A Systematic Review of the Arthropod-Borne Rickettsial Diseases with a Special Emphasis on Iran

Background: Rickettsialinfections occur worldwide. Rickettsia spp. are mandatory intracellular Gram-negative bacteria that can cause mild to severe disease.

Objectives:Recently, with increasing international travel to high-risk areas, the risk of rickettsia transmission has increased. These infections are also important because of their possible use as bioterrorism agents. In this study, we investigated arthropod-borne rickettsial diseases.

Methods: This systematic review study was performed based on PRISMA guidelines. All Persian and English language articles published until the end of 2019 were extracted during the search in the scientific databases of Web of Science, PubMed, Scopus, Cochrane Library, Science Direct, Google Scholar, Medlib, Irandoc, Magiran, and SID.

Results:  A total of 62 studies related to the field of arthropod-borne rickettsial diseases between 1940 and 2020 were included in the systematic review. Rickettsiae are related to arthropods which will act as vectors and reservoirs within the bacteria life cycle. To date, ticks (Acari: Ixodidae), lice (Phtiraptera), and fleas (Siphonaptera) have been identified as the main suitable vectors of rickettsiae. Recently, mosquitoes have been suggested as potential vectors for R. felis.

Conclusion: One of the most important rickettsial diseases in Iran has been typhus. Historically, typhus has been one of the main health problems with a financial effect in Iran; be that as it may, there are constrained data on the prevalence of typhus within the past centuries. In Iran, there were both epidemic and endemic typhus. Health care officials and physicians should always consider the potential risk of typhus outbreaks under certain conditions. Natural disasters, famines, and overcrowded camps increase the risk of transmission of these infectious diseases