{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T13:36:03Z","timestamp":1789824963318,"version":"4.0.1"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,2,7]],"date-time":"2017-02-07T00:00:00Z","timestamp":1486425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2017,11]]},"abstract":"Summary<\/jats:title>\n \n \n \n In Brazil, two pathogenic\n Rickettsia<\/jats:italic>\n species have been identified causing tick\u2010borne spotted fever (\n SF<\/jats:styled-content>\n ). The aetiological agent\n Rickettsia rickettsii<\/jats:italic>\n causes serious illness, particularly in the south\u2010eastern region of the country. Moreover, the\n Rickettsia<\/jats:italic>\n sp. strain Atlantic Rainforest cause milder clinical manifestations in south\u2010eastern, south and north\u2010east regions. This study has sought to analyse predictive factors for fatal\n SF<\/jats:styled-content>\n . A case\u2013control study was performed using disease notification records in Brazil. The cases included were individuals with laboratory confirmation and fatal progression of\n SF<\/jats:styled-content>\n , while the controls included individuals with\n SF<\/jats:styled-content>\n who were cured. A total of 386 cases and 415 controls were identified (1\u00a0:\u00a01.1), and the cases and controls were similar in age. The factors identified as being protective against death were reported presence of ticks (odds ratio [\n OR<\/jats:styled-content>\n ], 0.60; 95% confidence interval [\n CI<\/jats:styled-content>\n ], 0.41\u20130.88), residing in urban areas (\n OR<\/jats:styled-content>\n , 0.47, 95%\n CI<\/jats:styled-content>\n , 0.31\u20130.74) and presenting lymphadenopathy (\n OR<\/jats:styled-content>\n , 0.43; 95%\n CI<\/jats:styled-content>\n , 0.23\u20130.82). Males exhibited a greater chance of death (\n OR<\/jats:styled-content>\n , 1.57; 95%\n CI<\/jats:styled-content>\n , 1.13\u20132.18), as did patients who were hospitalized (\n OR<\/jats:styled-content>\n , 10.82; 95%\n CI<\/jats:styled-content>\n , 6.38\u201318.35) and who presented hypotension or shock (\n OR<\/jats:styled-content>\n , 10.80; 95%\n CI<\/jats:styled-content>\n , 7.33\u201315.93), seizures (\n OR<\/jats:styled-content>\n , 11.24; 95%\n CI<\/jats:styled-content>\n , 6.49\u201319.45) and coma (\n OR<\/jats:styled-content>\n of 15.16; 95%\n CI<\/jats:styled-content>\n , 8.51\u201327.02). The study demonstrates the severity profile of the\n SF<\/jats:styled-content>\n cases, defined either as the frequency of hospitalization (even in cases that were cured) or as the increased frequency of the clinical complications typically found in critical patients. Opportune clinical diagnosis, a careful evaluation of the epidemiological aspects of the disease and adequate care for patients are determining factors for reducing\n SF<\/jats:styled-content>\n fatality rates.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/zph.12345","type":"journal-article","created":{"date-parts":[[2017,2,7]],"date-time":"2017-02-07T06:56:39Z","timestamp":1486450599000},"source":"Crossref","is-referenced-by-count":18,"title":["Predictive Factors for Fatal Tick\u2010Borne Spotted Fever in Brazil"],"prefix":"10.1111","volume":"64","author":[{"given":"S. V.","family":"de Oliveira","sequence":"first","affiliation":[{"name":"Graduate Program in Tropical Medicine at the University of Bras\u00edlia Bras\u00edlia DF Brazil"},{"name":"Health Surveillance Secretariat of the Ministry of Health Bras\u00edlia DF Brazil"},{"name":"National Reference Laboratory for Rickettsial disease Vectors of the Oswaldo Cruz Foundation Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. C. A.","family":"Willemann","sequence":"additional","affiliation":[{"name":"Department of Health Surveillance of the Secretariat of Health of Santa Catarina State Florian\u00f3polis SC Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. S.","family":"Gazeta","sequence":"additional","affiliation":[{"name":"National Reference Laboratory for Rickettsial disease Vectors of the Oswaldo Cruz Foundation Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. N.","family":"Angerami","sequence":"additional","affiliation":[{"name":"Clinical Hospital of the State University of Campinas (UNICAMP) Campinas SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Gurgel\u2010Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Medical Parasitology and Vector Biology Laboratory University of Bras\u00edlia Bras\u00edlia DF Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1374.044"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2008.02160.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2008.02637.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ttbdis.2012.10.010"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6502a1"},{"key":"e_1_2_9_7_1","first-page":"1","article-title":"Diagnosis and management of tickborne rickettsial diseases: rocky Mountain spotted fever, ehrlichioses, and anaplasmosis \u2010 United States: a practical guide for physicians and other health\u2010care and public health professionals","volume":"55","author":"Chapman A. S.","year":"2006","journal-title":"MMWR Recomm. Rep."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2008.03.008"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2003.tb07449.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/324372"},{"key":"e_1_2_9_11_1","first-page":"4","article-title":"Situa\u00e7\u00e3o epidemiol\u00f3gica e import\u00e2ncia da febre maculosa no Estado de S\u00e3o Paulo","volume":"6","author":"Katz G.","year":"2009","journal-title":"BEPA"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.16-0192"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01914-14"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2109.150301"},{"key":"e_1_2_9_15_1","unstructured":"Minist\u00e9rio da Sa\u00fade Gabinete do Ministro. Portaria no 204 de 17 de fevereiro de2016a:Define a lista nacional de notifica\u00e7\u00e3o compuls\u00f3ria de doen\u00e7as agravos e eventos de sa\u00fade p\u00fablica nos servi\u00e7os de sa\u00fade p\u00fablicos e privados em todo o territ\u00f3rio nacional nos termos do anexo e d\u00e1 outras provid\u00eancias. Available at:bvsms.saude.gov.br\/bvs\/saudelegis\/gm\/2016\/prt0204_17_02_2016.html(accessed on 29 August 2016)"},{"key":"e_1_2_9_16_1","unstructured":"Minist\u00e9rio da Sa\u00fadedo Brasil. Secretaria de Vigil\u00e2ncia em Sa\u00fade (SVS). Guia de Vigil\u00e2ncia em Sa\u00fade.2016b:Febre maculosa brasileira e outras riquetsioses. 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