FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
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.
Get Full Text
Publication Date: 2018-10-31 PubMed ID: 30379820PubMed Central: PMC6242695DOI: 10.1371/journal.pntd.0006911Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article
  • Research Support
  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

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.

References

This article includes 26 references
  1. Acosta J, Urquijo L, Diaz A, Sepúlveda M, Mantilla G, Heredia D. Brote de rickettsiosis en Necoclí, Antioquia, febrero- marzo de 2006.. Inf Quinc Epidemiol Nac 2006;11: 177–192.
  2. García Pacheco OE, Giraldo MR, Duran M, Hidalgo M, Echeverri I, Rodríguez L. Estudio de brote febril hemorrágico en el corregimiento de Alto de Mulatos—Distrito Especial Portuario de Turbo, Antioquia, enero de 2008.. Inf Quinc Epidemiol Nac 2008;13: 145–160.
  3. Hidalgo M, Miranda J, Heredia D, Zambrano P, Vesga JF, Lizarazo D. Outbreak of Rocky Mountain spotted fever in Córdoba, Colombia.. Mem Inst Oswaldo Cruz 2011;106: 117–8.
    doi: 10.1590/S0074-02762011000100019pubmed: 21340366google scholar: lookup
  4. Biggs HM, Behravesh C, Bradley K, Dahlgren S, Drexler N, Dumler JS. Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis—United States.. Morb Mortal Wkly Report Recomm Reports 2016;65: 1–44.
    doi: 10.15585/mmwr.rr6502a1pubmed: 27172113google scholar: lookup
  5. Oteo JA, Nava S, de Sousa R, Mattar S, Venzal JM, Abarca K. Guías Latinoamericanas de la RIICER para el diagnóstico de las rickettsiosis transmitidas por garrapatas.. Rev Chil Infectología 2014;31: 54–65.
    pubmed: 24740776
  6. Quintero JC, Londoño AF, Díaz FJ, Agudelo-flórez P, Arboleda M, Rodas JD. Ecoepidemiología de la infección por rickettsias en roedores, ectoparásitos y humanos en el noroeste de Antioquia, Colombia.. Biomedica 2013;33: 38–51.
    doi: 10.7705/biomedica.v33i0.735pubmed: 24652248google scholar: lookup
  7. Arroyave E, Londoño AF, Quintero JC, Agudelo-flórez P, Arboleda M, Díaz FJ. Etiología y caracterización epidemiológica del síndrome febril no palúdico en tres municipios del Urabá antioqueño, Colombia.. Biomedica 2013;33: 99–107.
    doi: 10.7705/biomedica.v33i0.734pubmed: 24652254google scholar: lookup
  8. Londoño AF, Acevedo-Gutierrez L, Marín D, Contreras V, Díaz FJ, Valbuena G. Human prevalence for Rickettsias of the Spotted Fever Group (SFG) in endemic zones of Northwestern Colombia.. Ticks Tick Borne Dis 2017;8: 477–482.
    doi: 10.1016/j.ttbdis.2017.02.006pubmed: 28223058google scholar: lookup
  9. Amortegui-Torres V, Taborda-Marin A, Blanco JF. Edge effect on a Neritina virginea (Neritimorpha, Neritinidae) population in a black mangrove stand (Magnoliopsida, Avicenniaceae: Avicennia germinans) in the Southern Caribbean.. Panam J Aquat Sci 2013;8: 68–78.
  10. Quintero JC, Paternina LE, Uribe Y A, Muskus C, Hidalgo M, Gil J. Eco-epidemiological analysis of rickettsial seropositivity in rural areas of Colombia: A multilevel approach.. PLoS Negl Trop Dis 2017;18: 1–19.
    doi: 10.1371/journal.pntd.0005892pmc: PMC5619838pubmed: 28922404google scholar: lookup
  11. Organización Panamericana de la Salud/Universidad CES. Epidat: Programa para análisis epidemiológico de datos. Versión 4.1.. Galicia, España; 2014.
  12. Portillo A, Sousa R De, Santiba S, Duarte A, Edouard S, Novakova M. Guidelines for the Detection of Rickettsia spp.. Vector borne zoonotic Dis 2017;17: 23–32.
    doi: 10.1089/vbz.2016.1966pubmed: 28055574google scholar: lookup
