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Home / Equine Research Bank / PLoS Negl Trop Dis / Epidemiological characterization of incident cases of Ricket...
PLoS neglected tropical diseases2018; 12(10); e0006911; doi: 10.1371/journal.pntd.0006911

Epidemiological characterization of incident cases of Rickettsia infection in rural areas of Urabá region, Colombia.

Abstract: Most of the studies related to rickettsial infection in Colombia are cross-sectional because of the challenge in conducting prospective studies on infectious disease that may have a difficult diagnosis. Although cross-sectional studies are essential to detect people exposed to rickettsiae, they are not suited to demonstrate the recent circulation of this pathogen in areas at risk of transmission. To characterize the epidemiology of incident cases of Spotted fever group (SFG) rickettsial infection in humans and equines from rural areas of Urabá region in Colombia where outbreaks of rickettsiae previously occurred. A prospective study was conducted in the Alto de Mulatos and Las Changas in the Urabá region. Serum samples and socio-ecological information were collected from 597 people enrolled in 2015, and a second sample was collected from 273 people a year later. Indirect immune-fluorescence assays for detection of IgG antibody against rickettsiae were done using slides with Rickettsia rickettsii antigens. A titer ≥128 was considered positive. Incident cases were defined as (i) serological conversion of IgG titers from seronegative to seropositive or (ii) at least a four-fold increase in IgG end point titers in the second sample. The cumulative incidence of rickettsial infection was 6.23% (95%CI 3.67-9.78) in humans and 32.31% (21/65) of incident cases in equines. Incident cases were mostly females (82.35%), the median age of cases was 41.02 years (IQR 18.62-54.1), and 29.41% reported tick bites during the study period. Results from multivariate analysis showed that removal of ticks after working outdoors is a protective factor for rickettsial infection (RR 0.26, 95%CI 0.08-0.84) and that a higher incidence of infection occurred in people who reported fever in the last year (RR 4.26, 95%CI 1.15-9.31). These results showed recent circulation of SFG rickettsiae in areas where previous lethal outbreaks have been reported, supporting the implementation of preventive measures to halt rickettsial transmission in the studied communities.
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Publication Date: 2018-10-31 PubMed ID: 30379820PubMed Central: PMC6242695DOI: 10.1371/journal.pntd.0006911Google Scholar: Lookup
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Summary

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This study aims to explore and characterize the ongoing cases of Rickettsial (Spotted Fever Group) infection among humans and equines in rural areas of the Urabá region in Colombia. The researchers found a considerable incidence rate of these infections and suggested that taking off ticks after outdoor activities could reduce risk of infection. They call for urgent preventive measures to curb the transmission in these communities.

Introduction

  • The research study focuses on the ongoing cases of Rickettsial infection, a bacterial disease transmitted through tick bites, in the Urabá region of Colombia, where there were prior lethal outbreaks.
  • Previous studies in the region have been cross-sectional, meaning they look at data from a population at a specific point in time. While these types of studies are essential for identifying people who have been exposed to the Rickettsia bacteria, they do not reveal recent circulations of the pathogen.

Methods

  • The researchers conducted a prospective study, a type of observational study that follows over time a group of similar individuals (cohorts) who differ with respect to certain factors under study, to observe how these factors affect rates of a certain outcome.
  • The study was carried out in areas of the Alto de Mulatos and Las Changas in the Urabá region, where there were previous outbreaks of the disease.
  • The research team gathered serum samples and socio-ecological data from 597 individuals in 2015 and took another sample from 273 people a year later.
  • Their method of detecting the presence of the Rickettsia bacteria was through Indirect immune-fluorescence assays, a technique used to measure the concentration of antibodies in the blood which indicate an immune response to the bacteria.

Results

  • According to the test results, the cumulative incidence of Rickettsial infection among humans was 6.23%, and 32.31% of cases were found among equines.
  • Most of the infected cases were females, making up 82.35% of the total.
  • The median age of the infected individuals was 41.02 years, and 29.41% reported a tick bite during the study period.
  • The study also identified protective and risk factors for the infection. Removing ticks after outdoor work was a protective factor, reducing the risk of acquiring the Rickettsial infection.
  • Individuals who had reported having a fever in the past year had a much higher infection rate.

Conclusion

  • The researchers concluded that the current incidence of Rickettsial infection demonstrates ongoing circulation of the Rickettsia bacteria in areas that had earlier reported lethal outbreaks of the disease.
  • Consequently, they recommend the urgent implementation of preventive measures to stop the transmission of Rickettsia in the communities involved in the study.

Cite This Article

APA
Quintero Vélez JC, Aguirre-Acevedo DC, Rodas JD, Arboleda M, Troyo A, Vega Aguilar F, Osorio Quintero L, Rojas Arbeláez C. (2018). Epidemiological characterization of incident cases of Rickettsia infection in rural areas of Urabá region, Colombia. PLoS Negl Trop Dis, 12(10), e0006911. https://doi.org/10.1371/journal.pntd.0006911

Publication

PLoS neglected tropical diseases
ISSN: 1935-2735
NlmUniqueID: 101291488
Country: United States
Language: English
Volume: 12
Issue: 10
Pages: e0006911

Researcher Affiliations

Quintero Vélez, Juan Carlos
  • Grupo de Investigación Ciencias Veterinarias Centauro, Facultad de Ciencias Agrarias, Universidad de Antioquia, Medellín, Colombia.
Aguirre-Acevedo, Daniel Camilo
  • Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Rodas, Juan David
  • Grupo de Investigación Ciencias Veterinarias Centauro, Facultad de Ciencias Agrarias, Universidad de Antioquia, Medellín, Colombia.
Arboleda, Margarita
  • Instituto Colombiano de Medicina Tropical- CES, Apartadó, Antioquia, Colombia.
Troyo, Adriana
  • Centro de Investigación en Enfermedades Tropicales, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
Vega Aguilar, Francisco
  • Centro de Investigación en Enfermedades Tropicales, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
Osorio Quintero, Lisardo
  • Grupo Salud y Ambiente, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia.
Rojas Arbeláez, Carlos
  • Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia.

MeSH Terms

  • Adolescent
  • Adult
  • Age Distribution
  • Animals
  • Antibodies, Bacterial / blood
  • Colombia / epidemiology
  • Female
  • Fluorescent Antibody Technique, Indirect
  • Horse Diseases / epidemiology
  • Horses
  • Humans
  • Immunoglobulin G / blood
  • Incidence
  • Male
  • Prospective Studies
  • Rural Population
  • Sex Factors
  • Spotted Fever Group Rickettsiosis / epidemiology
  • Spotted Fever Group Rickettsiosis / veterinary
  • Young Adult

Conflict of Interest Statement

The authors have declared that no competing interests exist.

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