{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T04:41:52Z","timestamp":1772512912013,"version":"3.50.1"},"reference-count":31,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T00:00:00Z","timestamp":1755388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Several diseases caused by tick-borne pathogens, including Lyme borreliosis (LB) and spotted fever group rickettsioses, are endemic in the Balkan Peninsula, positioned between Central Europe and the Middle East. This cross-sectional study aimed to assess serological exposure to Borrelia spp. and spotted fever group Rickettsiae (SFGR) among individuals with recent tick bites and healthy controls in two Balkan countries\u2014Serbia and North Macedonia. Serum samples from 223 participants were tested for anti-Borrelia and anti-SFGR IgG antibodies. SFGR exposure was significantly higher in tick-exposed individuals from Skopje (North Macedonia) compared to those from Novi Sad (Serbia) (30.9% vs. 8.0%; p = 0.003). In contrast, anti-Borrelia IgG was more frequently detected in Novi Sad, though differences did not reach statistical significance. The findings support a north-to-south gradient in Borrelia exposure and a reverse trend for SFGR, consistent with earlier studies and regional tick infection data. Given the high SFGR exposure and limited clinical reporting in North Macedonia, the results highlight the likelihood that tick-borne rickettsioses remain under-recognized. Additionally, Borrelia exposure in North Macedonia warrants further investigation. These findings emphasize the need for enhanced tick-borne disease surveillance, identification of endemic zones, and improved diagnostic and public health infrastructure in both countries.<\/jats:p>","DOI":"10.3390\/pathogens14080814","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T16:22:33Z","timestamp":1755534153000},"page":"814","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Differential Exposure to Borrelia spp. and Spotted Fever Group Rickettsia in Serbia and North Macedonia: A Comparative Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-7223","authenticated-orcid":false,"given":"Dejan","family":"Jakimovski","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 1000 Skopje, North Macedonia"},{"name":"University Clinic for Infectious Diseases and Febrile Conditions, 1000 Skopje, North Macedonia"},{"name":"Clinical Medicine Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofija","family":"Mateska","sequence":"additional","affiliation":[{"name":"University Clinic for Infectious Diseases and Febrile Conditions, 1000 Skopje, North Macedonia"},{"name":"Clinical Medicine Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marija","family":"Najdovska","sequence":"additional","affiliation":[{"name":"University Clinic for Infectious Diseases and Febrile Conditions, 1000 Skopje, North Macedonia"},{"name":"Clinical Medicine Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Stamenkovska","sequence":"additional","affiliation":[{"name":"Clinical Medicine Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"},{"name":"Public Health Institution General Hospital, 1480 Gevgelija, North Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Verica","family":"Pavleva","sequence":"additional","affiliation":[{"name":"Clinical Medicine Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"},{"name":"Infectious Disease Department, Clinical Hospital Shtip, 2000 Shtip, North Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mile","family":"Bosilkovski","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 1000 Skopje, North Macedonia"},{"name":"University Clinic for Infectious Diseases and Febrile Conditions, 1000 Skopje, North Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4970-0748","authenticated-orcid":false,"given":"Dragana","family":"Mijatovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Diagnostics and Laboratory Research Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0122-1062","authenticated-orcid":false,"given":"Verica","family":"Simin","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Diagnostics and Laboratory Research Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3830-1947","authenticated-orcid":false,"given":"Ivana","family":"Bogdan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Diagnostics and Laboratory Research Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3092-4768","authenticated-orcid":false,"given":"Jasmina","family":"Gruji\u0107","sequence":"additional","affiliation":[{"name":"Diagnostics and Laboratory Research Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"},{"name":"Department of Transfusiology, Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Blood Transfusion Institute of Vojvodina, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milica","family":"Simeunovi\u0107","sequence":"additional","affiliation":[{"name":"Blood Transfusion Institute of Vojvodina, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0642-4942","authenticated-orcid":false,"given":"Miodrag","family":"Vranje\u0161","sequence":"additional","affiliation":[{"name":"Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2862-7182","authenticated-orcid":false,"given":"Eleftherios","family":"Meletis","sequence":"additional","affiliation":[{"name":"Faculty of Public and One Health, University of Thessaly, 43100 Karditsa, Greece"},{"name":"Epidemiology and Biostatistics Research Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7051-1541","authenticated-orcid":false,"given":"Polychronis","family":"Kostoulas","sequence":"additional","affiliation":[{"name":"Faculty of Public and One Health, University of Thessaly, 43100 Karditsa, Greece"},{"name":"Epidemiology and Biostatistics Research Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0821-0747","authenticated-orcid":false,"given":"Olympia","family":"Lioupi","sequence":"additional","affiliation":[{"name":"Faculty of Public and One Health, University of Thessaly, 43100 Karditsa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7902-6606","authenticated-orcid":false,"given":"Pavle","family":"Banovi\u0107","sequence":"additional","affiliation":[{"name":"Diagnostics and Laboratory Research Task Force, Balkan Association for Vector-Borne Diseases, 21000 Novi Sad, Serbia"},{"name":"Clinic for Lyme Borreliosis and Other Tick-Borne Diseases, Department of Prevention of Rabies and Other Infectious Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Department of Microbiology with Parasitology and Immunology, Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"104959","DOI":"10.1016\/j.idnow.2024.104959","article-title":"Tick-borne diseases at the crossroads of the Middle East and Central Europe","volume":"54","author":"Jakimovski","year":"2024","journal-title":"Infect. 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