Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link

Volume 32, Number 2—February 2026

Research

Predictors of Fatal Outcomes among Pediatric Patients Hospitalized for Rocky Mountain Spotted Fever, Sonora, Mexico, 2004–20241

Stephanie Bellman, Kaci D. McCoy, Diana Enriquez, Pamela Romo, JongIn Hwang, Kathleen Weimer, Sarah M. Gunter, José Luis Alomía-Zegarra, Kristy O. Murray2Comments to Author , and Gerardo Álvarez-Hernández2
Author affiliation: Emory University School of Medicine, Atlanta, Georgia, USA (S. Bellman, K.D. McCoy, J. Hwang, K. Weimer, K.O. Murray); Children’s Healthcare of Atlanta, Atlanta (S. Bellman, K.D. McCoy, J. Hwang, K. Weimer, K.O. Murray); University of Sonora, Hermosillo, Mexico (D. Enriquez, P. Romo, G. Álvarez-Hernández); Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas, USA (S.M. Gunter); Secretaría de Salud Pública del Estado de Sonora, Hermosillo (J.L. Alomía-Zegarra); Hospital Infantil del Estado de Sonora, Hermosillo (G. Álvarez-Hernández)

Main Article

Table 1

Sociodemographic characteristics of children in study of predictors of fatal outcomes among pediatric patients hospitalized for Rocky Mountain spotted fever, Sonora, Mexico, 2004–2024*

Characteristics Fatal cases Nonfatal cases Total p value†
Sex 500
M 50 (50.5) 219 (54.6) 269 (53.8) 0.50
F
 49 (49.5)
 182 (45.4)
 231 (46.2)
Age range, y 500
0–4 26 (26.3) 86 (21.4) 112 (22.4) 0.41
5–9 34 (34.3) 167 (41.7) 201 (40.2)
10–14 27 (27.3) 113 (28.2) 140 (28.0)
15–19 12 (12.1) 35 (8.7) 47 (9.4)
Median age, y (IQR)
 8.3 (4.1–12.3)
 8.3 (5.3–11.6)
 8.3 (5.3–11.8)
 0.72
Residence 500
Urban 80 (80.8) 340 (84.8) 420 (84.0) 0.36
Rural
 19 (19.2)
 61 (15.2)
 80 (16.0)
History of tick contact 492
Y 86 (91.5) 374 (94.0) 460 (93.5) 0.36
N
 8 (8.5)
 24 (6.0)
 32 (6.5)
Socioeconomic status‡ 499
Insufficient 82 (82.8) 350 (87.5) 432 (86.6) 0.25
Sufficient
 17 (17.2)
 50 (12.5)
 67 (13.4)
Ethnicity 500
Non-Indigenous 83 (83.8) 366 (91.3) 449 (89.8) 0.04
Indigenous
 16 (16.2)
 35 (8.7)
 51 (10.2)
Weight 260
Underweight
 3 (8.3)
 17 (7.6)
 20 (7.7)
 0.75
BMI or weight-for-length§ 260
Malnourished 3 (3.8) 16 (7.1) 19 (7.3) 0.73

*Values are no. (%) except as indicated. Bold font indicates statistical significance (p<0.05). BMI, body mass index; IQR, interquartile range. †Based on Fisher exact test, Pearson’s χ2, or Kruskal-Wallis analysis of variance. ‡Hospital Infantil del Estado de Sonora classifies patients into 8 socioeconomic categories, which we dichotomized as having either sufficient or insufficient economic resources. §BMI was calculated for children >24 months of age; weight-for-length was calculated for children <24 months of age.

Main Article

1Preliminary results from this study were presented at the Southeastern Pediatric Research Conference; June 6, 2025; Atlanta, Georgia, USA; and at the American Society of Tropical Medicine and Hygiene Conference; November 10, 2025; Toronto, Ontario, Canada.

2These senior authors contributed equally to this article.

Page created: January 20, 2026
Page updated: February 19, 2026
Page reviewed: February 19, 2026
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external