Progress report of Rickettsial disease diagnostic and research laboratory (RDDRL), Faculty of Medicine, University of Kelaniya

Abstract

INTRODUCTION: RDDRL was established at Faculty of Medicine, University of Kelaniya (FMUK) in June 2008 in collaboration with Centers for Disease Control and Prevention, Atlanta, Georgia, USA and Faculty of Veterinary Medicine, University of Peradeniya. OBJECTIVES: We present the contribution of RDDRL towards the diagnosis of ricketsioses over the 5 months since its inception. RESULTS: 84 acute serum samples were analysed [56 from Colombo North Teaching Hospital (CNTH), 4 from Teaching Hospital Jaffna (THJ), 7 from Base Hospital Kamburupitiya (BHK) 3 from Lady Ridgeway Hospital (LRH), 2 from Infectious Disease Hospital (IDH), 2 from Colombo South Teaching Hospital (CSTH), and 10 from the private sector hospitals (PVT)]. 48/84 (57%) had diagnostic titers; 31 (65%) for Rickettsia conorii (RC) and 17 (35%) for Orientia tsutsugamushi (OT). The total (%) positives for each hospital were; CNTH: 22/56 (39%), BHK: 7/7 (100%), Jaffna: 3/4 (75%), LRH: 1/3 (33%), IDH: 1/2 (50%), CSTH: 0/2(0%) and PVT: 8/10 (80%). The district total (ROOT); Gampaha: 33 (26:7), Matara: 7 (3:4), Jaffna: 3 (0:3), Puttlam: 5 (2:3). The mode (range) duration of febrile illness at the time of request was 14 (3-90) days and 6 samples were from severe complicated patients; 2-encephaiitis, 2-'Neuroleptic malignant syndrome', 1-muiti-organ failure and 1-severe gastroenteritis. CONCLUSIONS: Out of the clinically suspected patients, 57% were positive for rickettsiosis; 65% caused by R. conorii and 35% by O. tsutsugamushi. However, the request for serological diagnosis was made after a considerable delay in the majority of cases.