, or Spanish. We identified 13 English-language articles, 9 Portuguese-language articles, and 0 Spanish articles that met inclusion criteria. From these articles, we glean important insights into the reading process, including the teaching of subskills of reading, writing instruction, early literacy experiences, and the potential relationship between signed languages and literacy. We also note the need for multiple, converging sources of evidence and the value of an asset-driven approach to understanding deaf learners.
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Volume 30, Number 7—July 2024
Suggested citation for this article
At 3 severe infection cohort sites in Uganda, Orientia seropositivity was common. We identified 4 seroconversion cases but only 1 PCR-positive case. These results provide serologic and molecular support for Orientia spp. circulating in sub-Saharan Africa, possibly expanding its endemic range. Orientia infections could cause severe illness and hospitalizations in this region.
Scrub typhus is a leading cause of nonmalarial febrile illness in Southeast Asia ( 1 ). Scrub typhus is caused by miteborne Orentia tsutsugamushi infections, which until recently were thought to be limited to South and Southeast Asia. Molecular identification of different Orientia species in clinical cases from Chile ( 2 ) and the United Arab Emirates ( 3 ) has suggested a broader epidemiology. Orientia spp. were found in mites in Kenya ( 4 ), and descriptions of Orientia seroconversion in patients from sub-Saharan Africa have slowly accrued, suggesting the possibility of Orientia spp. transmission in Africa ( 5 ). We used archived samples collected in 2 severe infection prospective cohorts in western, central, and northwest Uganda to assess Orientia endemicity in the country.
Using archived samples, we measured serial Orientia immunofluorescence assay (IFA) IgG titers and performed reflex Orientia spp. reverse transcription PCR (RT-PCR). Samples were collected as part of 2 severe infection prospective cohorts and had undergone broad microbiologic testing. In both cohorts, adult patients > 18 years of age who fulfilled acute febrile illness (AFI; hospitals in Mubende and Arua, Uganda) or sepsis-specific (hospital in Fort Portal, Uganda) eligibility criteria were evaluated for enrollment at admission in the outpatient or emergency department, or on medical wards ( Appendix ) ( 6 ). Matched acute and convalescent serum samples were available from 269 of 310 participants enrolled in the sepsis cohort and 67 of 132 participants in the AFI cohort.
In brief, across both prospective cohorts, study teams collected demographic and symptom information, examination findings, and laboratory data on standardized forms during hospitalization and at 1 month after enrollment. Clinical tests were routinely performed, including complete blood counts and chemistries. Microbiologic testing included blood culture with antimicrobial sensitivity testing, HIV testing, malaria smears, and rapid diagnostic tests, as previously described ( 6 ) ( Appendix ).
We performed IgG IFAs by using Orientia tsutsugamushi Karp strain antigen slides (BIOCELL Diagnostics Inc., https://biocelldx.com ). Baseline (acute) and 1-month follow-up (convalescent) serum samples were screened at a titer of 1:64 and titrated up to 1:65,000. We considered a sample seropositive at a threshold titer of > 128. We performed IgG IFAs by using commercial slides to evaluate for cross-reactivity to spotted fever group rickettsia (SFGR), Rickettsia conorii Molish 7 strain, typhus group rickettsia (TGR), and Rickettsia typhi Wilmington strain (BIOCELL Diagnostics, Inc.). We performed a Kruskal-Wallis test to evaluate for differences between Orientia IFA IgG titers between those with and without available matched samples. We used a titer of 32 to calculate -fold increase if the screen was negative at a titer of 1:64. We had a blind second reader review < 5% of each batch.
Figure 1 . Alluvial diagram of serology from acute serum samples used in a study of Orientia genus endemicity among severe infectious disease cohorts, Uganda. The diagram represents Orientia spp.–positive...
Figure 2 . Phylogenetic tree (left) and aligned sequences (right) of Orientia spp. and locally endemic Rickettsia spp. in a study of Orientia genus endemicity among severe infectious...
