title: Common epidemiology of Rickettsia felis infection and malaria, Africa.
abstract: This study aimed to compare the epidemiology of Rickettsia felis infection and malaria in France, North Africa, and sub-Saharan Africa and to identify a common vector. Blood specimens from 3,122 febrile patients and from 500 nonfebrile persons were analyzed for R. felis and Plasmodium spp. We observed a significant linear trend (p<0.0001) of increasing risk for R. felis infection. The risks were lowest in France, Tunisia, and Algeria (1%), and highest in rural Senegal (15%). Co-infections with R. felis and Plasmodium spp. and occurrences of R. felis relapses or reinfections were identified. This study demonstrates a correlation between malaria and R. felis infection regarding geographic distribution, seasonality, asymptomatic infections, and a potential vector. R. felis infection should be suspected in these geographical areas where malaria is endemic. Doxycycline chemoprophylaxis against malaria in travelers to sub-Saharan Africa also protects against rickettsioses; thus, empirical treatment strategies for febrile illness for travelers and residents in sub-Saharan Africa may require reevaluation.
authors.affiliation: These authors contributed equally to this article.
authors.forename: Oleg
authors.initials: O
authors.lastname: Mediannikov
authors.forename: Cristina
authors.initials: C
authors.lastname: Socolovschi
authors.forename: Sophie
authors.initials: S
authors.lastname: Edouard
authors.forename: Florence
authors.initials: F
authors.lastname: Fenollar
authors.forename: Nadjet
authors.initials: N
authors.lastname: Mouffok
authors.forename: Hubert
authors.initials: H
authors.lastname: Bassene
authors.forename: Georges
authors.initials: G
authors.lastname: Diatta
authors.forename: Adama
authors.initials: A
authors.lastname: Tall
authors.forename: Hamidou
authors.initials: H
authors.lastname: Niangaly
authors.forename: Ogobara
authors.initials: O
authors.lastname: Doumbo
authors.forename: Jean Bernard
authors.initials: JB
authors.lastname: Lekana-Douki
authors.forename: Abir
authors.initials: A
authors.lastname: Znazen
authors.forename: M'hammed
authors.initials: M
authors.lastname: Sarih
authors.forename: Pavel
authors.initials: P
authors.lastname: Ratmanov
authors.forename: Herve
authors.initials: H
authors.lastname: Richet
authors.forename: Mamadou O
authors.initials: MO
authors.lastname: Ndiath
authors.forename: Cheikh
authors.initials: C
authors.lastname: Sokhna
authors.forename: Philippe
authors.initials: P
authors.lastname: Parola
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000453:epidemiology; D017954:Africa South of the Sahara; D000352:Africa, Northern; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004199:Disease Vectors; D005260:Female; D005602:France; D062306:Geography, Medical; D006801:Humans; D015994:Incidence; D007223:Infant; D008288:Malaria / Q000453:epidemiology* / Q000635:transmission; D008297:Male; D008875:Middle Aged; D010961:Plasmodium / Q000235:genetics; D015995:Prevalence; D012282:Rickettsia Infections / Q000453:epidemiology* / Q000635:transmission; D041161:Rickettsia felis / Q000235:genetics; D055815:Young Adult
keywords: Africa; Plasmodium species; Rickettsia felis; arthropod; bacteria; co-infection; febrile; fever; malaria; mosquito; parasites; reservoir; rickettsial; tropic; vector