  13. Souza CE, Camargo LB, Pinter A. High Seroprevalence for Rickettsia rickettsii in Equines Suggests Risk of Human Infection in Silent Areas for the Brazilian Spotted Fever.. PLoS One 2016;11: 1–9.
    doi: 10.1371/journal.pone.0153303pmc: PMC4827800pubmed: 27064788google scholar: lookup
  14. Horta MC, Labruna MB, Sangioni LA, Vianna MCB, Gennari SM, Mafra CL. Prevalence of antibodies to Spotted Fever Group rickettsiae in humans and domestic animals in a Brazilian Spotted Fever-endemic area in the state of São Paulo, Brazil: serologic evidence for infection by Rickettsia rickettsii and another Spotted Fever Gr.. Am J Trop Med Hyg 2004;71: 93–97.
    doi: 10.4269/ajtmh.2004.71.93pubmed: 15238696google scholar: lookup
  15. Omar RZ, Thompson SG. Analysis of a cluster randomized trial with binary outcome data using a multi-level model.. Stat Med 2000;19: 2675–2688.
    doi: 10.1002/1097-0258(20001015)19:19<2675::AID-SIM556>3.0.CO;2-Apubmed: 10986541google scholar: lookup
  16. Hosmer DW, Lemeshow S. Applied Logistic Regression Second Edi. John Wiley and Sons I, editor. Wiley Series in Probability and Sattistics. New York: A Wiley-Interscience Publication; 2000.
    doi: 10.2307/2074954google scholar: lookup
  17. SAS software 9.04.01. North Caroline, USA; 2016.
  18. Localio AR, Margolis DJ, Berlin JA. Relative risks and confidence intervals were easily computed indirectly from multivariable logistic regression.. J Clin Epidemiol 2007;60: 874–882.
    doi: 10.1016/j.jclinepi.2006.12.001pubmed: 17689803google scholar: lookup
  19. Hidalgo M, Orejuela L, Fuya P, Carrillo P, Hernandez J, Parra E. Rocky Mountain Spotted Fever, Colombia.. Emerg Infect Dis 2007;13: 1058–1060.
    doi: 10.3201/eid1307.060537pmc: PMC2878212pubmed: 18214179google scholar: lookup
  20. Wallace JW, Nicholson WL, Perniciaro JL, Vaughn MF, Funkhouser S, Juliano JJ. Incident Tick-Borne Infections in a Cohort of North Carolina Outdoor Workers.. Vector Borne Zoonotic Dis 2016;16: 1–7.
    doi: 10.1089/vbz.2015.1839pubmed: 27008102google scholar: lookup
  21. Delisle J, Mendell NL, Stull-Lane A, Bloch KC, Bouyer DH, Moncayo AC. Human Infections by Multiple Spotted Fever Group Rickettsiae in Tennessee.. Am J Trop Med Hyg 2016;94: 1212–1217.
    doi: 10.4269/ajtmh.15-0372pmc: PMC4889736pubmed: 27022147google scholar: lookup
  22. Openshaw JJ, Swerdlow DL, Krebs JW, Holman RC, Mandel E, Harvey A. Rocky mountain spotted fever in the United States, 2000–2007: interpreting contemporary increases in incidence.. Am J Trop Med Hyg 2010;83: 174–82.
    doi: 10.4269/ajtmh.2010.09-0752pmc: PMC2912596pubmed: 20595498google scholar: lookup
  23. McQuiston JH, Holman RC, Groom a V, Kaufman SF, Cheek JE, Childs JE. Incidence of Rocky Mountain spotted fever among American Indians in Oklahoma.. Public Health Rep 2000;115: 469–75.
    doi: 10.1093/phr/115.5.469pmc: PMC1308603pubmed: 11236019google scholar: lookup
  24. Holman RC, McQuiston JH, Haberling DL, Cheek JE. Increasing incidence of Rocky Mountain spotted fever among the American Indian population in the United States.. Am J Trop Med Hyg 2009;80: 601–5.
    pubmed: 19346384
  25. Dahlgren FS, Paddock CD, Springer YP, Eisen RJ. Expanding Range of Amblyomma americanum and Simultaneous Changes in the Epidemiology of Spotted Fever Group Rickettsiosis in the United States.. Am J Trop Med Hyg 2016;94: 35–42.
    doi: 10.4269/ajtmh.15-0580pmc: PMC4710442pubmed: 26503270google scholar: lookup
  26. Faccini-Martínez Á a, García-Álvarez L, Hidalgo M, Oteo J a. Syndromic classification of rickettsioses: an approach for clinical practice.. Int J Infect Dis 2014;28: 126–39.
    doi: 10.1016/j.ijid.2014.05.025pubmed: 25242696google scholar: lookup

