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Volume 13, Number 1—January 2007


Tickborne Relapsing Fever Diagnosis Obscured by Malaria, Togo

Annika Nordstrand*, Ignas Bunikis*, Christer Larsson*, Kodjo Tsogbe†, Tom G. Schwan‡, Mikael Nilsson§, and Sven Bergström*Comments to Author 
Author affiliations: *Umeå University, Umeå, Sweden; †Association Protestante des Oeuvres Médico-Sociales et Humanitaires du Togo, Lomé, Togo; ‡National Institutes of Health, Hamilton, Montana, USA; §The Swedish Institute for Infectious Disease Control, Solna, Sweden;

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Table 3

Coinfection with malaria and relapsing fever caused by Borrelia and treatment in patients in northern and southern Togo with fever, 2002–2004

Region, groupMalaria infection,* no. positive/
no. tested (%)
Borrelia infected† and treated for malaria, 
no. positive/no. tested (%)
Borrelia infections effectively treated, no. positive/no. tested (%)
All patientsBorrelia infectedMalaria positiveMalaria negative‡
Children34/96 (35.4)4/8 (50)4/4 (100)1/4 (25)0/8
Children46/68 (67.6)2/3 (66.7)1/2 (50)0/11/3 (33.3)
Adults35/80 (43.8)1/10 (10)0/11/6 (16.6)0/7
Total81/148 (54.7)3/13 (23.1)1/3 (33.3)1/7 (14.3)1/10 (10)
All154/244 (63.1)7/21 (33.3)5/7 (71.4)2/11 (18.2)1/18 (5.6)

*Determined by microscopy of Giemsa-stained blood smears.
†Determined by positive PCR result and Borrelia species identification by sequence in blood. Three malaria-negative adults were not included because treatment information was not available.
‡Values represent patients treated only for malaria. Two of these 4 patients were treated for malaria in combination with drugs for treating helminth infections.

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