Epidemiologic Characterization and Risk Factors of Rocky Mountain Spotted Fever in Children in Northeastern Mexico: A Retrospective Cross-sectional Study (2018-2024).

BACKGROUND

Rocky Mountain spotted fever (RMSF) is a vector-borne disease with nonspecific symptoms, including fever, headache, myalgia, and exanthema, which complicates timely diagnosis and treatment. Despite its significant morbidity and mortality, epidemiological data and risk factor analyses remain scarce in Mexico.

METHODS

A retrospective cross-sectional study was conducted from 2018-2024 in three hospitals in northeastern Mexico. We analyzed 90 pediatric patients with confirmed rickettsiosis via polymerase chain reaction (PCR) or immunofluorescence assay (IFA). Demographic, clinical, and laboratory data were evaluated to identify independent risk factors associated with disease severity and outcomes. Statistical analyses included logistic regression, Mann-Whitney U tests, and Pearson χ2 tests (p ≤0.05).

RESULTS

School-aged children comprised 46.6% of cases, with a predominance of females (54.4%). Key epidemiological exposures included tick bites (17.8%) and pet cohabitation (54.5%). Delayed doxycycline treatment (>5 d after symptom onset) was associated with increased mortality. Significant predictors of poor outcomes were neurological impairment (OR: 3.7, CI: 1.9-7.3), shock upon admission (OR: 4.5, CI: 2.2-9.1), and thrombocytopenia (p <0.001). The overall mortality rate was 36.7%.

CONCLUSIONS

Our findings underscore the significant clinical impact of rickettsioses in northeastern Mexico and the need to improve diagnostic capabilities, raising public awareness, and implementing effective vector control programs. Early recognition and timely doxycycline treatment are crucial to improving patient outcomes. Strengthening public health strategies through preventive measures and clinician education could reduce the morbidity and mortality associated with these infections.