Characteristics of louse-borne relapsing fever in Ethiopian children and adults

Louse-borne relapsing fever (LBRF) is endemic in Ethiopia. The epidemiological and clinical aspects of LBRF and the differences between the infection in children and that in adults were investigated in a rural hospital in Ethiopia. During the 5-year study (1997-2002), 197 patients had a confirmed diagnosis of LBRF. Most (62.1%) of the cases were children under 15 years of age. The adult cases (i.e. those aged greater than or equal to15 years) were far more likely to present with headache (76.9% v. 40%; P < 0.001), musculo-skeletal pains (61.5% v. 30.5%; P < 0.001), dizziness (64% v. 39%; P = 0.002) and bleeding (16.9% v. 3.8%,; P = 0.005) than the paediatric. The overall level of case fatality was 6.4%. Death appeared to be significantly associated with adulthood (P = 0.01), delay in consultation (P = 0.026) and the presence of vomiting (P = 0.023). LBRF is clearly still a public-health problem in Ethiopia, where the clinical manifestations of the disease differ according to the age of the case.