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Rickettsia felis Infection in Febrile Children, Ghana

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  • 1 Division of Tropical Medicine, 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • 2 Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
  • 3 Institute of Virology, University Hospital Giessen and Marburg, Marburg, Germany.
  • 4 German Center for Infection Research (DZIF), Partner Site Hamburg-Borstel-Lübeck, Hamburg, Germany.
  • 5 Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Rickettsial 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.

Author Notes

* Address correspondence to Peter Sothmann, Division of Tropical Medicine, 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. E-mail: p.sothmann@uke.de† These authors contributed equally to this work.

Financial support: This work was supported by grants from the German Center for Infection Research (Deutsches Zentrum für Infektionsforschung, DZIF, www.dzif.de) to Ralf Krumkamp (grant number: 80 00 201-3, TI 03.001) and Benno Kreuels (grant number: TI 07.001).

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Authors' addresses: Peter Sothmann, Division of Tropical Medicine, 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, and Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany, E-mail: p.sothmann@uke.de. Christian Keller, Institute of Virology, University Hospital Giessen and Marburg, Marburg, Germany, E-mail: christian.keller@staff.uni-marburg.de. Ralf Krumkamp and Juergen May, Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany, and German Center for Infection Research (DZIF), Partner Site Hamburg-Borstel-Lübeck, Hamburg, Germany, E-mails: krumkamp@bnitm.de and may@bnitm.de. Benno Kreuels, Division of Tropical Medicine, 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany, and German Center for Infection Research (DZIF), Partner Site Hamburg-Borstel-Lübeck, Hamburg, Germany, E-mail: kreuels@bnitm.de. Cassandra Aldrich, Stefanie Steierberg, Doris Winter, and Daniel Eibach, Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany, E-mails: aldrich@bnitm.de, stefanie@steierberg.de, winter@bnitm.de, and eibach@bnitm.de. Nimako Sarpong, Kennedy Gyau Boahen, and Ellis Owusu-Dabo, Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, E-mails: nimakosarpong@yahoo.com, gyaukennedy@yahoo.com, and owusudabo@kccr.de.

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