title: Epidemiology of tick-borne borreliosis in Morocco.
abstract: BACKGROUND
  The presence in Morocco of Argasid ticks of the Ornithodoros erraticus complex, the vector of tick-borne relapsing fever (TBRF) in North Africa, has been known since 1919, but the disease is rarely diagnosed and few epidemiological data are available.
  
  
  RESULTS
  Between 2006 and 2011, we investigated the presence of Ornithodoros ticks in rodent burrows in 34 sites distributed across Morocco. We also collected small mammals in 10 sites and we investigated TBRF in febrile patients in Kenitra district. The prevalence of Borrelia infections was assessed by nested PCR amplification in ticks and the brain tissue of small mammals, and by evaluation of thick blood films in patients. A high proportion of burrows were infested with ticks of the O. erraticus complex in all regions of Morocco, with a mean of 39.5% for the whole country. Borrelia infections were found in 39/382 (10.2%) of the ticks and 12/140 (8.6%) of the rodents and insectivores studied by PCR amplification, and 102 patients tested positive by thick blood film. Five small mammalian species were found infected: Dipodillus campestris, Meriones shawi, Gerbillus hoogstrali, Gerbillus occiduus and Atelerix algirus. Three Borrelia species were identified in ticks and/or rodents: B. hispanica, B. crocidurae and B. merionesi.
  
  
  CONCLUSIONS
  Tick populations belonging to O. erraticus complex are widely distributed in Morocco and a high proportion of ticks and small mammals are infected by Borrelia species. Although rarely diagnosed, TBRF may be a common cause of morbidity in all regions of Morocco.
authors.affiliation: Institut de Recherche pour le Développement, Laboratoire de Paludologie et de Zoologie Médicale, UMR 198, BP 1386 Dakar, Senegal.
authors.forename: Georges
authors.initials: G
authors.lastname: Diatta
authors.forename: Yassine
authors.initials: Y
authors.lastname: Souidi
authors.forename: Laurent
authors.initials: L
authors.lastname: Granjon
authors.forename: Céline
authors.initials: C
authors.lastname: Arnathau
authors.forename: Patrick
authors.initials: P
authors.lastname: Durand
authors.forename: Gilles
authors.initials: G
authors.lastname: Chauvancy
authors.forename: Youssouph
authors.initials: Y
authors.lastname: Mané
authors.forename: M'hammed
authors.initials: M
authors.lastname: Sarih
authors.forename: Driss
authors.initials: D
authors.lastname: Belghyti
authors.forename: François
authors.initials: F
authors.lastname: Renaud
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Trape
mesh_terms: D000293:Adolescent; D000818:Animals; D001898:Borrelia / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D001899:Borrelia Infections / Q000453:epidemiology* / Q000662:veterinary*; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004199:Disease Vectors; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007223:Infant; D008297:Male; D008969:Molecular Sequence Data; D009018:Morocco / Q000453:epidemiology; D026861:Ornithodoros / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D012376:Rodent Diseases / Q000453:epidemiology* / Q000382:microbiology; D012377:Rodentia; D017422:Sequence Analysis, DNA
chemical_list: D004269:DNA, Bacterial