Incidence of tick-borne relapsing fever in west Africa: longitudinal study
Incidence of tick-borne relapsing fever in west Africa: longitudinal study
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DOI：
10.1016/s0140-6736(06)68968-x
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发表时间：
2006-07-01
期刊：
影响因子：
168.9
通讯作者：
Trape, Jean-Francois
中科院分区：
文献类型：
--
作者：
Vial, Laurence;Diatta, Georges;Trape, Jean-Francois
背景撒哈拉以南国家持续的干旱导致了殖民化。非洲西部热带草原上的一种蜱虫，由松瑞鸟蜱（Ornithodoros sonrai）传播;这种蜱虫是引起蜱传回归热（TBRF）的鳄鱼疏螺旋体的传播媒介。我们的目的是确定TBRF在西非的发病率。方法从1990年至2003年，我们监测了TBRF在塞内加尔迪尔莫的发病率，每日临床监测和个人的血液检测发烧。从2002年至2005年，我们调查了存在0 sonrai在30个村庄，在塞内加尔，毛里塔尼亚和马里，并通过PCR的患病率测量的B crocidurae.Findings TBRF超过14年的平均发病率为11每100人-年（范围从1990年的4至25在1997年）。所有年龄组的发病率都很高。除了复发外，同一个体的重复感染也很常见，在研究期间，有些人受到多达六种不同感染的影响。流行病学研究表明，30个研究村庄中有26个（87%）被媒介蜱0 sonrai定殖，媒介的平均B crocidurae感染率为31%。在大多数被调查的村庄中存在病媒蜱及其高感染率表明，在塞内加尔、毛里塔尼亚和马里的大多数农村地区，结核分枝杆菌出血热是发热的常见原因。
Background The ongoing drought in sub-Saharan countries has led to the colonisation. of west African Savanna by Ornithodoros sonrai; this tick acts as a vector for Borrelia crocidurae, which causes tick-borne relapsing fever (TBRF). Our aim was to ascertain the incidence of TBRF in west Africa.Methods From 1990 to 2003, we monitored the incidence of TBRF in Dielmo, Senegal, by daily clinical surveillance and by blood testing of individuals with a fever. From 2002 to 2005, we investigated the presence of 0 sonrai in 30 villages in Senegal, Mauritania, and Mali, and measured by PCR the prevalence of B crocidurae.Findings The average incidence of TBRF over 14 years was 11 per 100 person-years (range from 4 in 1990 to 25 in 1997). All age-groups presented a high incidence of the disease. In addition to relapses, repeated infections in the same individuals were common, with some affected by up to six distinct infections during the study period. Epidemiological studies indicated that 26 of the 30 studied villages (87%) were colonised by the vector tick 0 sonrai and that the average B crocidurae infection rate of the vector was 31%.Interpretation The incidence of TBRF at the community level is the highest described in Africa for any bacterial disease. The presence of the vector tick in most villages investigated and its high infection rate suggest that TBRF is a common cause of fever in most rural areas of Senegal, Mauritania, and Mali.