ReviewCurrent opinion in infectious diseases2016
State of the art of diagnosis of rickettsial diseases: the use of blood specimens for diagnosis of scrub typhus, spotted fever group rickettsiosis, and murine typhus.
Review in Current opinion in infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 115 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
115 citing papers in PubMed, 4 syntheses or guidelines pooled it, 199 citations in OpenAlex.
- Laboratory Methods for Detection of Infectious Agents and Serological Response in Humans With Tick-Borne Infections: A Systematic Review of Evaluations Based on Clinical Patient Samples.Frontiers in public health · 2021Pooled it
- Selection of Diagnostic Cutoffs for Murine Typhus IgM and IgG Immunofluorescence Assay: A Systematic Review.The American journal of tropical medicine and hygiene · 2020Pooled it
- The epidemiology and clinical features of rickettsial diseases in North Queensland, Australia: Implications for patient identification and management.PLoS neglected tropical diseases · 2019Pooled it
- Antibiotics for treating scrub typhus.The Cochrane database of systematic reviews · 2018Pooled it
- Etiological spectrum of persistent fever in the tropics and predictors of ubiquitous infections: a prospective four-country study with pooled analysis.BMC medicine · 2022Trial
- Imaging in scrub typhus - a pictorial review.Abdominal radiology (New York) · 2026Review
- Mapping Scrub Typhus Across Multiple Hosts in India.EcoHealth · 2026Review
- Rickettsia massiliae and its public health significance across Palearctic and Oriental regions: a scoping review.Infectious diseases of poverty · 2026Article
- Outcomes of Hospitalized and Critically Ill Adults with Murine Typhus, Galveston, Texas, USA, 2019-2023.Emerging infectious diseases · 2026Review
- Assessment of the Pathogenicity ofPathogens (Basel, Switzerland) · 2026Article
- Antibodies to Tick Salivary Antigens AV422 and Calreticulin in Patients With Spotted Fever Group Rickettsioses and Other Febrile Illnesses in Northern Tanzania.The Journal of infectious diseases · 2026Article
- Infections After International Travel: Relevant Diagnoses in Children and Adolescents.Deutsches Arzteblatt international · 2026Review
- Bridging historical antigenic profiling and whole-genome taxonomy inScientific reviews · 2026Review
- Human infection with Candidatus Rickettsia jingxinensis: First identification and clinical characteristics.PLoS neglected tropical diseases · 2025Article
- Diagnostic heterogeneity in scrub typhus serology: A scoping review of IFA thresholds and regional standardisation needs (2005-2024).PLoS neglected tropical diseases · 2025Article
- Prevalence and risk factors for murine typhus, scrub typhus and spotted fever group rickettsioses among adolescent and adult patients presenting to Yangon General Hospital, Yangon, Myanmar.Tropical medicine & international health : TM & IH · 2025Article
- Rickettsioses as Underrecognized Cause of Hospitalization for Febrile Illness, Uganda.Emerging infectious diseases · 2025Article
- Estimating scrub typhus and murine typhus incidence among adolescents and adults in Yangon, Myanmar.Tropical medicine & international health : TM & IH · 2025Article
- Forehead Erythematous Rash: A Rare Manifestation of Tick-Borne Lymphadenopathy (TIBOLA).Cureus · 2025Article
- Article
55 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
Abstract
purpose of reviewWith improved malaria control, acute undifferentiated febrile illness studies in tropical regions reveal a startling proportion of rickettsial illnesses, especially scrub typhus, murine typhus, and spotted fever group rickettsioses. Laboratory diagnosis of these infections evolved little over the past 40 years, but combinations of technologies like PCR and loop-mediated isothermal amplification, with refined rapid diagnostic tests and/or ELISA, are promising for guidance for early antirickettsial treatment. RECENT
findingsThe long-term reliance on serological tests - useful only late in rickettsial infections - has led to underdiagnosis, inappropriate therapies, and undocumented morbidity and mortality. Recent approaches integrate nucleic acid amplification and recombinant protein-based serological tests for diagnosing scrub typhus. Optimized using Bayesian latent class analyses, this strategy increases diagnostic confidence and enables early accurate diagnosis and treatment - a model to follow for lagging progress in murine typhus and spotted fever. SUMMARY: A laboratory diagnostic paradigm shift in rickettsial infections is evolving, with replacement of indirect immunofluorescence assay by the more objective ELISA coupled with nucleic acid amplification assays to expand the diagnostic window toward early infection intervals. This approach supports targeted antirickettsial therapy, reduces morbidity and mortality, and provides a robust evidence base for further development of diagnostics and vaccines.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.