Epidemiological Study of Endemic Relapsing Fever in Hamadan Province, Western Iran
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Abstract
Background: Endemic relapsing fever remains under diagnosed in our area according to a low index of suspicion among clinicians, as well as its difficult diagnosis. The goal of this study was to present the epidemiological aspects of the disease in western Iran.
Methods: In this analytical-descriptive cross-sectional study, the epidemiological and clinical aspects of relapsing fever were investigated in Hamadan Province, western Iran from 1999 to 2013. A confirmed patient was defined as a person who had both febrile illness and detected spirochetes by Wright-Giemsa or dark-field microscopy in a peripheral blood smear. For the statistical analysis, the statistical software SPSS was used.
Results: During the study period, 276 cases of relapsing fever were recorded that 146 were male. Due to the age group distributions, most of the patients aged less than 20 yr. Patients noticed from April through March, most cases were reported in September (53 cases, 19.2%). Considering time trend of the mentioned disease between 1999 and 2013 showed an increasing trend of disease from 1999 to 2003 (from 2.5% to 21.0%), while the prevalence of disease had a decreasing trend after than from 21.0% in 2003.
Conclusion: The rate of endemic relapsing fever is similar in both male and female genders, but its prevalence reduced by increase of age. The trend of the changes in prevalence of the mentioned disease has shown to be downward in recent years probably due to improving health policies especially among children and adolescents and particularly in rural areas.
Adler S, Theodor O, Schieber H (1937) Ob- servations on tick-transmitted human spirochaetosis in Palestine. Ann Trop Med Parasitol. 31: 25–35.
Aghighi Z, Assmar M, Piazak N, Javadian E, Seyedi Rashti MA, Kia EB, Rassi Y, Vatandoost H (2007) Distribution of soft ticks and their natural infection with Borrelia in a focus of relapsing fever in Iran. Iran J Arthropod Borne Dis. 1(2): 14–18.
Arshi S, Majidpoor A, Sadeghi Homayoun
ED, Asmar M, Emdadi D, Derakhshan MH (2002) Relapsing fever in Ardabil, a northwestern province of Iran. Arch Iranian Med. 5(3): 141–145.
Babudieri B (1955) Survey of relapsing fe- ver in Jordan, final report. WHO World Health Organization Regional Office for the Eastern Mediterranean, Geneva.
Baltazard M, Bahmanyar M, Mofidi C (1948) Sur les infections à spirochetes transmises par les ornithodores en Iran. Bull Soc Path Exot. 41: 141–146.
Baltazard M, Bahmanyar M, Mofidi C (1950) Ornithodoros erraticus et fièvres récurrentes. Bull Soc Path Exot. 43:595–601.
Blevins SM, Greenfield RA, Bronze MS (2008) Blood smear analysis in babesi-osis, ehrlichiosis, relapsing fever, ma- laria, and Chagas disease. Cleve Clin J Med. 75(7): 521–530.
Carlisle RJ (1906) Two cases of relapsing fever with notes on the occurrence of this disease throughout the world at the present day. J Infect Dis. 3: 233–265.
Colebunders R, De Serrano P, Van Gompel A,Wynants H, Blot K, Van den Enden E, Van den Ende J (1993) Imported relapsing fever in European tourists. Scand J Infect Dis. 25: 533–536.
Colin de Verdière N, Hamane S, Victor As- sous M, Sertour N, Ferquel E, Cornet M (2011) Tickborne Relapsing fever caused by Borrelia persica in Uzbeki- stan and Tajikistan. Emerg Inf Dis. 17:1325–1327.
Croche Santander B, Sánchez Carrión A, Campos E, Toro C2, Marcos L, Vargas JC, Tort T (2015) Tick-borne relapsing fever in a rural area of southern Spain. An Pediatr (Barc). 82(1): e73–77.
Cutler SJ, Abdissa A, Trape JF (2009) New concepts for the old challenge of Afri- can relapsing fever borreliosis. Clin Microb Inf. 15: 400-406.
Cutler SJ, Bonilla EM, Singh RJ (2010) Population structure of East African relapsing fever Borrelia spp. Emerg Infect Dis. 16(7): 1076–1080.
Davis G, Hoogstraal H (1954) The relapsing fevers: a survey of the tick-borne spi- rochetes of Egypt J Egypt Public Health Assoc. 29: 138–140.
Diatta G, Souidi Y, Granjon L, Arnathau C, Durand P, Chauvancy G, Mané Y, Sarih M, Belghyti D, Renaud F, Trape JF (2012) Epidemiology of tick-borne borreliosis in Morocco. Plos Neg Trop Dis. 6(9): e1810.
Dschunkowsky E (1913) Das Ru¨ckfallfieber in Persien. Dtsch Med Woc-henschr.39: 419–420
Dworkin MS, Schwan TG, Anderson DE Jr (2002) Tick-borne relapsing fever in North America. Med Clin North Am.86: 417–433.
Dworkin MS, Schwan TG, Anderson DE Jr, Borchardt SM (2008) Tick-borne re- lapsing fever. Infect Dis Clin North Am. 22(3): 449–468.
