Nationwide prevalence of Rickettsia felis infections in patients with febrile illness in Bangladesh

Chowdhury, Nayeem; Paul, Shyamal Kumar; Aung, Meiji Soe; Hossain, Md. Akram; Ahmed, Salma; Haque, N; Nasreen, S A; Khan, Shafiqul Islam; Rahman, Shahriar; Rahman, Abu Shahin Mohammed Mahbubur; Ferdouse, Faria; Ahmed, Rajib; Sultan, Serageldeen; Ahmed, Muzahed Uddin; Urushibara, Noriko; Kobayashi, Nobumichi

doi:10.1016/j.nmni.2017.07.005

Cited by 4 publications

(6 citation statements)

References 12 publications

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“…The presence of rickettsial pathogens was investigated in eight places in all the divisions of Bangladesh. 15 In the present study, (26.1%) cases were confirmed among three bio-groups of rickettsial diseases by IFA from direct sera in febrile ill patients. The most frequent bio-group (35%) was typhus group followed by (32.5%) were scrub typhus group and (25%) were spotted fever group and (7.5%) were intermediate group (TG/ SFG) of rickettsioses.…”

Section: Resultssupporting

confidence: 63%

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Comparison of Immunofluorescence Assays Results for Diagnosis of Rickettsial Diseases Using Direct Serum and Filter Paper Serum Spots

et al. 2021

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Background: Rickettsial diseases are difficult to diagnose in Bangladesh due to low index of suspicion and lack of diagnostic facilities in most laboratories especially in rural areas. Immunofluorescence assay (IFA) is the gold standard serological test for diagnosis of Rickettsial diseases. For serological diagnosis of rickettsial diseases, use of filter paper is an inexpensive and convenient method for collecting, storing, and transporting of blood samples with little space without refrigeration. Current study shows that the rickettsial diseases were present in febrile patients in Bangladesh. The study also compared the results of direct serum by IFA and filter paper serum spot followed by IFA as an alternative way of testing frozen samples. Materials and Methods: This observational study for evaluation of rickettsial diseases from direct serum by IFA and sera dried on blotting paper followed by IFA at the department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. A total of 152 patients’ sera were selected by systemic random sampling of every 3rd sera of 556 febrile patients who were tested negative for dengue and or Chikungunya virus infection. Forty cases were confirmed by IFA from direct sera. In addition, 60 samples were selected from 152 sera by systemic random sampling of every 3rd sera for blotting on filter paper for further IFA test. Out of 60 sera, 35 were confirmed by IFA from direct sera and of the 35 confirmed positive cases, 31(88.6%) were positive by IFA after blotting paper assay. Taking the IFA of direct sera as gold standard test, the sensitivity, specificity, positive predictive value and negative predictive value of IFA from blotting paper eluted sera were 88%, 100%, 100% and 86% respectively. Conclusion: The study showed the use of filter paper is an inexpensive and convenient method for storing and transporting samples for serological tests like IFA in diagnosis of rickettsial diseases. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 153-158

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Section: Resultssupporting

confidence: 63%

“…2 There are few available published data regarding the presence of rickettsial diseases from Bangladesh are also found. 3,4,14,15 Rickettsial diseases are the oldest known vectorborn diseases 6 and may cause serious public health problems. Morbidity and mortality rates vary among various types of rickettsial diseases.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Immunofluorescence Assays Results for Diagnosis of Rickettsial Diseases Using Direct Serum and Filter Paper Serum Spots

et al. 2021

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“… 108 In more recent years, there have been increasing reports of circulating R. felis DNA from febrile patients in sub-Saharan Africa 109–111 and Asia. 112 , 113 Interestingly, when control subjects have been added to similar investigations, R. felis DNA has also been found from non-febrile controls as well as those with fever. 114 , 115 Molecular detection of the organism has been reported from skin lesions of patients as well as from swabs taken from the skin of healthy subjects.…”

