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DETECTION OF RICKETTSIA AFRICAE IN PATIENTS AND TICKS ALONG THE COASTAL REGION OF CAMEROON

Rickettsia africae was identified in seven (6%) of 118 patients with acute fevers of unknown etiology proven not to be malaria or typhoid fever from clinics along the coastal region of Cameroon by polymerase chain reaction (PCR) amplification and sequencing of the citrate synthase (gltA) and outer membrane protein A (ompA) genes of Rickettsia. The majority (71%) of the patients were female. Clinical manifestations included fever (100%), headache (71%), myalgia (71%), arthralgia (43%), pulmonary involvement (29%), and diffuse rash (14%). Moreover, R. africae was detected by PCR amplification and sequence analysis of the gltA and ompA genes in 62 (75%) of 83 adult Amblyomma variegatum ticks collected from cattle in the same region. These results confirm the presence of a previously unrecognized infectious disease in the indigenous Cameroonian population, as well as extend the established range of R. africae.

Received April 5, 2004. Accepted for publication April 9, 2004.

Acknowledgment: We thank Dr. Marcelo Labruna for his assistance during this project.

Financial support: This research was supported by an National Institutes of Health training grant from the Fogarty International Center (D43-TW00903) to David H. Walker and a University of Buea Staff development grant to Lucy M. Ndip.

Authors’ addresses: Lucy M. Ndip, Eric B. Fokam, Roland N. Ndip, and Vincent P. K. Titanji, Department of Life Sciences, Faculty of Science, University of Buea, PO Box 63, Buea, South West Province, Cameroon. Donald H. Bouyer, David H. Walker, and Jere W. McBride, Department of Pathology and Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, Galveston, TX 77555-0609.

Reprints requests: David H. Walker, Department of Pathology, Director, World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch Galveston, TX 77555-0609, Telephone: 409-772-2856, Fax: 409-772-1850, E-mail: dwalker{at}utmb.edu.

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