Emerging Infectious Diseases (Nov 2013)

Common Epidemiology of Rickettsia felis Infection and Malaria, Africa

  • Oleg Mediannikov,
  • Cristina Socolovschi,
  • Sophie Edouard,
  • Florence Fenollar,
  • Nadjet Mouffok,
  • Hubert Bassene,
  • Georges Diatta,
  • Adama Tall,
  • Hamidou Niangaly,
  • Ogobara Doumbo,
  • Jean Bernard Lekana-Douki,
  • Abir Znazen,
  • M’hammed Sarih,
  • Pavel Ratmanov,
  • Herve Richet,
  • Mamadou O. Ndiath,
  • Cheikh Sokhna,
  • Philippe Parola,
  • Didier Raoult

DOI
https://doi.org/10.3201/eid1911.130361
Journal volume & issue
Vol. 19, no. 11
pp. 1775 – 1783

Abstract

Read online

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.

Keywords