Possible Role ofRickettsia felisin Acute Febrile Illness among Children in Gabon

Abstract

Infection is widespread but most prevalent among young, rural residents with fever.

Rickettsia felis Infection in Febrile Children, Ghana

“…4,12,14,15 The detection of R. felis in afebrile individuals has furthermore led to the hypothesis that humans could be a natural reservoir of R. felis. 3,4,12,16 However, as R. felis DNA has also been detected on the skin of healthy Senegalese villagers and in the feces of several arthropod vectors such as Ctenocephalides felis or Liposcelis bostrychophila, it is still unclear to which extent these findings may be influenced by skin contamination. 5,12,17 In conclusion, our study is the first report on the detection of R. felis in febrile children in Ghana, and thus adds to the growing evidence for a widespread occurrence of R. felis in SSA.…”

Co-circulation of Plasmodium and Bacterial DNAs in Blood of Febrile and Afebrile Children from Urban and Rural Areas in Gabon

“…3 This is a methodological mistake because pathogens such as P. falciparum, S. pneumoniae, and R. felis have been detected in blood specimens from apparently healthy people in sub-Saharan Africa but not in Europe. 22,[29][30][31][32] Dubourg and others recently highlighted that, without the use of control groups, the management of infectious diseases will remain difficult in Africa, and that the pathogenic role of a microorganism should be considered when it is detected more frequently in patients than in controls. 24 Sensitivity of PCR assays also remained higher in comparison with microscopic analysis for Plasmodium detection.…”

“…21 The human β-actin gene was targeted and amplified to check the quality of DNA extracts. 15,21,22 Recent studies have shown that fastidious and emerging bacteria were involved in nonmalarial fever in Africa. [13][14][15][16][17][18][19][20] Thus, our study aimed mainly using molecular analyses to look for these bacteria (Borrelia spp., Bartonella spp., T. whipplei, and C. burnetii), but we also aimed to detect the presence of malaria and other more common bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, and Salmonella spp.…”

“…4,21 In rural areas of Gabon, bacteremias were under assessed, whereas studies conducted in other sub-Saharan African countries reported that the spectrum of bacteremias is more significant in rural areas. [13][14][15][16][17]20,22,23 To improve management of febrile illnesses in sub-Saharan Africa, the causes of bacteremia in febrile children should be investigated, and control groups of afebrile children should be systematically included. Indeed, the lack of afebrile control subjects in most studies conducted in sub-Saharan Africa on febrile patients is a major pitfall that compromises a solid understanding of the causes of fever in areas where asymptomatic carriage of microorganisms is common.…”

Flea-Borne Rickettsioses and Rickettsiae

“…In western Kenya, 7.2% of febrile patients were found to have R. felis versus 3.4% of controls (odds ratio 2.20, 95% confidence interval: 1.03–4.70, P = 0.04) 32. In Gabon, investigators found evidence of R. felis in 10.2% of febrile subjects versus 3.3% of afebrile subjects—a difference deemed statistically nonsignificant 33. In both these studies, it is unclear if other frequent causes of febrile illness were excluded.…”