Because no prior estimates of Orientia seroprevalence were available for Uganda, we used stringent criteria to define probable cases ( Appendix Figure 1 ). To evaluate the specificity of IFA results, we used a subset of high titer samples to corroborate evidence of antibody binding by using a dot blot, Western blot, and Gilliam strain IFA ( Appendix Methods, Figure 2 ). To optimize sensitivity for RT-PCR, we targeted mRNA and rRNA from serum from both cohorts ( 7 ), whole blood from the AFI cohort, or buffy coat from the sepsis cohort. We used QIAamp RNA Mini Kit (QIAGEN, https://www.qiagen.com ) to extract RNA. We performed RT-PCR targeting Orientia spp. 16S rRNA, Orien16S and rrs by using previously published methods ( 3 , 8 ), and mRNA from Orientia spp. 56-kDa antigen gene, SFGR OmpA ( sca0 ) gene, and TGR kDa ( 9 ) outer membrane protein gene. We only called positives that were in duplicate.
We found that 33.9% (148/436) of acute samples and 38.4% (129/336) of convalescent samples were seropositive ( > 128) for Orientia spp. Among acute samples, 25.5% (111/436) were positive at > 256 titer and 19.0% (85/436) were positive at ≥512 ( Figure 1 ). We observed no difference in acute IFA titers between patients with and without a convalescent blood samples (p = 0.33). Among samples with a positive 1:64 titer screen, the median acute titer was 128 (up to 8,192; interquartile range [IQR] 64–512) and median convalescent titer was 256 (up to 4,096; IQR 64–1,024). Seropositivity was highest (acute, 38.7% [120/310]; convalescent, 41.6% [112/269]) in Fort Portal, but was also high in Arua (acute, 26.5% [9/34]; convalescent, 30.0% [6/20]) and Mubende (acute, 20.7% [19/92]; convalescent, 23.4% [11/47]). The overall geometric mean titers were 90.8 (95% CI 80.2–102.8) for acute samples and 100.3 (95% CI 86.1–116.9) for convalescent samples.
Four participants met our case definition for Orientia spp. seroconversion ( Table 1 ). Participants meeting the case definition were 24–56 years of age; 3 were female and 1 was male, and 3 had HIV ( Table 2 ). Leukocyte counts ranged from 5–10 × 10 3 cells/μL, platelet counts were 56–220 × 10 3 cells/μL, and aspartate transaminase was 21–136 U/L. Three patients survived, but a 34-year-old woman with HIV in whom a papular rash developed died of unknown causes 8 months after follow-up. Three participants with seroconversion had negative malaria smears, blood cultures, and rapid antigen and molecular diagnostic tests for nonrickettsial pathogens ( Table 2 ).
We used molecular methods to confirm Orientia spp. infection. The acute serum sample from participant D was repeatedly rrs -positive with RT-PCR (mean cycle threshold 34.1, SD 0.4) and was confirmed by Sanger sequencing of the amplicon. A BLAST analysis ( https://blast.ncbi.nlm.nih.gov ) of a 96-bp sequenced fragment of the amplicon revealed 96%–100% homology with Orientia spp., and a single polymorphism aligned with Candidatus O. chuto ( Figure 2 ). RT-PCR was negative using other primers for Orientia spp. (Orien16S 56-kDa) targets, SFGR ( sca0 [ ompA ] targets, and TGR (17-kDa antigen gene) targets.
We identified Orientia seroconversion among 4 participants hospitalized with severe infection in sub-Saharan Africa. We demonstrated that Orientia seropositivity was common among patients admitted for severe infection at 3 hospitals in Uganda. Our findings of highly prevalent seropositivity at 3 sites, identification of seroconversion, and molecular confirmation of a case with otherwise negative broad microbiologic testing support Orientia circulation and raise suspicion for infections extending to East Africa.
Prior clinical evidence of suspected scrub typhus in Africa relied on case reports of returning travelers with Orientia seroconversion ( 5 ). In addition to seroconversion identified in this study, seroconversions were observed in a pediatric cohort in Kenya (3.6%; n = 10) ( 10 ), and in 1 case among 49 abattoir workers in Djibouti ( 11 ). Our well-characterized multisite results supplement the limited literature suggesting Orientia spp. infections in sub-Saharan Africa.
