title: Epidemiology of endemic Bartonella bacilliformis: a prospective cohort study in a Peruvian mountain valley community.
abstract: Bartonella bacilliformis has caused debilitating illness since pre-Incan times, but relatively little is known about its epidemiology. A population-based, prospective cohort investigation was conducted in a Peruvian community with endemic bartonellosis. By use of house-to-house and hospital surveillance methods, cohort participants were monitored for evidence of bartonellosis. Of 690 participants, 0.5% had asymptomatic bacteremia at study initiation. After 2 years of follow-up, the incidence of infection was 12.7/100 person-years. The highest rates were in children <5 years old, and there was a linear decrease in incidence with increasing age. Seventy percent of cases were clustered in 18% of households. Age and bartonellosis in a family member were the best predictors of B. bacilliformis infection. There were multiple clinical presentations and significant subclinical infection. A cost-effective control strategy should include vector control and surveillance efforts focused on children and clusters of households with highest endemicity.
authors.affiliation: Uniformed Services University of the Health Sciences, Department of Preventive Medicine, Bethesda, Maryland, USA. judithchamberlin@westat.com
authors.forename: Judith
authors.initials: J
authors.lastname: Chamberlin
authors.forename: Larry W
authors.initials: LW
authors.lastname: Laughlin
authors.forename: Sofia
authors.initials: S
authors.lastname: Romero
authors.forename: Nelson
authors.initials: N
authors.lastname: Solórzano
authors.forename: Scott
authors.initials: S
authors.lastname: Gordon
authors.forename: Richard G
authors.initials: RG
authors.lastname: Andre
authors.forename: Paul
authors.initials: P
authors.lastname: Pachas
authors.forename: Heidi
authors.initials: H
authors.lastname: Friedman
authors.forename: Carlos
authors.initials: C
authors.lastname: Ponce
authors.forename: Douglas
authors.initials: D
authors.lastname: Watts
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D001473:Bartonella / Q000276:immunology; D001474:Bartonella Infections / Q000097:blood / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005191:Family Characteristics; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population; D016036:Seroepidemiologic Studies
chemical_list: D000907:Antibodies, Bacterial