A Clinico-Epidemiological Study of Epidemic Typhus in Africa

Perine, Peter L.; Chandler, Bruce P.; Krause, Donald K.; McCardle, Peggy; Awoke, Sissay; Habte-Gabr, Eyassu; Wisseman, Charles L.; McDade, Joseph E.

doi:10.1093/clinids/14.5.1149

Cited by 74 publications

(33 citation statements)

References 25 publications

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“…It is still prevalent in areas where poor socioeconomic conditions and a high prevalence of louse infestations exist. The recent circulation or distribution of epidemic typhus is indefinite but since the 1990s, foci of epidemic typhushave been described in Africa, including Algeria (Mokrani et al, 2004) and central eastern African countries such as Ethiopia, Zaire, Rwanda and Burundi (Perine et al, 1992), in mountainous regions of South America (including Peru), in mountainous or highland regions of North America, in the Himalayan regions in Asia, and in Russia (Tarasevich et al, 1998). An autochthonous case of epidemic typhus has been recently reported in France (Badiaga and Brouqui, 2012).…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of typhus fever at the Kality Prison, Addis Ababa, Ethiopia

Mariam¹,

Gelaw²,

Assefa³

2015

Biomed Res Ther

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Abstract-Background: Peoples living in crowded situations like refugee camps and prisons are highly vulnerable to louse-born typhus infection. The information on the prevalence of louse-borne typhus among prisoners in Ethiopia is limited. Hence, the aim of this study was to determine the prevalence of typhus among prisoners at the Kality Prison, Addis Ababa, Ethiopia. Methods: A five-year retrospective study was conducted from February to March 2014. A total of 6104 typhus fever suspected prisoners tested for typhus at the Kality Prison Hospital from 2008 to 2012 were included. Data on the seroprevalence of typhus were abstracted from Kality Prison Laboratory. Data were entered and analyzed using SPSS 20 statistical software. Descriptive statistics and Chi-square were computed. In all cases p-values less than 0.05 was taken as statistically significant. Results: The overall prevalence of typhus fever infection was 26.3%. The prevalence of typhus fever infection was found to be higher among prisoners within the age group of 41-50 years (36.9%) and also among male patients (27.3%). The prevalence of typhus fever infection was higher by the year 2009 (40.7%) and overall in the five-year period the summer (31.8%) and fall (30%) seasons showed higher seroprevalence of typhus. Conclusions: The prevalence of typhus fever infection at Kality prison was high. This high prevalence could be a possible risk for epidemic typhus fever infection within the prison and for the nearby population. Therefore, targeted public health intervention could be important in this high-risk population.

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Section: Discussionmentioning

confidence: 99%

Seroprevalence of typhus fever at the Kality Prison, Addis Ababa, Ethiopia

Mariam¹,

Gelaw²,

Assefa³

2015

Biomed Res Ther

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“…Differentiating clinical signs of epidemic typhus from other febrile illnesses is difficult. Although previous clinical studies have identified a rash in over 50% of cases, 6 only about a quarter of the patients presented with a rash during this outbreak, highlighting the limited value of the rash in enhancing clinical suspicion. All seven reported deaths occurred earlier in the outbreak.…”

Section: Discussionmentioning

confidence: 63%

“…4,5 Epidemic typhus occurs most commonly among people living in overcrowded settings with suboptimal hygiene conditions. 6,7 The most affected populations are those living in impoverished conditions, areas of war or natural disasters, refugee camps, and areas with colder mountainous regions. 4,8 Epidemic typhus is rare but severe when it occurs.…”

Section: Introductionmentioning

confidence: 99%

“…The clinical course of treatment ranges between 10 and 28 days. 5,6 Epidemic typhus is characterized by high fever, severe headache, cough, severe muscle pain, rash, chills, low blood pressure, a high sensitivity to light, delirium, and coma in advanced stage. 7 It can be confused with severe malaria, leptospirosis, and other infectious diseases that cause high fever.…”

Section: Introductionmentioning

confidence: 99%

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A Mixed Outbreak of Epidemic Typhus Fever and Trench Fever in a Youth Rehabilitation Center: Risk Factors for Illness from a Case-Control Study, Rwanda, 2012

Umulisa

Omolo

Muldoon³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. In August 2012, laboratory tests confirmed a mixed outbreak of epidemic typhus fever and trench fever in a male youth rehabilitation center in western Rwanda. Seventy-six suspected cases and 118 controls were enrolled into an unmatched case-control study to identify risk factors for symptomatic illness during the outbreak. A suspected case was fever or history of fever, from April 2012, in a resident of the rehabilitation center. In total, 199 suspected cases from a population of 1,910 male youth (attack rate = 10.4%) with seven deaths (case fatality rate = 3.5%) were reported. After multivariate analysis, history of seeing lice in clothing (adjusted odds ratio [aOR] = 2.6, 95% confidence interval [CI] = 1.1-5.8), delayed (≥ 2 days) washing of clothing (aOR = 4.0, 95% CI = 1.6-9.6), and delayed (≥ 1 month) washing of beddings (aOR = 4.6, 95% CI = 2.0-11) were associated with illness, whereas having stayed in the rehabilitation camp for ≥ 6 months was protective (aOR = 0.20, 95% CI = 0.10-0.40). Stronger surveillance and improvements in hygiene could prevent future outbreaks.

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“…24 In addition, outbreaks of louse-borne typhus took place in the highlands of Ethiopia in the past, and a recent report showed a prevalence of 5% of positive Weil Felix tests among febrile children in northwest Ethiopia. 15,25 Nonetheless, our study is among the few studies using highly sensitive and specific real-time PCR methods to describe the presence of Rickettsia spp. in Ethiopia.…”

Section: Discussionmentioning

confidence: 95%

Treatable Bacterial Infections Are Underrecognized Causes of Fever in Ethiopian Children

Aarsland

Castellanos-González²,

Lockamy

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. Febrile illnesses remain a major cause of morbidity and mortality in resource-poor countries, but too often, tests are not available to determine the causes, leading to misdiagnosis and inappropriate treatment. To determine the cause of febrile illnesses, we recovered the malaria smears from 102 children presenting with fever to Soddo Christian Hospital in Wolaitta Soddo, Ethiopia. DNA was isolated from the smears and evaluated by real-time polymerase chain reaction. We identified pathogen DNA with probes for Plasmodium spp., Streptococcus pneumoniae, Rickettsia spp., Salmonella spp., and Borrelia spp. Overall, we showed that it is possible to isolate high-quality DNA and identify treatable pathogens from malaria blood smears. Furthermore, our data showed that bacterial pathogens (especially Pneumococcus, Rickettsia spp., and Borrelia spp.) are common and frequently unrecognized but treatable causes of febrile illnesses in Ethiopian children. BACKGROUND

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A Clinico-Epidemiological Study of Epidemic Typhus in Africa

Cited by 74 publications

References 25 publications

Seroprevalence of typhus fever at the Kality Prison, Addis Ababa, Ethiopia

Seroprevalence of typhus fever at the Kality Prison, Addis Ababa, Ethiopia

A Mixed Outbreak of Epidemic Typhus Fever and Trench Fever in a Youth Rehabilitation Center: Risk Factors for Illness from a Case-Control Study, Rwanda, 2012

Treatable Bacterial Infections Are Underrecognized Causes of Fever in Ethiopian Children

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