Epidemiological evaluation of Mediterranean spotted fever in children of the Karak province in south Jordan

  • Omar Nafi Faculty of Medicine, Mutah University, Karak, Jordan
  • Yasseen Tarawnah Karak Health Directorate, Ministry of Health, Karak, Jordan
  • Amjad Tarawnah Faculty of Medicine, Mutah University, Karak, Jordan
Keywords: Mediterranean spotted fever, Rickettsia conorii, Jordan, children, epidemiology

Abstract

Introduction: The aim of this study was to describe the epidemiological patterns of Mediterranean spotted fever (MSF) as well as its treatment and outcomes in children in south Jordan.

Methodology: A retrospective observational study was conducted from June 2013 to December 2015. Data regarding demographics, clinical presentation, laboratory findings, treatment, and outcomes were collected.

Results: In total, 35 male and 20 female patients (mean age: 6 years ± 3.6) were included. The incidence of MSF was 7.9 cases/100,000 inhabitants/year; MSF affected 89% of individuals in the summer, 74.5% of those living in a rural area with tent housing, and 100% of those who had contact with animals. All cases presented with fever, and 94.5% had a skin rash. Serological tests were positive in 87.2% of cases, and Rickettsia conorii (the Moroccan strain) was present in all positive cases. All cases had thrombocytopenia, but none had leukocytosis. Hyponatremia was present in 71% of cases, and 49%, 61.8%, and 72.7% had increased urea, alanine transaminase, and aspartate aminotransferase levels, respectively. Doxycycline was administered to all patients, with a cure rate of 96.4% and mortality rate of 3.6%.

Conclusions: MSF caused by R. conorii (the Moroccan strain) is prevalent in Jordan, and contact with animals is the route of transmission. The patients’ responses to doxycycline were excellent. A high index of suspicion, early diagnosis, and specific treatment considerably decrease mortality. MSF should be considered as a possible cause of febrile disease in those with a rash and in those living in rural areas.

Author Biographies

Omar Nafi, Faculty of Medicine, Mutah University, Karak, Jordan

associated professor of pediatrics

Pediatric departement, faculty of medicine

 

Yasseen Tarawnah, Karak Health Directorate, Ministry of Health, Karak, Jordan
Disease Control Department, Karak Health Directorate,
Amjad Tarawnah, Faculty of Medicine, Mutah University, Karak, Jordan
assistant professor of pediatrics, pediatric departement
faculty of medicine.
Published
2017-03-31
How to Cite
1.
Nafi O, Tarawnah Y, Tarawnah A (2017) Epidemiological evaluation of Mediterranean spotted fever in children of the Karak province in south Jordan. J Infect Dev Ctries 11:242-246. doi: 10.3855/jidc.8154
Section
Original Articles