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Louse-borne relapsing fever: I. A clinical and laboratory study of 363 cases in the Sudan
Abstract:
Louse-borne relapsing fever seems to have become endemic in the southern Sudan. The epidemic history of the disease in the Sudan is reviewed. We have studied 363 Sudanese patients involved in an outbreak of louse-borne relapsing fever in Khartoum (Sudan) between January and June 1974. 318 of the 363 patients were new immigrants from the soughern Sudan to Khartoum. The clinical presentation varied. The common clinical fetures of the disease were: fever (94%), headache (85%), hepatosplenomegaly (74%), body and joint pains (66%), abdominal pain and tenderness (63%), jaundice (46%) and epistaxis (40%). Thrombocytopenia was common. Biochemical evidence of hepatocellular and renal damage was present in most patients. The mortality rate was 5-5% with treatment. Post-mortem examination was performed on six cases. The organs predominantly involved were the liver, spleen, brain and lungs. The common causes of death were severe hepatic damage, lobar pneumonia, subarachnoid haemorrhage and splenic rupture.
Insights
Louse-borne relapsing fever is endemic in southern Sudan. This study details a 1974 Khartoum outbreak, highlighting common symptoms like fever and jaundice, and a 5.5% mortality rate with treatment.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Louse-borne relapsing fever (LBRF) appears endemic in southern Sudan.
- A review of the epidemic history of LBRF in Sudan is presented.
- Sudan has faced recurrent outbreaks of LBRF.
Purpose of the Study:
- To describe the clinical presentation and outcomes of a louse-borne relapsing fever outbreak in Khartoum.
- To analyze the demographic and clinical features of patients during the outbreak.
- To identify common causes of mortality in treated patients.
Main Methods:
- A retrospective study of 363 Sudanese patients diagnosed with LBRF.
- Data collected from January to June 1974 during an outbreak in Khartoum.
- Clinical features, biochemical data, and post-mortem findings were analyzed.
Main Results:
- Fever (94%), headache (85%), and hepatosplenomegaly (74%) were common symptoms.
- Thrombocytopenia and biochemical evidence of hepatocellular and renal damage were prevalent.
- The mortality rate was 5.5% with treatment; common causes of death included hepatic damage and pneumonia.
Conclusions:
- Louse-borne relapsing fever poses a significant public health challenge in Sudan.
- Prompt diagnosis and treatment are crucial for reducing mortality.
- Further research into LBRF pathogenesis and prevention strategies is warranted.