Underdiagnosis of Rickettsiosis in Primary Health Care Facilities: A Cross-sectional Study in Jakarta, Indonesia

AIM: To establish the rate of rickettsiosis among patients presenting acute febrile illnesses at primary healthcare facilities in Jakarta, Indonesia. BACKGROUND: Rickettsiosis is a major public health problem in Indonesia. Though they are found in many different areas and have great clinical signifi...

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Main Authors: Aiman Idrus Alatas, Delly Chipta Lestari, Khie Chen Lie, Dewi Lokida, Suratno Lulut Ratnoglik
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716524003473
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author Aiman Idrus Alatas
Delly Chipta Lestari
Khie Chen Lie
Dewi Lokida
Suratno Lulut Ratnoglik
author_facet Aiman Idrus Alatas
Delly Chipta Lestari
Khie Chen Lie
Dewi Lokida
Suratno Lulut Ratnoglik
author_sort Aiman Idrus Alatas
collection DOAJ
description AIM: To establish the rate of rickettsiosis among patients presenting acute febrile illnesses at primary healthcare facilities in Jakarta, Indonesia. BACKGROUND: Rickettsiosis is a major public health problem in Indonesia. Though they are found in many different areas and have great clinical significance, there is a limited diagnostic capacity for human rickettsiosis particularly at the primary care level. Since its symptoms can resemble those of other causes of acute fever, failure to diagnose rickettsiosis could lead to severe outcomes, including neurological complications, multi-organ dysfunction, and many more. METHODS: A total of 50 subjects with acute febrile illness from three primary health centers were involved in this cross-sectional study. Blood collected from patients was retrospectively analyzed for rickettsiosis using Immunofluorescence Assay (IFA) IgM and polymerase chain reaction (PCR). The distribution of rickettsiosis was further stratified by age, laboratory findings, and initial diagnosis. RESULTS: Among these 50 patients, seven were diagnosed with rickettsiosis based on blood work (IFA IgM: 5; PCR: 1; both: 1). Surprisingly, none of these individuals had initially been thought to have rickettsial infections. The infected population consisted mainly of adults (6 out of 7). Four rickettsiosis patients were initially diagnosed with typhoid fever, one with an upper respiratory tract infection, and two with nonspecific fever. Routine blood tests showed normal white blood cell counts in all cases. CONCLUSIONS: These findings show the considerable underreporting of rickettsiosis in primary health care centers in Jakarta. It is important to enhance awareness and diagnostic capacity to prevent underdiagnosis and associated complications.
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spelling doaj-art-a788176a4e384449bf31574fccd6c2a32024-12-27T04:08:41ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-01395354Underdiagnosis of Rickettsiosis in Primary Health Care Facilities: A Cross-sectional Study in Jakarta, IndonesiaAiman Idrus Alatas0Delly Chipta Lestari1Khie Chen Lie2Dewi Lokida3Suratno Lulut Ratnoglik4Program of Clinical Microbiology Residency, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaDepartment of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDivision of Tropical Medicine & Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta, IndonesiaIndonesia Research Partnership on Infectious Diseases (INA-RESPOND) Laboratory, Tangerang, IndonesiaDepartment of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, IndonesiaAIM: To establish the rate of rickettsiosis among patients presenting acute febrile illnesses at primary healthcare facilities in Jakarta, Indonesia. BACKGROUND: Rickettsiosis is a major public health problem in Indonesia. Though they are found in many different areas and have great clinical significance, there is a limited diagnostic capacity for human rickettsiosis particularly at the primary care level. Since its symptoms can resemble those of other causes of acute fever, failure to diagnose rickettsiosis could lead to severe outcomes, including neurological complications, multi-organ dysfunction, and many more. METHODS: A total of 50 subjects with acute febrile illness from three primary health centers were involved in this cross-sectional study. Blood collected from patients was retrospectively analyzed for rickettsiosis using Immunofluorescence Assay (IFA) IgM and polymerase chain reaction (PCR). The distribution of rickettsiosis was further stratified by age, laboratory findings, and initial diagnosis. RESULTS: Among these 50 patients, seven were diagnosed with rickettsiosis based on blood work (IFA IgM: 5; PCR: 1; both: 1). Surprisingly, none of these individuals had initially been thought to have rickettsial infections. The infected population consisted mainly of adults (6 out of 7). Four rickettsiosis patients were initially diagnosed with typhoid fever, one with an upper respiratory tract infection, and two with nonspecific fever. Routine blood tests showed normal white blood cell counts in all cases. CONCLUSIONS: These findings show the considerable underreporting of rickettsiosis in primary health care centers in Jakarta. It is important to enhance awareness and diagnostic capacity to prevent underdiagnosis and associated complications.http://www.sciencedirect.com/science/article/pii/S2213716524003473RickettsiosisPrimary Health CareAcute Febrile
spellingShingle Aiman Idrus Alatas
Delly Chipta Lestari
Khie Chen Lie
Dewi Lokida
Suratno Lulut Ratnoglik
Underdiagnosis of Rickettsiosis in Primary Health Care Facilities: A Cross-sectional Study in Jakarta, Indonesia
Journal of Global Antimicrobial Resistance
Rickettsiosis
Primary Health Care
Acute Febrile
title Underdiagnosis of Rickettsiosis in Primary Health Care Facilities: A Cross-sectional Study in Jakarta, Indonesia
title_full Underdiagnosis of Rickettsiosis in Primary Health Care Facilities: A Cross-sectional Study in Jakarta, Indonesia
title_fullStr Underdiagnosis of Rickettsiosis in Primary Health Care Facilities: A Cross-sectional Study in Jakarta, Indonesia
title_full_unstemmed Underdiagnosis of Rickettsiosis in Primary Health Care Facilities: A Cross-sectional Study in Jakarta, Indonesia
title_short Underdiagnosis of Rickettsiosis in Primary Health Care Facilities: A Cross-sectional Study in Jakarta, Indonesia
title_sort underdiagnosis of rickettsiosis in primary health care facilities a cross sectional study in jakarta indonesia
topic Rickettsiosis
Primary Health Care
Acute Febrile
url http://www.sciencedirect.com/science/article/pii/S2213716524003473
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