Molecular and serological evidence of flea-associated typhus group and spotted fever group rickettsial infections in Madagascar

Rado J L Rakotonanahary (Corresponding Author), Thomas Alan Harrison, Alice N Maina, Ju Jiang, Allen L Richards, Minoarisoa Rajerison, Sandra Telfer

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BACKGROUND: Rickettsiae are obligate intracellular bacteria responsible for many febrile syndromes around the world, including in sub-Saharan Africa. Vectors of these pathogens include ticks, lice, mites and fleas. In order to assess exposure to flea-associated Rickettsia species in Madagascar, human and small mammal samples from an urban and a rural area, and their associated fleas were tested.

RESULTS: Anti-typhus group (TGR)- and anti-spotted fever group rickettsiae (SFGR)-specific IgG were detected in 24 (39%) and 21 (34%) of 62 human serum samples, respectively, using indirect ELISAs, with six individuals seropositive for both. Only two (2%) Rattus rattus out of 86 small mammals presented antibodies against TGR. Out of 117 fleas collected from small mammals, Rickettsia typhi, a TGR, was detected in 26 Xenopsylla cheopis (24%) collected from rodents of an urban area (n = 107), while two of these urban X. cheopis (2%) were positive for Rickettsia felis, a SFGR. R. felis DNA was also detected in eight (31%) out of 26 Pulex irritans fleas.

CONCLUSIONS: The general population in Madagascar are exposed to rickettsiae, and two flea-associated Rickettsia pathogens, R. typhi and R. felis, are present near or in homes. Although our results are from a single district, they demonstrate that rickettsiae should be considered as potential agents of undifferentiated fever in Madagascar.

Original languageEnglish
Article number125
JournalParasites & Vectors
Publication statusPublished - 4 Mar 2017

Bibliographical note

This research was supported by the Wellcome Trust (RCDF and Senior Fellowship to ST, #081705 and #095171), the Institut Pasteur de Madagascar, and the Global Emerging Infections Surveillance and Response System, a Division of the Armed Forces Health Surveillance Center [847705.82000.25GB.A0074].


  • Rickettsia
  • Rickettsioses
  • fleas
  • prevalence
  • Madagascar
  • murine typhus
  • flea-borne spotted fever


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