Spotted Fever Group Rickettsioses in Central America: The Research and Public Health Disparity among Socioeconomic Lines

Tick-borne diseases including rickettsial diseases are increasing in incidence worldwide. Many rickettsial pathogens can cause disease which is commonly underdiagnosed and underreported; Rickettsia pathogens in the spotted fever group (SFGR) are thus classified as neglected bacterial pathogens. The Central American region shoulders a large proportion of the global neglected disease burden; however, little is known regarding SFGR disease here. Although development varies, four of the seven countries in this region have both the highest poverty rates and SFGR disease burdens (El Salvador, Honduras, Guatemala, and Nicaragua), compared to Belize, Panama, and Costa Rica. Utilizing the Human Development Index (HDI), we compared published articles related to SFGR Rickettsia prevalence in the lowest-HDI-scoring countries to the highest-HDI-scoring countries. Our analysis identified a distinct dichotomy in publication, and by proxy, potentially awareness and knowledge of SFGR tick-borne disease in Central America, where the least-developed countries are at the highest risk for, yet the most vulnerable to, SFGR disease.