Dworkin MS, Shoemaker PC, Fritz CL, Dowell ME, Anderson DE (2002) The Epidemiology of tick-borne relapsing fever in the United States. Am J Trop Med Hyg. 66(6): 753–758.
Euzeby JP (1997) List of bacterial names with standing in nomenclature: a folder available on the Internet.. Int J Syst Bacteriol. 47: 590–592 (Last full up- date: December 06, 2008. URL: http:// www.bacterio.net).
Fukunaga M, Okada K, Nakao M, Konishi T, Sato Y (1996) Phylogenetic analysis of Borrelia species based on flagellin gene sequences and its application for molecular typing of Lyme disease bor- reliae. Int J Syst Bacteriol. 46: 898–905.
Goubau PF (1984) Relapsing fevers. A re- view. Ann Soc Belg Med Trop. 64:335–364.
Jump UP, Ryan KJ, Ray CG (editors) (2004) Sherris Medical Microbiology (4th ed). McGraw Hill. New York, USA.
Kalra SL, Rao KN (1951) Observations on the epidemiology of relapsing fever in Kashmir. Indian J Med Res. 39: 313–321.
Kassiri H, Kasiri A, Karimi M, Kasiri E, Lotfi M (2014) The seven-year longi- tudinal study on relapsing fever borre- liosis in Western Iran. Asian Pac J Trop Dis. 4(2): S679–S683.
Masoumi- Asl H, Goya MM, Vatandoost H, Zahraei SM, Mafi M, Asmar M, Pia- zak N, Aghighi Z (2009) The epidemi- ology of tick-borne relapsing fever in Iran during 1997-2006. Travel Med In- fect Dis. 7: 160–164.
Moemenbellah-Fard MD, Benafshi O, Raf- inejad J, Ashraf H (2009) Tick-borne'relapsing fever in a new highland en- demic focus of western Iran. Ann Trop Med Parasitol. 103(6): 529–537.
Nicholson FD (1919) Tick fever in Palestine.BMJ. 2: 811.
Platonov AE, Karan LS, Kolyasnikova NM, Makhneva NA, Toporkova MG, Ma- leev VV, Fish D, Krause PJ (2011) Humans infected with relapsing fever spirochete Borrelia miyamotoi, Russia. Emerg Infect Dis. 17(10): 1816–1823.
Rafinejad J, Shemshad K, Banafshi O (2012) Epidemiological study on tick-borne (Acari: Argasidae) relapsing fever in Kurdistan Province, IRAN, 2000-2004. Fla Entomol. 95(3): 758–763.
Rodhain F (1976) Borrelia et fièvres récur-rentes. Aspects épidémiologiques ac- tuels. Bull Inst Pasteur. 74: 173–218.
Rodhain F (1998) Joseph Desire Tholozan and the Persian relapsing fever. Hist Sci Med. 32: 309–13 (in French).
Schwan TG, Policastro PF, Miller Z, Thompson RL, Damrow T, Keirans JE (2003) Tick-borne relapsing fever caused by Borrelia hermsii, Montana. Emerg Infect Dis. 9(9): 1151–1154.
Sidi G, Davidovitch N, Balicer RD, Anis E, Grotto I, Schwartz E (2005) Tick- borne relapsing fever in Israel. Emerg Infect Dis. 11: 1784–1786.
Theodorides J (1998) A great Franco-Mau- ritian epidemiologist: Joseph DesireTholozan (1820–1897). Bull Soc Patho Exot. 91: 104–108.
Trape JF, Diatta G, Amathau C, Bitam I, Sa- rih M, Belghyti D, Bouattour,A, El- guero E, Vial L, Mané Y, Balde C, Pugnolle F, Chauvancy G, Mahé G, Granjon L, Duplantier JM, Durand P, Renaud F (2013) The epidemiology and geographic distribution of relaps- ing fever borreliosis in West and North Africa, with a review of the Orni- thodoros erraticus complex (Acari: Ix- odida). Plos One. 8(11): e78473.
Vatandoost H, Ghaderi A, Javadian E, Za- hirnia AH, Rassi Y, Piazak N, Kia EB, Shaeghi M, Telmodarreiy Z, Abolhasani M (2003) Distribution of soft ticks and their infection with Borrelia in Hama- dan Province, Iran. Iran J Public Health.32(1): 22–24.
Vial L, Diatta G, Tall A, Hadi Ba EL, Bou- ganali H, Durand P, Sokhna C, Rogier C, Renaud F, Trape JF (2006) Inci- dence of tick-borne relapsing fever in West Africa: longitudinal study. Lan- cet. 368: 37–43.
Wyplosz B, Milhaila Amrouche L, Baixench MT, Bigel ML, Berardi Grassias L, Fontaine C, Hornstein M, Izri A, Baranton G, Postic D (2005) Imported tick borne relapsing fever, France. Emerg Infect Dis. 11: 1801–1803.
| Files | ||
| Issue | Vol 10 No 4 (2016) | |
| Section | Original Article | |
| Keywords | ||
| Endemic relapsing fever Tick Borrelia Epidemiology Iran | ||
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