Serological Evidence of Rickettsial Infection by Weil-Felix Test in Tertiary Care Hospital in Bangladesh
Mahfuja Begam
Department of Microbiology, Pabna Medical College, Pabna, Bangladesh.
Shaira Akter Shampa
Department of Virology, Sir Salimullah Medical College, Dhaka, Bangladesh.
Aleya Farzana
Department of Microbiology, Sir Salimullah Medical College, Dhaka, Bangladesh.
Mahbuba Chowdhury
Department of Microbiology, Dhaka Medical College, Dhaka, Bangladesh.
Shirin Tarafder *
Department of Microbiology and Immunology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka-1000, Bangladesh.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Rickettsial infections are re-emerging diseases and are major causes of febrile illnesses throughout the Asia-Pacific region. It is difficult to diagnose due to the non-specific clinical manifestations, absence of reliable and affordable diagnostic tests thereby contributes to increasing the acute febrile burden and preventive illness in many populations. Undiagnosed or late-diagnosed cases are associated with high morbidity and mortality.
Objectives: The study aimed to determine rickettsial disease by Weil-Felix test and to know the frequency of rickettsial diseases in febrile patients presenting to tertiary care hospitals in Dhaka, Bangladesh.
Methods: In this study, a total of 135 peripheral blood samples were taken and tested by Weil Felix test from clinically suspected patients of rickettsial fever.
Results: Weil- Felix test was positive in 33((24.4%) cases. Of Weil- Felix test-positive cases, OX-2 was positive in 87.87% cases, followed by OX-K (6.06%), OX-19 (3.03%), and both OX-2 & OX-K (3.03%) cases. OX-2 positive cases are suggestive of spotted fever group, OX-K of scrub typhus group, OX-19 of typhus group, and OX-2 & OX-K are suggestive of both spotted fever group and scrub typhus group. This finding suggests that most cases were infected with spotted fever group rickettsiae (SFGR).
Conclusion: Analyzing the present study's findings, it may be concluded that rickettsial infection is not uncommon in Bangladesh. Weil-Felix test can be used in laboratories to diagnose rickettsial diseases where specific reliable serological or molecular test is not available.
Keywords: Rickettsial disease, weil-felix test, febrile illness, spotted fever group, typhus fever group, scrub typhus