Serological evidence indicates widespread distribution of rickettsioses in Myanmar

Abstract Background Little research has been published on the prevalence of rickettsial infections in Myanmar. In this study, we determined the seroprevalence of IgG antibodies to rickettsial species in different regions of Myanmar. Methods We collected 700 leftover blood samples from patients of all age groups in primary care clinics and hospitals in seven different regions in Myanmar. Samples were screened for scrub typhus group, typhus group and spotted fever group IgG antibodies with ELISAs. A subsequent IFA was performed for the same rickettsial group to confirm seropositivity if ELISA was above a threshold of Optical Density (OD)≥0.5. Results Overall IgG seroprevalence for scrub typhus was 19% (95% CI: 16-22%), for murine typhus was 5% (95% CI: 3-7%) and for spotted fever group was 3% (95% CI: 2-5%), with especially high scrub typhus seroprevalence in northern (59%) and central Myanmar (19-33%). Increasing age was associated with higher odds of seropositivity for scrub- and murine typhus (age per 10 years, unadjusted odds ratio estimates: 1.54, p  Conclusion Our findings indicate that rickettsial infections are widespread in Myanmar, with especially high seroprevalence of scrub typhus in central and northern regions. Rickettsial infections should be considered by healthcare workers as common causes of fever in Myanmar.