McQuiston J H, Holman R C, Groom A V, Kaufman S F, Cheek J E, Childs J E
Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Public Health Rep. 2000 Sep-Oct;115(5):469-75. doi: 10.1093/phr/115.5.469.
Although the state of Oklahoma has traditionally reported very high incidence rates of Rocky Mountain spotted fever (RMSF) cases, the incidence of RMSF among the American Indian population of the state has not been studied. The authors used data from several sources to estimate the incidence of RMSF among American Indians in Oklahoma.
The authors retrospectively reviewed an Indian Health Service (IHS) hospital discharge database for 1980-1996 and available medical charts from four IHS hospitals. The authors also reviewed RMSF case report forms submitted to the Centers for Disease Control and Prevention (CDC) for 1981-1996.
The study data show that American Indians in the IHS Oklahoma City Area were hospitalized with RMSF at an annual rate of 48.2 per million population, compared with an estimated hospitalization rate of 16.9 per million Oklahoma residents. The majority of cases in the IHS database (69%) were diagnosed based on clinical suspicion rather than laboratory confirmation. The incidence of RMSF for Oklahoma American Indians as reported to the CDC was 37.4 cases per million, compared with 21.6 per million for all Oklahoma residents (RR 1.7, 95% confidence interval [CI] 1.5, 2.1).
Rates derived from the IHS database may not be comparable to state and national rates because of differences in case inclusion criteria. However, an analysis of case report forms indicates that American Indians n Oklahoma have a significantly higher incidence of RMSF than that of the overall Oklahoma population. Oklahoma American Indians may benefit from educationa campaigns emphasizing prevention of tick bites and exposure to tick habitats.
尽管俄克拉荷马州传统上报告的落基山斑疹热（RMSF）病例发病率非常高，但该州美国印第安人群体中的RMSF发病率尚未得到研究。作者使用来自多个来源的数据来估计俄克拉荷马州美国印第安人中RMSF的发病率。
作者回顾性审查了1980 - 1996年印第安卫生服务局（IHS）医院出院数据库以及四家IHS医院的可用病历。作者还审查了1981 - 1996年提交给疾病控制与预防中心（CDC）的RMSF病例报告表。
研究数据表明，IHS俄克拉荷马城地区的美国印第安人因RMSF住院的年发病率为每百万人口48.2例，而俄克拉荷马州居民的估计住院率为每百万人口16.9例。IHS数据库中的大多数病例（69%）是基于临床怀疑而非实验室确诊。向CDC报告的俄克拉荷马州美国印第安人的RMSF发病率为每百万人口37.4例，而所有俄克拉荷马州居民为每百万人口21.6例（相对危险度1.7，95%置信区间[CI] 1.5，2.1）。
由于病例纳入标准不同，IHS数据库得出的发病率可能与州和全国发病率不可比。然而，对病例报告表的分析表明，俄克拉荷马州的美国印第安人RMSF发病率明显高于俄克拉荷马州总体人群。俄克拉荷马州的美国印第安人可能会从强调预防蜱叮咬和接触蜱栖息地的教育活动中受益。
