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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 4

Sociodemographic and treatment predictors of fatal outcomes among pediatric patients hospitalized for Rocky Mountain spotted fever, Sonora, Mexico, 2004–2024*

Characteristic β coefficient SE aOR (95% CI)†
Intercept 0.13 0.35 1.14 (0.58–2.25)
Ethnicity‡ 1.04 0.45 2.84 (1.15–6.90)
Days of in-hospital doxycycline treatment −0.46 0.05 0.63 (0.57–0.69)
Days from symptom onset to doxycycline treatment 0.17 0.05 1.19 (1.08–1.31)
Treatment with IV or oral doxycycline monotherapy§ −1.71 0.40 0.18 (0.08–0.38)

*Results of logistic multivariable analysis. aOR, adjusted odds ratio; IV, intravenous. †Accounting for all the variables included in the final model. Ten observations excluded due to missing data. ‡Referent was non-Indigenous. §Referent was no dose of doxycycline or inclusion of other antibiotics in treatment course.

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.

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