Epidemiology of Intracellular Bacterial Pathogens spp., spp., spp., and spp. in West Africa from 2000 to 2023: A Systematic Review.

Intracellular bacteria such as spp., spp., spp., and spp. cause febrile illnesses similar to malaria and arboviruses, leading to under-reporting in sub-Saharan Africa. Following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, we included studies on these bacteria in humans, animals, and vectors in West Africa (2000-2023). Case reports, editorials, studies on other pathogens, and coinfections were excluded. Data was retrieved from African Journals Online, Google Scholar, and PubMed (last search: December 31, 2023). The risk of bias was assessed using an adapted Cochrane RoB 2.0 tool. Data were analyzed using Excel 2016 and QGIS. A random-effects model estimated prevalence, with subgroup analysis based on country, detection method, period, and host type. Heterogeneity was measured via the index (>50% indicating moderate heterogeneity). Publication bias was assessed by stratifying studies by risk of bias. Out of 27 articles included, 10 covered studies on spp., 5 spp., 6 spp., 3 spp., and 3 both spp. and spp. Among them, 10 studies focused on vectors, 5 on animals, 5 on humans, and 7 on One Health. The prevalence of spp. was the highest in humans, 19.46%, 95% confidence interval: [19.42-19.50]. spp. had the highest prevalence in animals, 82.57%, 95% CI: [82.46-82.69], and vectors 37.62%, 95% CI: [37.53-37.71]. Prevalence increased significantly post 2010 (81.4%). PCR-based detection showed a higher prevalence (63%). In the risk-of-bias analysis, the quality of the studies, which were included, did not affect the results and overall validity of findings. Intracellular bacteria spread widely among humans, animals, and vectors. One Health approach is essential for managing zoonotic bacterial diseases in Africa. Variation in prevalence underlines the need for methodological standardization and future research should focus on harmonizing methods by integrating molecular methods.