Epidemiology of endemic Bartonella bacilliformis: a prospective cohort study in a Peruvian mountain valley community.
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.
Chamberlin
Judith
J
Uniformed Services University of the Health Sciences, Department of Preventive Medicine, Bethesda, Maryland, USA. judithchamberlin@westat.com
Laughlin
Larry W
LW
Romero
Sofia
S
Solórzano
Nelson
N
Gordon
Scott
S
Andre
Richard G
RG
Pachas
Paul
P
Friedman
Heidi
H
Ponce
Carlos
C
Watts
Douglas
D
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
D000907:Antibodies, Bacterial