Section: The Curious and Controversial Epidemiology Of Flea-borne Spomentioning

confidence: 92%

Manifestations and Management of Flea-Borne Rickettsioses

Martinez

Ramírez-Hernández

Blanton

2021

RRTM

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Murine typhus and flea-borne spotted fever are undifferentiated febrile illnesses caused by Rickettsia typhi and Rickettsia felis , respectively. These organisms are small obligately intracellular bacteria and are transmitted to humans by fleas. Murine typhus is endemic to coastal areas of the tropics and subtropics (especially port cities), where rats are the primary mammalian host and rat fleas ( Xenopsylla cheopis ) are the vector. In the United States, a cycle of transmission involving opossums and cat fleas ( Ctenocephalides felis ) are the presumed reservoir and vector, respectively. The incidence and distribution of murine typhus appear to be increasing in endemic areas of the US. Rickettsia felis has also been reported throughout the world and is found within the ubiquitous cat flea. Flea-borne rickettsioses manifest as an undifferentiated febrile illness. Headache, malaise, and myalgia are frequent symptoms that accompany fever. The incidence of rash is variable, so its absence should not dissuade the clinician to consider a rickettsial illness as part of the differential diagnosis. When present, the rash is usually macular or papular. Although not a feature of murine typhus, eschar has been found in 12% of those with flea-borne spotted fever. Confirmatory laboratory diagnosis is usually obtained by serology; the indirect immunofluorescence assay is the serologic test of choice. Antibodies are seldom present during the first few days of illness. Thus, the diagnosis requires acute- and convalescent-phase specimens to document seroconversion or a four-fold increase in antibody titer. Since laboratory diagnosis is usually retrospective, when a flea-borne rickettsiosis is considered, empiric treatment should be initiated. The treatment of choice for both children and adults is doxycycline, which results in a swift and effective response. The following review is aimed to summarize the key clinical, epidemiological, ecological, diagnostic, and treatment aspects of flea-borne rickettsioses.

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“…Well-Felix is a nonspecific agglutination test which detects anti-rickettsial antibodies in patient's serum. Well-Felix test is based on crossreactions which occur between antibodies produced in acute rickettsial infections with antigens of OX (OX 19, OX 2, and OXK) strains of Proteus species 4 . The Well-Felix test can be done as either a slide or a tube test.…”

Section: Introductionmentioning

confidence: 99%

“…Islam MA and his colleagues found that Brucella prevalence was (2.5-18.6) % in Bangladesh 16 . Chowdhury et al17 found Rickettsia felis in blood samples from all the regions in Bangladesh was 19.6% cases. In this study Brucella species was not found, it may be due to patients attended at OPD may not have history of contact with domestic animals.…”

mentioning

confidence: 98%

Status of Triple Antigen Test among Community Acquired Febrile Illness Patient attended at Tertiary Care Hospital, Bogura

Yasmin¹,

Yusuf

Mowla³

et al. 2020

Bangladesh J. Infect. Dis.

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Background: Bacterial etiologies of febrile illnesses have significantly become important due to high mortality and morbidity. Objective: This study aimed to identify the prevalence of rickettsial fever, brucellosis, and typhoid fever by triple antigen test. Methodology: This cross-sectional study was conducted at TMSS Medical College Bogura district in Bangladesh for 6 months. Febrile patients aged from 1 to 65 years of both sexes were recruited from the outpatient department of this Medical College Bogura. Blood sample were taken from all patients for antibody test by microscopic plate agglutination test according to manufacturer instruction. Results: A total of 140 patients were enrolled and 74/140 (52.86%) patients were positive by any of three antigens, among them female were 54/74 (72.97%), most common age group was 21 to 30 years which was 22/74(29.73%), TO titre was greater than TH titre, which was 24/36 (66.66%). Conclusion: The study has underscored the importance of febrile antigen detection for bacterial diseases including zoonosis such as ricketial fever, brucellosis and typhoid fever in febrile patient and thus reducing diagnostic dilemma of febrile diseases. However, further diagnostic tests for diagnosis of febrile illnesses also needed. This will be helpful for febrile patients to receive the correct diagnoses and facilitation of accurate and prompt treatment. Bangladesh Journal of Infectious Diseases 2020;7(1):18-21

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Nationwide prevalence of Rickettsia felis infections in patients with febrile illness in Bangladesh

Cited by 4 publications

References 12 publications

Comparison of Immunofluorescence Assays Results for Diagnosis of Rickettsial Diseases Using Direct Serum and Filter Paper Serum Spots

Comparison of Immunofluorescence Assays Results for Diagnosis of Rickettsial Diseases Using Direct Serum and Filter Paper Serum Spots

Manifestations and Management of Flea-Borne Rickettsioses

Status of Triple Antigen Test among Community Acquired Febrile Illness Patient attended at Tertiary Care Hospital, Bogura

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