Rickettsia africae infections in sub‐Saharan Africa: A systematic literature review of epidemiological studies and summary of case reports

• Published in: Tropical medicine & international health Vol. 29; no. 7; pp. 541 - 583
• Main Authors: Zhang, Elizabeth Y., Kalmath, Prarthana, Abernathy, Haley A., Giandomenico, Dana A., Nolan, Melissa S., Reiskind, Michael H., Boyce, Ross M.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-07-2024
• Subjects: Africa South of the Sahara - epidemiology; African tick bite fever; Animals; Case reports; Disease prevention; Disease transmission; Epidemiology; Health risks; Humans; Insect bites; Literature reviews; Livestock; Local population; Medical diagnosis; one health; Populations; Rickettsia; Rickettsia - isolation & purification; Rickettsia africae; Rickettsia Infections - epidemiology; Rickettsia Infections - microbiology; Risk Factors; surveillance; Tick-Borne Diseases - epidemiology; Tick-Borne Diseases - microbiology; Ticks; Ticks - microbiology; tick‐borne disease; Travellers; Africa South of the Sahara; tick‐borne disease; surveillance; one health; Rickettsia; ticks; African tick bite fever
• ISSN: 1360-2276; 1365-3156; 1365-3156
• DOI: 10.1111/tmi.14002

Rickettsia africae is a tick‐borne bacteria known to cause African tick bite fever (ATBF). While the disease was first described more than 100 years ago, knowledge of transmission risk factors and disease burden remain poorly described. To better understand the burden of R. africae, this article reviewed and summarized the published literature related to ATBF epidemiology and clinical management. Using a systematic approach, consistent with the PRISMA guidelines, we identified more than 100 eligible articles, including 65 epidemiological studies and 41 case reports. Most reports described R. africae in ticks and livestock, while human studies were less common. Human disease case reports were exclusively among returning travellers from non‐endemic areas, which limits our disease knowledge among at‐risk populations: people living in endemic regions. Substantial efforts to elucidate the ATBF risk factors and clinical manifestations among local populations are needed to develop effective preventative strategies and facilitate appropriate and timely diagnosis.