Citations

This article has been cited 8 times.
  1. Gual-Gonzalez L, Cantillo-Barraza O, Torres ME, Quintero-Vélez JC, Medina M, Self SCW, Nolan MS. Antibody Seroprevalence to Spotted Fever Group Rickettsiae in Miraflores, Colombia: A Cross-Sectional Study in Humans and Dogs. Am J Trop Med Hyg 2024 Jun 5;110(6):1245-1252.
    doi: 10.4269/ajtmh.23-0593pubmed: 38593790google scholar: lookup
  2. Gual-Gonzalez L, Torres ME, Self SCW, Cantillo-Barraza O, Nolan MS. Spotted Fever Group Rickettsia spp. Molecular and Serological Evidence among Colombian Vectors and Animal Hosts: A Historical Review. Insects 2024 Mar 2;15(3).
    doi: 10.3390/insects15030170pubmed: 38535366google scholar: lookup
  3. Torres-Bustamante M, Cantillo-Barraza O, Ko AI, Wunder EA, Quintero-Vélez JC. Eco-epidemiological study of seropositivity against Rickettsia and Leptospira agents in rural areas of Urabá, Colombia. Res Sq 2024 Jan 4;.
    doi: 10.21203/rs.3.rs-3760267/v1pubmed: 38260656google scholar: lookup
  4. Silva-Ramos CR, Gil-Mora J, Serna-Rivera CC, Martínez Díaz HC, Restrepo-López N, Agudelo-Flórez P, Arboleda M, Díaz FJ, Faccini-Martínez ÁA, Hidalgo M, Melby PC, Aguilar PV, Cabada MM, Tobón-Castaño A, Rodas JD. Etiological characterization of acute undifferentiated febrile illness in Apartadó and Villeta municipalities, Colombia, during COVID-19 pandemic. Infez Med 2023;31(4):517-532.
    doi: 10.53854/liim-3104-11pubmed: 38075419google scholar: lookup
  5. Quintero-Vélez JC, Rodas JD, Rojas CA, Ko AI, Wunder EA. Leptospira Infection in Rural Areas of Urabá Region, Colombia: A Prospective Study. Am J Trop Med Hyg 2022 Dec 14;107(6):1267-1277.
    doi: 10.4269/ajtmh.21-1103pubmed: 36375452google scholar: lookup
  6. Quintero-Vélez JC, Cienfuegos-Gallet AV, Quintero LO, Úsuga AF, Cifuentes S, Solari S, Rodas JD, Diaz FJ, Rojas CA. Epidemiology of Rickettsial Infection in the Municipality of Uramita, Colombia. Am J Trop Med Hyg 2021 Aug 9;105(4):1013-1023.
    doi: 10.4269/ajtmh.20-0104pubmed: 34370699google scholar: lookup
  7. Bragagnollo GR, Camargo RAA, Guimarães MDN, Santos TSD, Monteiro ELM, Ferreira BR. Development and validation of an interactive educational technology on spotted fever. Rev Lat Am Enfermagem 2020;28:e3375.
    doi: 10.1590/1518-8345.3678.3375pubmed: 33027405google scholar: lookup
  8. Villar D, Schaeffer DJ. Disarmament is the New War, Gold is the New Opium, and Ecohealth is the Historic Victim. Environ Health Insights 2019;13:1178630219862241.
    doi: 10.1177/1178630219862241pubmed: 31320800google scholar: lookup
Subscribe to our newsletter
Join 99,780 horse owners like you who receive our email updates on horse health and nutrition.