ArticlePLoS neglected tropical diseases2025
Spatial and clinical epidemiology of spotted fever rickettsioses and ehrlichiosis, North Carolina, 2010-2019.
Article in PLoS neglected tropical diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundNorth Carolina (NC) ranks among the top five states for spotted fever rickettsiosis (SFR) cases and second for ehrlichiosis in the U.S. Identifying geographic clusters of cases is important to elucidate disease risk and inform public health response, including resource allocation. This study examined geographic patterns of tick-borne disease incidence in NC over a 10-year period and modeled predictors of disease severity. METHODOLOGY/
findingsWe analyzed 6,748 SFR and 1,216 ehrlichiosis cases reported to the NC Electronic Disease Surveillance System between January 2010 and December 2019. Average annual incidence was evaluated in two-year periods using global spatial autocorrelation (Moran's I) and Local Indicator of Spatial Association. We found that ehrlichiosis clusters were detected in north and central NC as well as the coastal Tidewater region, with consistently high incidence in these areas. SFR clustering occurred in similar areas, with high and increasing incidence statewide. Severe cases of ehrlichiosis followed a similar pattern, while severe SFR clusters were distributed more broadly across the state. Additionally, Black/African-American individuals made up a greater proportion of both severe ehrlichiosis and SFR cases relative to non-severe cases. Regression models showed that known tick exposures were associated with lower odds of severe SFR. For SFR, treatment delays of 1-7 days were linked to severity, but delays >7 days were not. In contrast, delays >7 days for ehrlichiosis were associated with lower odds of severe disease. CONCLUSIONS/SIGNIFICANCE: Associations found here between severity and treatment delay may reflect care-seeking behaviors, testing practices, and background seroprevalence. Geographic differences in disease incidence and severity warrant further investigation and future surveillance. Public health interventions should focus on the north-central and Tidewater regions, focusing on exposure risks awareness for outdoor activities and checking for ticks, which could impact treatment timing and ultimately reduce severity.
Indexed as
Identifiers
What OpenQuestion holds
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.