In addition to prior suggestive evidence, our results build on a shift in understanding of worldwide Orientia spp. clinical infections. SFGR and TGR test results were negative in our cohorts, decreasing the likelihood of cross-reactivity. Despite IFA being the preferred method for rickettsial diagnosis, intrinsic interobserver variability limitations exist ( 12 ); we aimed to reduce those limitations through our reading approach and seroconversion criteria. Although we were able to confirm an infection by using real-time RT-PCR, sequence results were limited to a small fragment of the abundant 16S rRNA. The clinical relevance requires further confirmation with Orientia culture growth and extended genome sequencing. Because we relied on convalescent serology, we might have missed early fatal cases, which could skew our results toward less severe illness. Research efforts are needed to characterize the circulating species, incidence, pathogenic potential, and clinical relevance of Orientia infections in East Africa.
In summary, our findings suggest Orientia spp. circulation within the human–environment interface in Uganda and suggest novel Orientia infections within severe infection cohorts in Uganda. After excluding common causes of infections, our findings provide evidence of locally acquired Orientia infections among adults in sub-Saharan Africa.
Dr. Blair is an infectious diseases physician-scientist at Uniformed Services University, Bethesda, Maryland, USA. His research interests include molecular and imaging approaches to clinically detect emerging infectious diseases.
Acute Febrile Illness and Sepsis in Uganda Study Team members: Nehkonti Adams, Rodgers R. Ayebare, Helen Badu, Melissa Gregory, Francis Kakooza, Mubaraka Kayiira, Willy Kayondo, Stacy M. Kemigisha Hannah Kibuuka, Abraham Khandathil, Prossy Naluyima, Edgar C. Ndawula, David F. Olebo, Matthew Robinson, Abdullah Wailagala, and Peter Waitt.
This study was conducted in compliance with the Declaration of Helsinki and Good Clinical Practice Guidelines. All participants signed written informed consent prior to study procedures. The investigators have adhered to the policies for protection of human subjects as prescribed in 45 CFR 46. Parent acute febrile illness cohort: The study and informed consent process were reviewed and approved by the Joint Clinical Research Centre (JCRC) Research Ethics Committee (JC1518) and the Uganda National Council for Science and Technology (UNCST), HS 371ES, and Johns Hopkins University School of Medicine Internal Review Board (IRB no. 00176961). Parent sepsis cohort: This protocol and informed consent were approved by the US Army Medical Research and Development Command Institutional Review (approval no. M-10573) and Makerere University School of Public Health (IRB no. 490). Secondary use protocol: this laboratory work was reviewed and received an exempt determination by Uniformed Services University (IRB no. DBS.2020.174).
Pathogen testing was supported by cooperative agreement with the Naval Medical Logistics Command (NMLC; agreement no. N626451920001) and by the Congressionally Directed Medical Research Program (agreement no. W81XWH-19-2-0057).
The opinions and assertions expressed herein are those of the authors and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences, US Department of Defense, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., or any other government or agency. Mention of trade names, commercial products, or organizations does not imply endorsement by the US government. Some of the authors of this work are employees of the US government. This work was prepared as part of their official duties. Title 17 U.S.C. x105 provides that “Copyright protection under this title is not available for any work of the United States government.” Title 17 U.S.C. x101 defines a US government work as a work prepared by a military service member or employee of the US government as part of that person’s official duties.
Y.C.M. receives research funding from Becton Dickinson, Quanterix, and Hologic, and receives funding support from miDiagnostics to Johns Hopkins University. Y.C.M. receives research funding from Becton Dickinson, Quanterix, and Hologic, and receives funding support from miDiagnostics to Johns Hopkins University. M.L. receives research funding support from Pfizer Inc. to Infectious Diseases Institute.
Suggested citation for this article : Blair PW, Kobba K, Okello S, Alharthi S, Naluyima P, Clemens E, et al.; Acute Febrile Illness and Sepsis in Uganda study teams. Evidence of Orientia spp. endemicity among severe infectious disease cohorts, Uganda. Emerg Infect Dis. 2024 Jul [ date cited ]. https://doi.org/10.3201/eid3007.231040
DOI: 10.3201/eid3007.231040
1 Members of the Acute Febrile Illness and Sepsis in Uganda study teams are listed at the end of this article.
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Because no prior estimates of Orientia seroprevalence were available for Uganda, we used stringent criteria to define probable cases (Appendix Figure 1).To evaluate the specificity of IFA results, we used a subset of high titer samples to corroborate evidence of antibody binding by using a dot blot, Western blot, and Gilliam strain IFA (Appendix Methods, Figure 2).