Factors Influencing Disease Outcomes in Relapsing Fever Patients: Insights from Ethiopia

Background Relapsing fever (RF) is a recurrent febrile illness caused by various Borrelia spirochetes, with humans as the only known reservoirs. Despite recurring epidemics and high mortality rates in East Africa, limited research focuses on RF compared to other infectious diseases. This study aims to assess the clinical characteristics, outcomes, and associated factors with disease outcome among RF patients admitted to Yekatit-12 Hospital Medical College. Methods An institutional based retrospective cross sectional study was done and the study period was from April 2023 to June 2023. Data were analyzed using SPSS version 7 (2020), and results were disseminated accordingly. Results A total of 119 confirmed RF cases were identified, with a mean age of 24.1 ± 7.4 years. All cases were male, with an average symptom duration of 4.5 ± 2.86 days. Most patients were street dwellers or daily laborers. The majority received combination therapy, with ceftriaxone and doxycycline as the treatments of choice. The incidence of Jarisch-Herxheimer Reaction (JHR) was 36.1%, and the case fatality rate was 45.4%. Factors significantly associated with poor outcomes included JHR (p = 0.023, AOR = 2.8, 95% CI: 1.09–7.64), mechanical ventilation use (p < 0.001, AOR = 2.7, 95% CI: 1.05–7.1), longer symptom duration (p = 0.021, AOR = 3.1, 95% CI: 1.24–7.9), and multi-organ failure (p = 0.002, AOR = 3.8, 95% CI: 1.23–11.6). Conclusion This study highlights the significant burden of relapsing fever among younger, predominantly male laborers, with severe complications contributing to high mortality. It underscores the importance of early detection, prompt treatment, and targeted public health strategies to improve outcomes.