Detection of Rickettsial Infection Among Febrile Patients in Semarang City

Abstract

Rickettsial infection is a critical public health problem caused by Rickettsia sp and is distributed worldwide, mainly transmitted by the fleas of rodent. Semarang City has abundant rodent population but the report of Rickettsial infection cases was very limited. The aim of this study is to identify Rickettsial infections among febrile patients at Primary Health Centre in Semarang City. Blood samples were collected from patients at twenty Primary health centres in Semarang City and laboratory tests were performed at the Banjarnegara Research and Development of Zoonosis Control Unit. In this study, the detection of Rickettsial infection in febrile patients was carried out using an IgM Enzyme-linked Immunosorbent Assay (ELISA) Test using 17 kDa protein antigen of Rickettsia. Out of 142 enrolled patients, 40 (28.2%) had a positive result for IgM against Rickettsia with 18 (45%) male patients and 22 (55%) female patients. The predominant symptoms were fatigue, nausea, and headache. There was no mortality observed among the patients. Most of those tested with a positive result were over 20 years old. Rickettsia infection was a frequent case yet still an under-recognized cause of febrile illness in Semarang. This infection should be considered by clinicians in the differential diagnoses of febrile diseases so that local clinicians can provide appropriate drug treatment.