{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:32:45Z","timestamp":1760059965509,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health Malaysia Research","award":["NMRR-23-01107-JVW"],"award-info":[{"award-number":["NMRR-23-01107-JVW"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Background: Rickettsioses are diseases caused by obligate intracellular non-motile coccobacilli transmitted via arthropods. The most common rickettsioses are scrub typhus (ST), typhus group rickettsioses (TGR), and spotted fever group rickettsioses (SFGR). This study aims to provide information and insight into rickettsioses seropositivity among suspected patients in East and Peninsular Malaysia over a six-year period from 2016 to 2021. Methodology\/Principal Findings: Data obtained from four state hospitals and one national research institute providing rickettsial serological testing were analyzed using the IBM SPSS (Statistical Package for the Social Sciences) software program. The six-year analysis revealed that ST had the highest number of seropositivity cases, followed by TGR, and SFGR, for both immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies. Of the 3228 samples, 21.6%, 16.1%, and 13.9% of suspected patients were IgM seropositive for ST, TGR, and SFGR, respectively. IgG seropositivity for ST was 21.9%, followed by TGR at 21.4%, and SFGR at 17.2% among suspected rickettsioses cases. All regions in Malaysia were significantly associated with IgM seropositivity for ST, TGR, and SFGR. IgM seropositivity for SFGR was significantly higher in females. Age group 41\u201365 years was highly associated with IgG seropositivity for ST, TGR, and SFGR. Conclusions\/Significance: Analysis of six-year data on ST, TGR, and SFGR seropositivity in Malaysia revealed variations across regions, age groups, and genders. This seropositivity study underscores ST, TGR, and SFGR as possible causes of acute febrile illness among patients suspected of rickettsial disease in Malaysia. The findings contributed to the awareness of reemerging rickettsioses and warrant public health interventions that may reduce the incidence of rickettsioses in Malaysia. Abstract summary: Scrub typhus (ST), typhus group rickettsioses (TGR), and spotted fever group rickettsioses (SFGR) are significant global public health concerns. Our results showed that the highest number of IgM and IgG seropositivity cases was observed for ST, followed by TGR and SFGR. All regions in Malaysia were significantly associated with IgM seropositivity for ST, TGR, and SFGR. East Malaysia exhibited significantly higher seropositivity for ST, TGR, and SFGR than other regions in Malaysia. IgM seropositivity for SFGR was significantly higher in females. The age group 41\u201365 years was highly associated with IgG seropositivity for ST, TGR, and SFGR. This study highlights the value of serological data in uncovering the hidden burden of disease in Malaysia. In addition, the findings contributed to bridging knowledge gaps on the limited data from Malaysia spanning extended periods, despite being one of the countries in the endemic Tsutsugamushi Triangle. The findings from this study may direct future research on rickettsioses and warrant public health interventions in Malaysia.<\/jats:p>","DOI":"10.3390\/tropicalmed10080205","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T10:28:09Z","timestamp":1753352889000},"page":"205","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rickettsioses Seropositivity in Malaysia: A Six-Year Trend, 2016\u20132021"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4350-0067","authenticated-orcid":false,"given":"Bee Yong","family":"Tay","sequence":"first","affiliation":[{"name":"Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Selangor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2031-6275","authenticated-orcid":false,"given":"Fashihah Sherina","family":"Abdul Hadi Sabri","sequence":"additional","affiliation":[{"name":"Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Selangor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zamtira","family":"Seman","sequence":"additional","affiliation":[{"name":"Sector for Biostatistics & Data Repository, National Institutes of Health, Ministry of Health, Shah Alam 40170, Selangor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norlela","family":"Othman","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital Sultanah Nur Zahirah, Kuala Terengganu 20400, Terengganu, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haida","family":"Subakir","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital Sultan Ismail, Johor Bahru 81100, Johor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahrul Laili","family":"Abd Hadi","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital Raja Permaisuri Bainun, Ipoh 30450, Perak, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adilahtul Bushro","family":"Zaini","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital Sungai Buloh, Sungai Buloh 47000, Selangor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5488-6789","authenticated-orcid":false,"given":"Norli Anida","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Mathematics Division, Centre for Foundation Studies in Science, Universiti Malaya, Kuala Lumpur 50603, Selangor, Malaysia"},{"name":"Center for Data Analytics Consultancy and Services, Faculty of Science, Universiti Malaya, Kuala Lumpur 50603, Selangor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9908-5547","authenticated-orcid":false,"given":"Nur Anisah","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Center for Data Analytics Consultancy and Services, Faculty of Science, Universiti Malaya, Kuala Lumpur 50603, Selangor, Malaysia"},{"name":"Institute of Mathematical Sciences, Faculty of Science, Universiti Malaya, Kuala Lumpur 50603, Selangor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Yazid","family":"Abdad","sequence":"additional","affiliation":[{"name":"Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford OX3 7BN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siti Roszilawati","family":"Ramli","sequence":"additional","affiliation":[{"name":"Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Selangor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4404","DOI":"10.1128\/JCM.01526-10","article-title":"Isolation of a novel Orientia species (O. chuto sp. nov.) from a patient infected in Dubai","volume":"48","author":"Izzard","year":"2010","journal-title":"J. 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