The hidden burden of Bartonella quintana on the African continent: should the bacterial infection be considered a neglected tropical disease?

Abstract

Abstract Bartonella quintana is a louse-borne gram-negative bacillus that remains a poorly characterized cause of bacteremia, fever and infective endocarditis. Due to the link with pediculosis, B. quintana transmission is tied to poverty, conflict, over-crowding and inadequate water access to maintain personal hygiene. Although these risk factors may be present globally, we argue that a substantial burden of undocumented B. quintana infection occurs in Africa due to the high prevalence of these risk factors. Here, we describe the neglected burden of B. quintana infection, endocarditis and vector-positivity in Africa and evaluate whether B.quintana meets criteria to be considered a neglected tropical disease according to the World Health Organization.