Contribution à une étude épidémiologique de la fièvre boutonneuse dans la wilaya d’Ain Témouchent

Abstract

Mediterranean spotted fever (MSF), a zoonotic disease transmitted primarily through the bite of the brown dog tick (Rhipicephalus sanguineus), continues to pose a significant public health challenge in Algeria. The aim of this study was to contribute to characterize the regional epidemiology of MSF in the Wilaya of Aïn Témouchent and to perform a detailed assessment of the epidemiological, clinical, and hospital-related features of reported cases. This retrospective descriptive study was conducted using two complementary datasets. The first comprised 1,128 cases of Mediterranean spotted fever reported by the various Primary Public Healthcare Facilities in the Wilaya of Aïn Témouchent between January 2021 and December 2025. The second involved a detailed analysis of the clinical and laboratory characteristics of 50 patients hospitalized at Ahmed Medaghri Hospital in Aïn Témouchent. The epidemiological analysis demonstrated a substantial increase in MSF incidence in 2023, with 427 reported cases. Women represented 58% of affected individuals, and most patients were from rural settings (82%). A clear seasonal distribution was observed, with 69% of infections occurring during the summer period. Epidemiological investigations identified tick bites (84%) and contact with dogs (78%) as the principal exposure factors. Among hospitalized patients, the clinical picture was characterized by the typical triad of fever, maculopapular rash, and an inoculation eschar (tache noire). The most frequent laboratory abnormalities were thrombocytopenia, leukopenia or leukocytosis, and increased liver transaminase levels consistent with hepatic cytolysis. Most patients responded well to doxycycline therapy and experienced favorable outcomes, although a limited number developed severe disease with multiorgan involvement. In conclusion, the diagnosis of MSF remains primarily based on clinical findings and epidemiological history. Early administration of appropriate antibiotic therapy is associated with a favorable outcome and complete recovery in the vast majority of patients.