ENFERMEDAD POR RICKETTSIA EN ZONAS URBANAS: ¿UN PATÓGENO SUBDIAGNOSTICADO?
- 1. Dr. Domingo Guzmán Lander" Hospital Barcelona, Anzoátegui, Venezuela
Description
Introducción: Las rickettsiosis son zoonosis transmitidas por garrapatas, con creciente impacto en salud pública. Su emergencia en áreas urbanas, vinculada a urbanización de hábitats naturales y adaptación de vectores, ha sido reportada en Latinoamérica, con alta letalidad. Esta revisión evidencia su circulación urbana, impacto clínico-epidemiológico y factores de subdiagnóstico, para orientar estrategias de vigilancia.
Metodología: Se condujo una revisión en bases de datos usando términos controlados relacionados con Rickettsia y entornos urbanos. Los estudios seleccionados incluyeron investigaciones epidemiológicas, clínicas o moleculares con diagnóstico confirmado en áreas urbanas. Dos fases de filtrado garantizaron relevancia, evaluándose calidad con STROBE y Newcastle-Ottawa. Los datos extraídos se sintetizaron narrativamente.
Resultados: En entornos urbanos, Rickettsia felis y Rickettsia rickettsii, tienen distribución global. Reservorios urbanos incluyen roedores, perros y zarigüeyas, que albergan vectores como pulgas y garrapatas. La urbanización, con su alteración de ecosistemas y aumento de interacciones humano-fauna, aumenta su circulación. Diagnósticamente, las pruebas serológicas presentan limitaciones por reactividad cruzada entre grupos y baja sensibilidad en fase aguda, con acceso en zonas endémicas limitado. Adicional, la confusión con otras fiebres tropicales subestima la incidencia real.
Discusión: Los retrasos diagnósticos en rickettsiosis urbanas se asocian a superposición clínica con otras patologías, limitaciones técnicas diagnósticas, con detección en vectores urbanos adaptados. Factores de riesgo incluyen convivencia con perros infestados y condiciones socioambientales precarias, requiriéndose estrategias para su abordaje.
Conclusión: Se requiere integrar su sospecha sistemática en síndromes febriles urbanos, optimizando protocolos con herramientas accesibles y algoritmos escalonados. Es importante un enfoque One Health, que fortalezca la vigilancia en vectores/reservorios urbanos y fomente colaboración interdisciplinaria para mitigar su impacto. Futuras investigaciones deben explorar determinantes socioambientales e intervenciones comunitarias en esta interfaz humano-animal-urbana emergente.
Abstract (English)
Introduction: Rickettsial diseases are tick-borne zoonoses with increasing public health impact. Their emergence in urban areas, linked to urbanisation of natural habitats and vector adaptation, has been reported in Latin America, with high lethality. This review highlights its urban circulation, clinical-epidemiological impact and underdiagnosis factors to guide surveillance strategies.
Methodology: A database review was conducted using controlled terms related to Rickettsia and urban settings. Selected studies included epidemiological, clinical or molecular investigations with confirmed diagnosis in urban areas. Two filtering phases ensured relevance, with quality being assessed with STROBE and Newcastle-Ottawa. Extracted data were synthesised narratively.
Results: In urban settings, Rickettsia felis and Rickettsia rickettsii have a global distribution. Urban reservoirs include rodents, dogs and opossums, which harbour vectors such as fleas and ticks. Urbanisation, with its alteration of ecosystems and increased human-fauna interactions, increases their circulation. Diagnostically, serological tests are limited by cross-reactivity between groups and low sensitivity in the acute phase, with limited access in endemic areas. In addition, confusion with other tropical fevers underestimates the real incidence.
Discussion: Diagnostic delays in urban rickettsial disease are associated with clinical overlap with other pathologies, diagnostic technical limitations, and detection in adapted urban vectors. Risk factors include cohabitation with infested dogs and poor socio-environmental conditions, requiring strategies for its approach.
Conclusion: Systematic suspicion of urban febrile syndromes needs to be integrated, optimising protocols with accessible tools and stepwise algorithms. A One Health approach is important, strengthening surveillance in urban vectors/reservoirs and fostering interdisciplinary collaboration to mitigate their impact. Future research should explore socio-environmental determinants and community interventions at this emerging human-animal-urban interface.
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Additional details
Additional titles
- Translated title (English)
- RICKETTSIAL DISEASE IN URBAN AREAS: AN UNDERDIAGNOSED PATHOGEN?
Identifiers
- ISSN
- 2530-5468
Dates
- Submitted
-
2025-05-29
- Accepted
-
2025-07-01
Software
- Repository URL
- https://revistacientificasanum.com
References
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