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Rickettsia felis Infection in Febrile Children, Ghana
Peter Sothmann1,2, Christian Keller3, Ralf Krumkamp2,4
1Division of Tropical Medicine, 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Insights
Rickettsia felis, a cause of febrile illness, was detected in 1.5% of Ghanaian children. This finding highlights the widespread occurrence of Rickettsia felis infections in sub-Saharan Africa.
Area of Science:
- Infectious Diseases
- Molecular Diagnostics
- Pediatrics
Background:
- Rickettsial infections are a significant, yet often overlooked, cause of febrile illness in sub-Saharan Africa.
- Understanding the epidemiology of these infections is crucial for public health in the region.
Purpose of the Study:
- To investigate the prevalence and clinical characteristics of rickettsial disease in pediatric patients in Ghana.
- To identify specific Rickettsia species affecting children in the Ashanti Region.
Main Methods:
- Real-time polymerase chain reaction (PCR) was used to screen blood samples from febrile children (<15 years) in Ghana's Ashanti Region.
- Two independent PCR assays were employed to detect rickettsial DNA.
- Samples were analyzed for coinfection with Plasmodium falciparum.
Main Results:
- Rickettsia felis DNA was detected in 7 out of 470 (1.5%) blood samples.
- No other Rickettsia species were identified.
- Coinfection with Plasmodium falciparum was observed in 3 of the 7 R. felis-positive cases. Common symptoms included fever, cough, and vomiting; rash was notably absent in positive cases.
Conclusions:
- This study provides the first report of Rickettsia felis in Ghana.
- The findings support the increasing evidence of Rickettsia felis's prevalence in sub-Saharan Africa, often co-occurring with malaria.
Abstract:
AbstractRickettsial infections are an underrecognized cause of febrile illness in sub-Saharan Africa. To evaluate the epidemiology and clinical features of rickettsial disease in pediatric patients in Ghana, we screened blood samples from febrile children aged less than 15 years presenting to an outpatient department in Ghana's Ashanti Region for the presence of rickettsial DNA. We detected Rickettsia felis in 7/470 (1.5%) blood samples, using two independent real-time polymerase chain reactions. No other Rickettsia species were found. R. felis was detected repeatedly in one patient, and coinfection with Plasmodium falciparum was found in 3/7 samples. Symptoms apart from fever included cough (6/7) and vomiting (4/7). None of the R. felis-positive patients reported a rash. This study is the first report on R. felis in Ghana and adds to the growing evidence for its widespread occurrence with and without malaria coinfection in sub-Saharan Africa.
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